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.

Delhi's air quality index (AQI) remained in the 'very poor' category on Wednesday, as the city's average AQI stood at 329 as of 7am. The Central Pollution Control Board (CPCB) data in all stations, though, showed that it was below the 'severe' range, with some locations in the 'poor' range too.

Delhi has not yet experienced the cold wave this season, however, the city is still covered with smog, and the air quality continues to threaten people's health. The Delhi winters haven't peaked yet, so what made the pollution so worse already? Gufran Beig, Chair Professor at National Institute of Advanced Studies, IISC-Campus and Founder Project Director SAFAR, writes for Indian Express that while the AQI right now may be 'very poor', "It will return, playing hide-and-seek for at least another month".

No Buffer To Protect Public Health From Delhi's Air Pollution

He says that the wind speed across Delhi and its wider airshed "dropped close to zero". This means "nothing was coming in and nothing was going out". He also noted that stubble burning in the neighboring state is not the problem, rather Delhi is choking on its own emission. He explains that the vertical dispersion was restricted by a shallow inversion layer, which was approximately 500 to 700 metres deep. Which means, emission from a fixed point sources linger where they released, and it creates a localized pollution hotspot instead of spreading, because there was almost no wind.

He explained that the atmosphere here has temporarily lost its capacity to clean itself. Even if this is for couple of days, this has become very apparent in Delhi. "When the air stands still, stagnation sets in, ventilation collapses, and the system is left with no buffer to protect public health. When the weather naps, there is nowhere left to hide. Yet, we continue to blame the weather instead of our emissions," he writes.

Read: AQI Explained: It’s Not Temperature, As Delhi CM Says, Here’s What the Air Quality Index Really Means

Could There Be A Solution?

Beig writes that if Delhi is able to cut its local pollution by 50 per cent, the pollution too could drop by 50 per cent. The emission should happen across the airshed. However, the focus should be for a long-term action on the source of emission and not short-term optics like cloud seeding, smog towers, water sprinkling or air purifiers.

In fact, as per a study published in Sustainability (MDPI), an open access journal, which mapped Delhi's air quality between 1990 to 2022 and found that transports emit around 10 to 30% of pollution, whereas agricultural residue burning, which is a seasonal source of pollution leads to less than 3% of pollution, whereas firecrackers, another seasonal source, leads to less than 1% of pollution.

Pollution's Impact On Health

However, despite the global studies highlighting the country's ever-growing pollution problem, the Centre stated that "there is no conclusive data available in the country to establish direct correlation if death/disease exclusively due to air pollution."

The study estimated: “1·5 million deaths occurred annually due to long-term exposure to PM2·5 in India every year in excess of the 5 μg/m3 that is recommended by the WHO ambient air quality guidelines.”

The study noted that every 10μg/m³ increase in annual PM2·5 concentration was associated with an 8.6 pc higher risk of all-cause mortality.

Using India’s National Ambient Air Quality Standards, researchers estimate that about 3.8 million deaths between 2009 and 2019 were linked to PM2.5 exposure. When WHO guidelines were applied, the number rose sharply to 16.6 million, nearly one-fourth of all deaths in the country. The analysis relied on advanced causal methods and high-resolution models that mapped district-level PM2.5 exposure across India, while accounting for factors such as socioeconomic status, age distribution, and indoor air pollution.

Norovirus, often called the “stomach flu” or “winter vomiting illness,” is currently circulating in California and across the United States. Health experts say proper cleaning and disinfecting can slow its spread. These precautions matter because norovirus is extremely contagious and there is no specific treatment for it, according to the Centers for Disease Control and Prevention.

Between August 1 and November 13, health officials recorded 153 norovirus outbreaks across 14 states. The CDC defines an outbreak as two or more similar illnesses linked to suspected or lab-confirmed norovirus cases. Although California is not among the states reporting outbreaks, CDC data shows a noticeable rise in positive norovirus tests throughout November across the western US.

What Is Norovirus?

Norovirus is described as a “highly contagious” virus that causes vomiting, diarrhea, and stomach cramps, according to the California Department of Public Health. It leads to acute gastroenteritis, which means inflammation of the stomach or intestines, and affects people of all ages, the CDC said.

Despite its nickname, norovirus has nothing to do with influenza. The flu is caused by the influenza virus, not norovirus, the agency clarified.

Winter Vomiting Disease: How Does The Stomach Bug Spread?

Norovirus spreads easily from person to person, especially while someone is actively sick, according to the California Department of Public Health. Symptoms usually last one to three days, but a person can still spread the virus for up to two days after they start feeling better.

The virus is present in vomit and stool and can spray into the air or settle on nearby surfaces. It can survive for weeks on uncleaned items such as countertops, phones, and doorknobs, the department said.

“You can get sick after touching or caring for someone who is sick, or after touching or eating something that is contaminated,” the department noted.

Norovirus spreads quickly in crowded or enclosed settings, including schools, child care facilities, hospitals, nursing homes, jails, and cruise ships.

According to state and federal health officials, the most common ways people catch norovirus include:

• Touching, caring for, or sharing food with someone who has norovirus
• Eating or drinking contaminated food or beverages, including undercooked shellfish like oysters
• Touching a contaminated surface and then touching your mouth before washing your hands
• Sharing a toilet or bathroom with someone who is sick
• Swallowing contaminated water, including water from swimming pools or recreational areas
• Cleaning up vomit or diarrhea without protective gear, such as gloves or a face mask

Do You Need To Disinfect After Norovirus?

“If you or someone in your household has norovirus, it’s important to clean and disinfect areas where vomiting or diarrhea occurred,” the California Department of Public Health advised. Cleaning with soap and water removes germs, while disinfecting kills those that remain.

You can use commercial disinfectants, but it’s important to read the label and make sure norovirus is listed among the germs it targets. You can also check the Environmental Protection Agency’s registration number and confirm it appears on the EPA’s List G, which includes products proven effective against norovirus.

Another option is making a bleach solution at home. The US Department of Agriculture recommends mixing 5 to 25 tablespoons of household bleach with one gallon of water. This solution should be used only on hard or nonporous surfaces and applied with a spray bottle or disposable mop, sponge, or paper towel. Let it sit for about five minutes before wiping it away.

The USDA also advises paying close attention to frequently touched items such as doorknobs, handles, and remote controls. Many disinfectant wipes do not fully kill norovirus, the agency warned.

How To Disinfect After Norovirus?

The CDC recommends wearing rubber or disposable gloves while cleaning. Use paper towels to wipe the affected area completely, then place the towels in a plastic trash bag. The California Department of Public Health also suggests wearing a face mask.

After disinfecting, clean the area again with soap and water, the CDC said. Keep in mind that vomit can aerosolize the virus, meaning surfaces several feet away may also be contaminated, according to the USDA.

Once you’re done, throw away the gloves and mask, then take out the trash, the California Department of Public Health advised.

Millions of people across the UK who take certain everyday medicines are being warned by the NHS to steer clear of a specific fruit. Health officials say combining this fruit or its juice with some medications can trigger serious reactions and unexpected side effects. The advice applies to patients prescribed some of the most commonly used drugs in the country, including certain statins, amlodipine, and medicines for anxiety. Statins, in particular, are widely prescribed to help reduce levels of “bad” LDL cholesterol in the blood.

Why Statins Are Commonly Prescribed?

Statins work by limiting how much cholesterol the liver makes. This helps slow down the build-up of fatty deposits inside the arteries, which in turn lowers the risk of heart attacks and strokes. Doctors prescribe statins both to manage high cholesterol and to prevent future heart-related problems. For most people, they are taken daily as tablets and are often part of long-term treatment.

What Does Amlodipine Do?

Amlodipine, commonly sold under the brand name Istin, belongs to a group of medicines known as calcium channel blockers. It is mainly used to treat high blood pressure. For people with hypertension, amlodipine can reduce strain on the heart and lower the risk of serious complications such as heart disease, heart attacks, and strokes.

NHS Warning On Statins Or Amlodipine

Patients taking certain forms of amlodipine, particularly calcium channel blockers, are advised not to consume grapefruit. The NHS website clearly states: “Do not take amlodipine with grapefruit juice.”

The reason lies in how grapefruit affects the body. It interferes with enzymes and transport proteins in the gut, such as CYP3A4 and P-gp, which normally help break down medicines and control how much enters the bloodstream. When these processes are blocked, higher-than-intended amounts of the drug can build up in the body, increasing the risk of side effects.

What Patients Should Keep In Mind

Not every medicine reacts the same way to grapefruit juice, which is why doctors advise checking before making changes. Always speak to your GP or pharmacist, read the information leaflet that comes with your medicine, and look out for any warnings related to grapefruit.

It is also important to understand that simply spacing the fruit and the medicine apart is not enough. In most cases, grapefruit should be avoided entirely for as long as you are on the medication, unless your doctor says otherwise. Patients are also encouraged to be cautious with other citrus fruits, such as Seville oranges, pomelos, and limes, as they can have similar effects on how medicines work.

What To Do If You’ve Already Consumed It?

If you have eaten grapefruit or had its juice while taking statins, amlodipine, or anti-anxiety medication, there is no need to panic. In many cases, a single exposure does not lead to serious harm, but it is important to stay alert. Pay attention to how your body feels over the next day or two, especially if you notice symptoms such as dizziness, muscle pain, unusual tiredness, nausea, flushing, or a sudden drop in blood pressure.

Do not stop taking your medication on your own. Skipping doses or stopping treatment abruptly can be risky, particularly for heart and blood pressure medicines. Instead, make a note of what you consumed and when, and contact your GP or pharmacist for advice. They can tell you whether any action is needed based on the specific drug, dose, and your overall health.