Overview

This is a disease that is transmitted from mosquitoes to humans and affects many people in the world. Found in densely populated countries and continents, like Africa, Asia and the tropics of the Americas, this has severe symptoms. This viral disease is caused by the Chikungunya virus of the Togaviridae. First identified in the United Republic of Tanzania in 1952 and subsequently in other countries like Africa and Asia. Since 2004 the outbreak of CHIKV virus has become more widespread and caused partly due to the viral adaptations allowing the virus to be spread more easily by Aedes albopictus mosquitoes. The transmission has been noted to persist in countries where there is a large population, but interestingly, the transmission has been interrupted on islands where a high proportion of the population is infected and then immune.

Symptoms

The onset of the disease is usually in 4-8 days and after a bite of an infected mosquitoes, it is characterized by an abrupt onset of fever and then joint pain. This joint pain is severed and lasts for a few days but may prolong for months maybe even years. Other signs are joint swelling, muscle pains, headache, nausea, fatigue and rash. These symptoms also overlap with those of dengue and Zika virus and can be misdiagnosed. Most people fully recover from the infection and experience only mild and sometimes the infection even goes unrecognized. However, there have been cases of eye, heart, and neurological complications. The elderly and newborns are more susceptible to the infection and if they have any underlying conditions then they are likely to become severely ill increasing the risk of death.

Diagnosis and treatment

The diagnosis and treatment of the virus may be done by blood sampling and other tests like reverse transcriptase–polymerase chain reaction (RT–PCR). Other tests detect the activity of the antibodies. These can be detected in the first week after illness onset and can be detected for about 2 months. Many clinical measures can be taken to address fever and joint pain. But there is no specific anti-viral drug treatment for the virus.

Preventing Chikungunya

As this disease is caused by the bite of a mosquito, you must reduce the opportunities to let the mosquito breed. Mosquitoes bite during the day and night, and for people who live in risk areas like southeast Asia, Africa and tropical regions of America, many outbreaks happen each year. The best way to prevent it is to protect yourself from the mosquito's bite. You also must get vaccinated before travelling to any of these regions. Use insect repellent, and wear long-sleeved shirts and pants. You can also treat your clothes and gear with permethrin. As we all know, they tend to breed in humid places and places where they have access to water, so try to close the rooms that are air-conditioned with screens and windows. Use nets and mosquito repellents if you are sleeping outside. There are many different types of mosquito repellents like paper, liquid etc, and they are quite effective. If your job needs, you to be stationary for long hours or frequently go outside you must take the necessary precautions.

For decades, many cancer patients in India have lived with a frightening belief — that a biopsy can make cancer spread. This misconception continues to delay diagnosis, often costing patients the opportunity for timely treatment. This is one of the most common fears I encounter in clinic.

Almost every week, someone tells me, 'Doctor, if you cut it, it will spread.' Families repeat it, neighbors reinforce it, and patients postpone the test. Actually, this concern is linked to a genuine scientific phenomenon known as needle-tract seeding. These phenomena suggest that a few tumor cells may be displaced along the path of the biopsy needle.

However, this event is extremely uncommon and should not be confused with cancer spreading. Seeding is not the same as spreading. A few displaced cells sitting in a needle track are not a metastasis.

Published studies estimate the risk of needle-tract seeding to be extremely low. A 2015 systematic review reported the overall incidence to be below one percent, while more recent reviews, including a 2024 analysis of breast needle biopsy, found no evidence that diagnostic biopsies increase cancer recurrence or reduce long-term survival.

If tumor cells are displaced during a biopsy, they are usually removed when the tumor is surgically excised. In many cases, radiotherapy, systemic treatment and the body's own immune system also eliminate these cells.

In many tier-two and tier-three cities, it takes two to three weeks to reach final report to the treating doctor. During that period, the untreated cancer continues to grow naturally. The patient does not see natural history. He sees cause and effect. The biopsy happened; the lesion grew. The conclusion writes itself — and it is wrong. This delay unintentionally reinforces the misconception that the biopsy triggered the growth, when in reality the cancer was progressing on its own.

At the same time, every tissue injury, including a biopsy, activates the body's wound-healing response, leading to inflammation and new blood vessel formation. Laboratory and animal studies suggest that this temporary inflammatory environment may favor tumor cells. However, these findings have not translated into poorer outcomes for patients. So, the fear is not irrational. It is simply misdirected, and it is mis proportioned.

The diagnosis is not the danger. The delay is. Biopsy helps precision oncology. It helps deciding the treatment approach. Without this we would be treating in the dark.

The consequences of delaying diagnosis are serious. Patients of oral cancer diagnosed while the disease is still localized have a five-year survival rate of nearly 79 per cent. Once the cancer spreads to distant organs, survival drops to around 19 per cent. Unfortunately, nearly two-thirds of oral cancer patients in India are still diagnosed at an advanced stage.

A UK woman has claimed that Wegovy and Mounjaro, the blockbuster GLP-1 weight-loss drugs from Novo Nordisk and Eli Lilly, did not help her lose much weight despite more than a year of treatment.

Karen Lay, 56, from Essex, spent £4,000 on the medications, hoping they would help her slim down from 16 stone (224 pounds). However, after 15 months, she lost less than a stone, despite eating very little.

Lay now says the injections were far from a "magic fix" and credits a structured diet for helping her lose two stone, the Daily Mail reported.

Started Wegovy, Mounjaro Out of 'Sheer Desperation'

Lay began taking Wegovy in late 2023 after trying several diets without success. She remained on the medication for nine months, even though she felt something "wasn't right."

“My appetite reduced slightly at first,” Lay, a financial services worker, was quoted as saying. “But not enough to make a meaningful difference, so I increased the dosage each month.”

After seeing limited results with Wegovy, Lay stopped the medication for four weeks before switching to Mounjaro. She described the transition period as experiencing the "worst food noise" and said she gained more than seven pounds while waiting for the first drug to clear from her system.

Lay then spent six months on Mounjaro but said she was "barely eating" and still failed to achieve the weight loss she expected.

“I only lost seven pounds,” she said. “I realised the injections simply weren't effective for me and something had to change.”

Her doctor eventually advised her to stop taking the medication because they were concerned she was not eating enough, the report said.

Lay said the experience was “emotionally exhausting and honestly quite soul-destroying,” and "deeply disheartening.” Watching others succeed on the drugs made it even harder.

Switched to Diet Instead

After discontinuing the injections, Lay adopted a very low-calorie diet with support from expert nutrition advisers who provided personalized guidance.

“Once the medication was fully out of my system, I began to feel genuinely better,” Lay said, adding that her “energy returned, digestion improved, and the constipation disappeared.”

Within a year, she went from a dress size 18 to size 12, the smallest she had been in 17 years, with her weight falling to 13 stone 5 pounds, the report said.

Non-responders To GLP-1 Drugs

Clinical trials have shown that most people taking these medications experience substantial weight loss.

• Wegovy: Average weight loss of about 21% after 72 weeks.
• Mounjaro: Average weight loss of about 22.5% over a similar period.

Around 2.5 million adults in the UK are estimated to be using weight-loss injections, while hundreds of thousands have signed up for the newly approved Wegovy pill, which was rolled out by the NHS this month.

But some people are 'non-responders', meaning they do not lose a meaningful amount of weight despite treatment. Research earlier this year found that around one in 10 people taking GLP-1 medications are considered non-responders.

Why Weight-Loss Drugs May Not Work For All

Although GLP-1 receptor agonists have delivered remarkable results for many people, they do not work the same way for everyone. Obesity is a complex condition influenced by brain signaling, hormones, genetics, and metabolism, meaning treatment responses can vary significantly. Possible reasons include:

• Genetic and hormonal variability
• Underlying medical conditions
• Unrealistic expectations about weight-loss outcomes

• Switching to another GLP-1 medication
• Using older, approved weight-loss medications
• Structured lifestyle changes involving diet and physical activity
• Comprehensive medical management of obesity tailored to the individual.

Oral Rehydration Solution (ORS) is one of the simplest yet most effective life-saving solutions that every household should keep readily available, doctors said on World ORS Day.

Observed every year on July 29, World ORS Day raises awareness about the importance of ORS—a scientifically formulated mix of glucose and electrolytes, including sodium and potassium—that helps prevent and treat dehydration caused by diarrhea, vomiting, fever, heat, and excessive sweating.

First introduced in 1969, ORS has transformed the treatment of dehydration worldwide. Since 2003, the World Health Organization (WHO) and UNICEF have recommended a low-osmolarity ORS formula, which improves fluid absorption and reduces the need for intravenous fluids. Today, ORS remains the gold standard for preventing and treating dehydration, particularly in children and people living in resource-limited settings.

ORS Prevents Dehydration, It Doesn't Treat the Illness

Dr. Ranjana Bhatt, Associate Director - Internal Medicine, Paras Health, Panchkula, told HealthandMe that ORS is not a medicine that cures the underlying illness but is designed to prevent and correct dehydration.

Dehydration occurs when the body loses more water and electrolytes than it takes in, most commonly due to diarrhea or vomiting. It can develop rapidly, especially in young children, older adults, and people with chronic illnesses.

Why ORS Works Better Than Water

ORS works through a well-established biological process in the small intestine. It contains the right balance of glucose and sodium, which are absorbed together through special proteins called sodium-glucose cotransporters (SGLTs). As sodium enters the bloodstream, water follows, allowing the body to rehydrate efficiently.

This mechanism makes ORS more effective than plain water—and often more effective than many commercial sports drinks—for replacing lost fluids and electrolytes quickly and safely.

"Recognizing the early signs of dehydration, such as excessive thirst, dry mouth, dizziness, reduced urination, and unusual fatigue, and starting ORS promptly can prevent serious complications. On ORS Day, we encourage every family to make ORS a household essential and use it appropriately while seeking timely medical care whenever symptoms are severe or persistent," Dr. Bhatt said.

Why Every Household Should Keep ORS

Dr. Amit Prakash Singh, Consultant - Internal Medicine, CK Birla Hospital, Delhi, told HealthandMe that ORS is one of the simplest, most affordable, and most effective ways to prevent dehydration.

"ORS is accessible for almost everyone, and the product is recommended by the World Health Organization to start treating dehydration caused by diarrhea at home. Having ORS packets at home enables treating dehydration without going to the doctor first and potentially avoiding hospitalization," he said.

When Should You Use ORS?

Besides diarrhea, ORS can help replace fluids and electrolytes lost due to:

• Fever-related dehydration
• Vomiting and gastroenteritis
• Heat exhaustion and heatstroke
• Heavy sweating after strenuous exercise
• Hangovers caused by dehydration
• Viral illnesses such as dengue
• Dehydration in older adults and people with chronic illnesses.

"ORS is not just for diarrhea. Whenever there is a lot of fluid loss or electrolyte loss, ORS can be used. ORS can be consumed for vomiting due to gastroenteritis, food poisoning, or viral infection (provided the person can sip small amounts repeatedly)," Dr. Singh said.

ORS Is Not A Cure

Doctors caution that ORS only replaces lost fluids and electrolytes—it does not treat the underlying disease.

It may help prevent dehydration after fever, vomiting, or excessive sweating, but it is not a treatment for abdominal pain, acidity, indigestion, constipation, gastritis, or irritable bowel syndrome (IBS). Persistent or severe symptoms should always be evaluated by a healthcare professional, Dr Singh said.

How To Identify Original ORS

When buying ORS, check the following:

• Look for packaging that states "WHO Recommended Formula." Any other mark or logo may not indicate a WHO-recommended ORS formulation.
• Read the label carefully. Some products may be marketed as "Ready-to-Serve Fruit Beverage" or carry a disclaimer such as: "This is only a trademark and does not represent its true nature. Not a WHO Oral Rehydration Salts." These products are not WHO-recommended ORS.
• Check the ingredients. Genuine ORS should contain glucose, sodium, and potassium in the recommended proportions.