If hand sanitisers kill 99.99% of germs, then who are those 0.01% who survive? There are three major kinds of germs which remain active even when you have used your sanitiser.

Norovirus

Among them, is the norovirus that causes diarrhoea and vomiting outbreaks in places like cruise ships and schools. It is superior to many other viruses because it has a protein capsid, which is resistant to the effects of alcohol.

Norovirus is a group of viruses that causes common illnesses and is also very contagious. It is especially active in the colder month and comes back seasonally. The first norovirus outbreak occurred in Norwalk, Ohio, USA, in a school in 1968, this is where it gets it name from.

Enterococcus faecium

The next on the list is enterococcus faecium, and it lives in the gut. As per a 2024 study titled Enterococcus faecium: evolution, adaptation, pathogenesis and emerging therapeutics, published in Nature journal, it is a Gram-positive bacterium that is a core member of the intestinal microbiota of humans and animals and an opportunistic pathogen that causes life-threatening infections, particularly among hospitalized patients. It mutates in a way that it absorbs carbohydrates and forms a gooey, slime-like substance called the biofilm, which makes it resistant to alcohol.

Clostridium Difficile

Another one is clostridium difficile. This is responsible for causing horrendous diarrhoea and vomiting in hospitalised patients. It also has a remarkable ability to respond to environmental stressors including alcohol gel by going to sleep. It produces spores and allows all metabolic activity.

Clostridium difficile (C. diff) is a type of bacteria that can cause colitis, a serious inflammation of the colon. Infections from C. diff often start after you've been taking antibiotics. It can sometimes be life-threatening.

Why Do You Label Read 99.99%?

Apart from the germs and pathogens, another reason why your label reads that it kills 99.99% is to avoid any legal hassles. If someone uses a specific product and falls sick, then the person cannot sue the company as the company did not give a 100% safety guarantee against the germs.

A better way to be healthy is always to clean your hands with soap and water and wear gloves wherever is possible.

Commonly prescribed medicines for high blood pressure and heart disease could also help antidepressants work better, according to a new study by researchers at the All India Institute of Medical Sciences (AIIMS).

The research offers hope for people with depression whose condition is not adequately managed with standard antidepressants.

About The Study

The study found that certain cardiovascular medications, when taken along with antidepressants, may improve the brain's response to treatment, potentially making clinical depression treatments more effective.

The findings establish a foundation for repurposing common medicines to improve mental health treatment. The researchers stress that larger clinical trials are needed to validate the study before it can be included in standard depression treatments.

"Our findings suggest that some drugs already being used to treat hypertension and heart disease may have the potential to act as adjuncts to antidepressant therapy," the AIIMS research team said.

They also said that the strategy could particularly benefit patients who do not respond to antidepressants well.

Also read: NBA Star Kevin Love Says Robin Williams Changed How He Sees Depression; Here's Why Symptoms Often Get Missed

How Can The Findings Help?

Even though depression affects hundreds of millions of people worldwide, almost one-third of patients do not receive adequate relief from their first antidepressant.

Even when medications work, they often take several weeks to show results. This has led researchers to explore more ways to improve treatment outcomes, especially for mental health issues.

Repurposing existing medicines is considered an attractive strategy because their safety profiles are already well understood, potentially reducing the time and cost needed to bring new treatment options into clinical practice.

Also read: Mental Health Crisis In Israel Military: Why Suicides Among Soldiers Are Increasing?

How Could Heart Medicines Improve The Efficacy Of Antidepressants?

Antidepressants, including selective serotonin reuptake inhibitors (SSRIs), are among the most commonly prescribed medicines for moderate to severe depression. They work by changing the levels of neurotransmitters like serotonin in the brain, helping regulate mood over time.

However, individual responses may vary widely, and many patients end up needing multiple treatment approaches before achieving any relief.

While the exact biological mechanisms are still under investigation, researchers believe that some cardiovascular drugs may have an effect on pathways associated with inflammation, blood flow to the brain, or nerve signaling, all of which are increasingly play a role in depression treatment.

The researchers noted that these medicines are not intended to replace antidepressants. Instead, they could eventually be used alongside standard treatment to improve its effectiveness in some patients.

Also read: IIT Delhi, AIIMS Develop First Hindi Music Therapy for Stroke Patients: How Survivors Find Their Voice

Word Of Caution

Experts caution that patients should not start or stop blood pressure or heart medications in the hope of treating depression without clinical supervision.

More clinical studies are required to identify which cardiovascular drugs offer the greatest benefit, which patients are most likely to respond, and whether the combination remains safe over long-term use.

The AIIMS study could pave the way for a cost-effective strategy to improve depression treatment by giving a new role to medicines that are already widely available.

Why looking beyond the obvious can save lives.

A 50-year-old woman recently came to my clinic seeking a second opinion.

For weeks, she had been treated for asthma. She was using inhalers regularly, yet her cough persisted, and her breathlessness continued to worsen, even while resting. Something about her story didn't add up.

A simple chest X-ray revealed the real problem: a massive pleural effusion, a large collection of fluid surrounding the lung and preventing it from expanding normally. Further evaluation confirmed the underlying cause, lung cancer that had spread to the pleura, the thin membrane lining the lungs.

Her symptoms were genuine. The diagnosis, however, was not asthma.

When Common Symptoms Hide Serious Disease

Cough and breathlessness are among the most frequent reasons people visit a doctor. In most cases, the cause is something common, such as asthma, allergies, or a respiratory infection.

But common symptoms do not always point to common diseases. The key is recognizing when the clinical picture no longer fits.

If symptoms:

• Persist despite appropriate treatment
• Continue to worsen or behave unexpectedly
• Are accompanied by warning signs such as unexplained weight loss, persistent chest pain, fever, or coughing up blood

Then it is time to pause, reassess, and investigate further rather than simply changing medications.

In this patient's case, inhalers could never have relieved the pressure caused by fluid around the lung. Nor could they have treated an underlying tumor. The delay didn't change the diagnosis, but it delayed the answers, appropriate treatment, and the opportunity to plan the next steps.

Lung Cancer Is No Longer Following the Old Rulebook

For decades, lung cancer was largely associated with older men who smoked heavily. That picture has changed.

In our practice, we diagnose approximately two to three new cases of primary lung cancer every three months, and nearly 40% of these patients are women or individuals who have never smoked.

Increasingly, we are seeing:

• Younger patients with no history of smoking
• Women diagnosed with adenocarcinoma; a subtype often seen in non-smokers
• The growing influence of air pollution, occupational exposures, genetics, radon, and biomass fuel exposure

If we continue to associate lung cancer only with smoking, we risk missing a significant proportion of patients who need timely diagnosis.

Three Important Lessons

1. Treat the Patient, Not Just the Diagnosis

Asthma should not become a permanent label simply because someone has a cough or wheeze.

When symptoms fail to improve within a few weeks of appropriate treatment, it is important to step back, reconsider the diagnosis, and investigate further.

2. Never Underestimate Simple Investigations

A chest X-ray remains one of the most valuable first-line investigations.

In just a few minutes, it can identify pneumonia, tuberculosis, heart failure, pleural effusion, lung masses, and many other conditions that require an entirely different treatment approach.

Even in an era of advanced imaging and artificial intelligence, the fundamentals of clinical medicine remain indispensable.

3. Earlier Diagnosis Creates Better Opportunities

When detected early, lung cancer is often more treatable and offers significantly better outcomes.

Even in advanced disease, timely diagnosis can make an enormous difference. Procedures such as draining pleural fluid, initiating targeted therapy, immunotherapy, or palliative treatment can greatly improve both symptoms and quality of life.

When Should a Persistent Cough Raise Concern?

Seek medical evaluation if you experience:

• A cough lasting longer than three weeks
• Breathlessness that is new, worsening, or occurring at rest
• Chest pain, unexplained weight loss, persistent fatigue, or coughing up blood
• Symptoms that do not improve despite inhalers or antibiotics
• Significant exposure to smoking, second-hand smoke, air pollution, biomass fuel, workplace chemicals, or a family history of lung cancer
• Persistent symptoms deserve proper evaluation, not repeated assumptions.

I often remind my patients that the body rarely sends repeated signals without a reason.

A persistent cough or unexplained breathlessness should never be dismissed simply because it resembles asthma. While asthma is common, it is only one of many possible causes.

Artificial intelligence can generate a list of potential diagnoses within seconds. But medicine is about more than identifying possibilities. It requires listening carefully, examining thoughtfully, choosing the right investigations, and connecting the clinical clues.

The woman who came to me was looking for reassurance.

Instead, she received something far more important: a correct diagnosis, a clear treatment plan, and the opportunity to move forward with certainty.

Because every cough is not asthma. And every breath deserves an explanation.

(By Dr. Sachin Kumar, Director – Pulmonology & Critical Care Medicine, Sakra World Hospital, Bengaluru)

Tadalafil, a widely used drug for erectile dysfunction and enlarged prostate symptoms, may increase the risk of glaucoma, the leading cause of blindness, in men with lower urinary tract symptoms (LUTS), according to a new study.

Although the study identified a significant association, the researchers emphasized that it was observational and does not prove that tadalafil directly causes glaucoma.

However, they suggested that men taking tadalafil long-term for LUTS may benefit from regular eye examinations, particularly those with existing glaucoma risk factors such as a family history of the disease or ocular hypertension.

What the Study Found

Researchers from the National Taiwan University Hospital in Taipei, Taiwan, found that men taking tadalafil for LUTS were:

• 22% more likely to develop glaucoma.
• 33% more likely to develop primary open-angle glaucoma, the most common form of the disease.
• 32% more likely to develop ocular hypertension (high pressure inside the eye).
• 33% more likely to begin glaucoma treatment.

The findings were published in the British Journal of Ophthalmology.

Also read: Israeli Scientists Find Surprising New Benefit of Viagra: It May Help Stop Cancer Spread

How the Study Was Conducted

The researchers analyzed health data from 73,854 men aged 40 years and older with a history of lower urinary tract symptoms.

Half of the participants had been prescribed tadalafil or another phosphodiesterase type 5 inhibitor (PDE5i) for up to five years, while the remaining participants received other treatments.

The increased glaucoma risk remained consistent, particularly among men aged over 50 years.

Tadalafil: How It Works?

Tadalafil works by relaxing smooth muscles and improving blood flow. Besides treating erectile dysfunction, it is also prescribed to relieve urinary symptoms caused by an enlarged prostate, such as frequent urination and urgency.

Previous studies have linked PDE5 inhibitors to several eye-related side effects, and the new findings add to concerns about their long-term effects on eye health.

"Tadalafil use for lower urinary tract symptoms was associated with a significant increase in the risk of glaucoma, ocular hypertension, primary open-angle glaucoma and initiation of glaucoma treatment in a large, multinational, real-world cohort," the researchers concluded.

Read More: GLP-1 Drugs Like Mounjaro, Ozempic Linked To 82 Deaths In UK, 162 In US

What Is Lower Urinary Tract Symptoms

Lower urinary tract symptoms (LUTS) are common urinary problems that affect the storage or passage of urine. They are particularly common in elderly men and are often linked to conditions such as an enlarged prostate, an overactive bladder or problems affecting the body's fluid balance.

Common symptoms include:

• A weak or slow urine stream
• Difficulty starting urination
• A sudden, urgent need to urinate
• Frequent urination, especially at night
• Feeling that the bladder has not emptied completel

What is Glaucoma?

Glaucoma is a group of eye diseases that can damage the optic nerve, potentially leading to irreversible vision loss and even blindness if left untreated.

It is a chronic disease that affects an estimated 80 million individuals globally, according to the World Glaucoma Association.

A major challenge with glaucoma is its lack of symptoms in the initial stages. As a result, the condition is often diagnosed at an advanced stage, where treatment yields the least results. More than 75 percent of glaucoma cases globally remain undiagnosed.

When to see a doctor for glaucoma:

• Vision suddenly gets blurry
• Severe eye pain
• Headache
• Nausea
• Vomiting
• Rainbow-colored rings or halos around lights.