Experiencing daytime sleepiness is something that is usually perceived as a minor inconvenience, but for older adults, it could be an early warning sign of Dementia. This neurodegenerative disease leads to the progressive decline of brain cells. This eventually

affects memory, cognition, and personality, making everyday tasks more difficult. As one of the fastest-growing neurological disorders across the world, dementia poses a significant health threat to ageing populations.

Is Dementia Linked To Poor Sleep?

Daytime sleepiness is a direct result of poor sleep quality. Now, a recent research, published in the journal Neurology, highlighted a potential link between poor sleep and the development of dementia, particularly a condition called motoric cognitive risk syndrome (MCR). The study found that 35.5% of participants who reported extreme daytime sleepiness developed MCR, which is a precursor to dementia.

For this study, researchers followed 445 older adults (average age 76) over three years, aiming to determine whether poor sleep could increase the risk of mild cognitive impairment (MCI), which often leads to dementia. At the start, none of the participants had MCI, but by the end of the study, 36 individuals had developed the condition.

The researchers discovered that participants with poor sleep were more likely to develop MCI compared to those who slept well. However, when depression symptoms were taken into account, the link between poor sleep and MCI became less pronounced, suggesting that while sleep issues are a concern, mental health also plays a key role in dementia risk.

To assess sleep quality, the Pittsburgh Sleep Quality Index (PSQI) was used, evaluating factors such as sleep duration, disturbances, and daytime alertness. Among these, "daytime dysfunction"—defined as excessive sleepiness and low energy during the day—was most strongly associated with an increased risk of MCI. Those experiencing daytime dysfunction were more than three times as likely to develop MCI as those who didn’t report such symptoms.

There are many types of dementia:

Dementia is not a specific disease. According to the Centers for Disease Control and Prevention (CDC), it is an overall term that describes a decline in mental ability that interferes with daily life. People with dementia often have symptoms like trouble remembering, thinking, or making everyday decisions. These symptoms tend to get worse over time.

Alzheimer’s disease is the most common type of dementia, and it mostly affects the elderly. Each form of dementia has a different cause. Though dementia mostly affects older adults, it is not a part of normal ageing. An estimated 6.7 million older adults have Alzheimer's disease in the United States. That number is expected to double by 2060, as per data from the CDC.

In 2022, 3.8% of men and 4.2% women in US were diagnosed with dementia. The percentage of people increase with age from 1.7% for those aged 65-74 to 13.1% for those aged 85 and older. Alzheimer's accounts for 60 to 80% of all dementia cases and it is most prevalent in California, Florida, and Texas, as these states have the highest number of people.

Medicine is evolving—and quickly. With chronic diseases surging and scientific innovations accelerating, a new generation of best-selling medicines is revolutionizing the way we treat cancer, diabetes, autoimmune diseases, and obesity. These are not merely pharma successes—these are clinical game changers fueling billions of dollars in investment, research, and optimism.

These most-anticipated drugs in 2025 reflect this shift. Cancer drugs such as Keytruda are raising the bar in oncology, and metabolic medicines such as Ozempic and Mounjaro are transforming the treatment of diabetes and weight. And drugs such as Dupixent and Skyrizi are breaking ground in treating chronic inflammatory diseases, bringing targeted comfort to tens of millions.

The best-selling medications in the world are not only business blockbusters—they are also medical breakouts in the treatment of cancer, diabetes, obesity, and chronic disease. Although sales estimates provide mind-boggling numbers—such as Merck & Co.'s Keytruda poised to exceed $31 billion—the tale behind the tabulation is based on mighty innovations that are transforming how we address some of the globe's most urgent health issues.

The pharma landscape of 2025 is considerably characterized by a focused attempt to address some of the most debilitating and entrenched health issues of our era. Cancer, especially aggressive and difficult-to-treat types such as non-small cell lung cancer, melanoma, and multiple myeloma, continues to remain high on the agenda, with cutting-edge immunotherapies and biologics at the forefront. Simultaneously, increasing worldwide incidence of metabolic disorders like type 2 diabetes and obesity has fueled a new generation of therapies targeted at controlling blood sugar, facilitating weight loss, and lowering cardiovascular risk.

What Diseases are The Main Focus?

Cancer (Oncology)

Cancer is still the biggest and best-funded field in contemporary medicine, with non-small cell lung cancer, melanoma, multiple myeloma, and triple-negative breast cancer ranking high. New immunotherapies and monoclonal antibodies are transforming therapy by educating the immune system to recognize and destroy cancer cells more precisely and with fewer side effects than conventional chemotherapy.

Leading the charge is Keytruda (pembrolizumab), an immunotherapy medication that's transforming cancer treatment. Approved for use to treat several kinds of cancer, including melanoma, non-small cell lung cancer, head and neck cancer, and others, Keytruda functions by strengthening the immune system so it can more effectively find and kill cancer cells. This type of mechanism, referred to as a checkpoint inhibitor, has significantly enhanced survival rates for many aggressive cancers.

Its estimated $31 billion worth of sales in 2025 attests to more than pure economic success—it is a testament to the extent to which immunotherapies have become integrated in oncology therapy worldwide. The rising cancer burden across the world and high growth in the use of immunotherapies in early-stage treatment are among the principal factors propelling its quick ascension.

Type 2 Diabetes

Type 2 diabetes is a metabolic disorder with insulin resistance and persistent hyperglycemia, resulting in long-term damage to the heart, kidneys, and nerves. New drugs not only are enhancing glucose control but also are showing substantial reductions in cardiovascular risks, making them an dual solution for two of the world's top causes of death.

Then come Ozempic and Wegovy, which are trade names for semaglutide, made by Novo Nordisk. The two drugs, though chemically the same, have very different uses. Ozempic is indicated for the treatment of type 2 diabetes, whereas Wegovy is indicated for long-term weight management in people who have obesity or overweight and one or more weight-related conditions.

Semaglutide is a mimic of the GLP-1 hormone, controlling insulin secretion, appetite, and digestion. Its success is representative of the increasing convergence between metabolic health and management of chronic disease. Together, these drugs are expected to account for more than $36 billion in 2025, not just an indication of their medical importance but also of society's increasing interest in the prevention of diabetes and obesity.

Obesity

Obesity is increasingly being seen as a chronic, complex disease rather than merely a matter of lifestyle, and it's firmly connected with diabetes, heart disease, and some types of cancer. New generation weight-loss medications imitate gut hormones to reduce hunger, control blood sugar, and achieve long-term weight loss without surgery.

Eli Lilly's blockbuster, tirzepatide, takes a parallel course with its two brand names, Mounjaro for type 2 diabetes and Zepbound for weight loss. With its novel dual-action mechanism acting on GLP-1 and GIP receptors, it has even more potent appetite suppression and glucose lowering compared to earlier treatments.

Mounjaro's $19.8 billion forecasted sales, combined with Zepbound's $11.3 billion, are testament to the status of tirzepatide as a next-generation therapy for the obesity-diabetes continuum. With obesity as a gateway disease for cancer, cardiovascular disease, and type 2 diabetes, the role of drugs such as these in the preventive sphere cannot be overemphasized.

Chronic Inflammatory Diseases

Diseases like eczema (atopic dermatitis), asthma, nasal polyps, and eosinophilic esophagitis are fueled by hyperactive immune reactions that lead to ongoing inflammation and tissue injury. Biologics for targeted therapies are enabling patients to control these diseases over the long term by silencing particular immune pathways, leading to enhanced quality of life and reduced flare-ups.

Outside of cancer and metabolic disorders, chronic inflammatory and viral diseases also top the list of 10:

Dupixent (dupilumab) is revolutionizing treatment of patients with atopic dermatitis, asthma, and eosinophilic esophagitis by addressing the IL-4 and IL-13 pathway responsible for allergic inflammation. Its estimated $16.9 billion indicates the increasing application of biologics in dermatological and respiratory conditions.

Skyrizi (risankizumab), for plaque psoriasis, psoriatic arthritis, and Crohn's disease, employs IL-23 blockade to decrease systemic inflammation. Its increasing popularity indicates an increased emphasis on fewer side effects and targeted immunomodulators.

HIV/AIDS

Treatment for HIV has improved with once-daily combination tablets that suppress the virus, prevent transmission, and promote near-normal life expectancy. The regimens are now maximized for tolerability and long-term administration, including pediatric and adolescent options.

Biktarvy, which is an HIV drug made by Gilead, combines three antiviral medicines to hold back the virus and make treatment regimens easier. As HIV progresses to become a chronic manageable disease, Biktarvy's projected $13.4 billion sales reflect its place in contemporary, once-daily HIV treatment.

Cardiovascular Disease

The prevention of strokes, blood clots, and heart attacks is a central focus in world health, especially in older adults. Oral anticoagulants are commonly used to treat atrial fibrillation and prevent thromboembolism after surgery or due to chronic disease without the requirement for ongoing blood monitoring.

Eliquis (apixaban), an anticoagulant for stroke prevention and deep vein thrombosis, remains a best-seller. With aging populations and increasing cases of atrial fibrillation, so does demand for safer anticoagulants increase. Its $13 billion forecast confirms the value of preventive cardiology.

COVID-19

Although the pandemic's peak has already gone, innovation in vaccines continues to safeguard susceptible groups and look ahead to future variants. mRNA-based platforms became a template for rapid-response vaccine development, representing a pivot in infectious disease prevention.

At the same time, Comirnaty, the Pfizer-BioNTech COVID-19 vaccine, holds its commercial value at $13.5 billion in anticipated 2025 sales. While demand for vaccination on a worldwide scale has leveled off, booster drives, new strains, and breaking into mRNA-based flu and RSV vaccines keep Comirnaty in worldwide circulation.

Top 10 Drugs Projected by Global Sales in 2025

Rank	Drug Name	Company	Active Ingredient(s)	Primary Indications	Projected Revenue (in USD billions)
1	Keytruda	Merck & Co.	Pembrolizumab	Melanoma, non-small cell lung cancer, head & neck cancers	$31.0
2	Ozempic	Novo Nordisk	Semaglutide	Type 2 diabetes mellitus, cardiovascular risk reduction	$22.3
3	Mounjaro	Eli Lilly	Tirzepatide	Type 2 diabetes mellitus	$19.8
4	Dupixent	Sanofi	Dupilumab	Atopic dermatitis, asthma, nasal polyposis, eosinophilic esophagitis, prurigo nodularis	$16.9
5	Skyrizi	AbbVie	Risankizumab	Plaque psoriasis, psoriatic arthritis, Crohn’s disease	$13.7
6	Eliquis	BMS/Pfizer	Apixaban	Stroke prevention, deep vein thrombosis, pulmonary embolism, postoperative thromboprophylaxis	$13.5
7	Biktarvy	Gilead	Bictegravir, Emtricitabine, Tenofovir alafenamide	HIV-1 infection	$13.4
8	Wegovy	Novo Nordisk	Semaglutide	Chronic weight management (obesity/overweight)	$13.4
9	Darzalex	Johnson & Johnson	Daratumumab	Multiple myeloma	$13.2
10	Zepbound	Eli Lilly	Tirzepatide	Chronic weight management (obesity/overweight)	$11.3

What holds all of these number-one-selling medications together is their evidence of a larger shift in world medicine. The action is more personalized, with gene-targeting and biologics mirroring the old one-size-fits-all approach. There's a discernible trend toward preventive health, where problems like diabetes, obesity, and cardiovascular disease are treated early and aggressively.

Additionally, the triumph of drugs such as Keytruda, Dupixent, and Skyrizi reflects the broadening scope of immune-based treatments, not only in cancer but in dermatology, gastroenterology, and pulmonology. Likewise, the call for metabolic treatments reflects public health efforts addressing global epidemics such as obesity and diabetes.

Though forecasted 2025 revenues of leading medicines present stunning numbers, the actual story involves what these medications are accomplishing for patients. From transforming cancer treatment to allowing long-term weight management, to allowing people with HIV to live longer and healthier—these drugs are milestones in contemporary medicine.

A man in his 50s from northern New South Wales, Australia, is fighting for his life in hospital after contracting Australian bat lyssavirus (ABLV), marking the state’s first ever confirmed human case. The incident, which has left health authorities and the public deeply concerned, highlights the persistent and often underestimated threat posed by zoonotic diseases—those transmitted from animals to humans.

The man was bitten by a bat several months ago and, despite seeking medical attention at the time, began displaying symptoms of lyssavirus only recently. He is now in critical condition, and health officials have confirmed that an investigation is underway to determine if other factors contributed to his infection.

The current case marks only the fourth confirmed human infection with ABLV in Australia. The previous three cases, all in Queensland between 1996 and 2012, resulted in fatalities. Each instance has reinforced the lethal nature of the virus and the critical importance of prevention and early intervention.

NSW Health and national health authorities have issued urgent reminders for the public to avoid handling bats under any circumstances. Only trained and vaccinated wildlife carers should attempt to rescue or manage bats in distress. Keira Glasgow, Director of Health Protection at NSW Health, emphasized, “The best thing you can do is to call your local wildlife carers agency to help you.”

Anyone exposed to a bat bite or scratch, regardless of vaccination status, should seek urgent medical care. Authorities stress that even minor contact can be dangerous, and any delay in seeking treatment increases the risk of fatal disease progression.

Bats are natural reservoirs for a range of viruses, including lyssaviruses and coronaviruses. Their unique immune systems allow them to harbor pathogens without succumbing to disease, but these viruses can be deadly when transmitted to other species, including humans.

In Australia, bats play essential ecological roles as pollinators and insect controllers, but their close proximity to urban areas and frequent human-wildlife interactions increase the risk of zoonotic spillover. This case underscores the importance of maintaining safe distances from wildlife and respecting the boundaries between human and animal habitats.

What is Lyssavirus?

Australian bat lyssavirus is a member of the Lyssavirus genus, within the same viral family as rabies. First identified in Australian flying foxes in 1996, its discovery shattered previous assumptions that Australia was free from rabies-like viruses. ABLV is genetically and clinically similar to rabies, causing severe neurological disease that is almost always fatal once symptoms appear.

The virus is found in various bat species across Australia, including fruit bats, flying foxes, and insect-eating microbats. Any bat in the country is considered a potential carrier, regardless of apparent health.

How the Virus Spreads?

Transmission occurs when the saliva of an infected bat enters the body through a bite, scratch, or contact with broken skin or mucous membranes (such as the eyes, nose, or mouth). Notably, even a minor scratch or seemingly insignificant contact can be enough to transmit the virus.

Bats carrying ABLV may not always show obvious signs of illness. However, infected bats can display unusual behaviors such as aggression, paralysis, inability to fly, or being found in atypical locations during the day. These signs should serve as warnings to the public to avoid contact and report such animals to wildlife authorities.

The incubation period for ABLV is highly variable, ranging from a few days to several years after exposure. This unpredictability makes monitoring and post-exposure management challenging.

Early symptoms mimic the flu:

• fever
• headache
• fatigue
• malaise

However, the disease progresses rapidly, with patients soon developing:

• Muscle weakness and sensory changes
• Confusion and agitation
• Convulsions and seizures
• Paralysis and loss of consciousness

Once neurological symptoms develop, the prognosis is grim. Death typically occurs within one to two weeks of symptom onset, and there have been no documented survivors of symptomatic ABLV infection in Australia to date.

Can Lyssavirus Be Treated?

There is currently no effective treatment for ABLV once symptoms have begun. The only hope for survival lies in immediate and appropriate post-exposure management. This includes:

• Wash the wound thoroughly with soap and water for at least 15 minutes.
• Use an antiviral antiseptic such as povidone-iodine or alcohol.
• Even if previously vaccinated against rabies, medical assessment is essential.

Medical professionals will assess the risk and may administer a combination of rabies immunoglobulin and rabies vaccine. If the exposure is on the head or neck, vaccination should occur within 48 hours. However, once symptoms develop, supportive care is the only option, and the outcome is almost invariably fatal.

While ABLV is currently confined to Australia, the broader lesson is universal. Zoonotic diseases—those that jump from animals to humans—are a growing global health concern, exacerbated by habitat encroachment, climate change, and increased human-wildlife contact.

How Can You Protect Yourself?

• Never attempt to handle bats or other wild animals. If you find an injured or distressed bat, contact trained wildlife carers.
• If bitten or scratched by a bat, immediately wash the wound, apply antiseptic, and seek urgent medical care—even if the injury seems minor.
• Vaccination is recommended for individuals at higher risk, such as wildlife carers and veterinarians.
• Educate children and communities about the risks associated with bats and the importance of reporting contact to adults and authorities.

Disclaimer: This article is for informational purposes only and does not substitute professional medical advice. Always consult healthcare professionals for diagnosis, treatment, or concerns regarding infectious diseases or bat exposure.

As Covid-19 vaccination campaigns reached billions worldwide, so too did widespread public fear of infrequent but highly publicized cases of sudden death after vaccination. Over the past few months, the fear has sparked a spate of conjecture and disinformation, particularly on social media. On Wednesday, the Government of India's Ministry of Health and Family Welfare (MoHFW) released a statement of the utmost certainty: there is no causative association between Covid-19 vaccines and sudden death in adults. This finding, based on wide-ranging research conducted by the All India Institute of Medical Sciences (AIIMS) and the Indian Council of Medical Research (ICMR), is a watershed event for public health worldwide.

The MoHFW stands on the basis of two large, methodologically sound studies. The first, by ICMR's National Institute of Epidemiology, was a multicentric case–control study carried out over 47 Indian hospitals between May and August 2023. The second, a prospective study currently being conducted by AIIMS in association with ICMR, is investigating causes of sudden unexpected deaths among young adults.

What Prompted the Investigation?

In the past year, increased media coverage and public anxiety about sudden, unexpected deaths, especially among those aged 18–45, fueled a spate of misinformation that some tried to attribute to Covid-19 vaccination. In response, the Indian government launched extensive investigations in various institutions to give a data-based analysis of these incidents.

The health ministry emphasized that some of the national agencies, such as ICMR, AIIMS, and the National Centre for Disease Control (NCDC), carried out systematic studies to investigate the underlying reasons behind sudden deaths among adults. The objective was to conclude with certainty whether or not there exists any relation between the said deaths and earlier Covid-19 vaccinations.

A multicentre matched case–control study, "Factors associated with unexplained sudden deaths among adults aged 18–45 years in India", was carried out by ICMR's National Institute of Epidemiology during May-August 2023. This study covered 47 hospitals and aimed at determining the potential correlation between Covid-19 vaccination and unexplained deaths in young adults.

The verdict was clear: no heightened risk of sudden death from Covid-19 vaccines.

At the same time, AIIMS is carrying out a long-term prospective study named "Establishing the cause in sudden unexplained deaths in young," which is funded and supported by ICMR. The preliminary results support ICMR's findings. The top causes of sudden death remain:

• Myocardial infarction (heart attack)
• Genetic predispositions (inherited heart rhythm disorders)
• Lifestyle issues, including alcohol misuse, drug abuse, smoking, and overexertion
• Post-Covid complications like cardiac inflammation or clotting abnormalities

Interestingly, scientists noted that the cause patterns have continued to follow trends similar to those observed in history. That is, the rates of sudden deaths in young adults have not presented any significant upward leap or shift that would be traceable to the Covid-19 vaccination campaign.

Debunking Misinformation

The health ministry’s statement comes amid a surge of unfounded claims linking Covid-19 vaccines to heart attacks and sudden deaths. “Scientific experts have reiterated that statements linking Covid vaccination to sudden deaths are false and misleading, and are not supported by scientific consensus,” the ministry said. Such speculation, they warn, can erode public trust in vaccines and fuel hesitancy, potentially reversing the hard-won gains of global immunization campaigns.

Union Minister of Health Mansukh Mandaviya highlighted the role of evidence-based decision-making: "The ICMR report yielded strong evidence discrediting insinuations that the vaccines were behind heart attacks or sudden death. Decisions have to be made on scientific studies and facts, not on misinformation."

Vaccines Remain Safe and Essential

The Health Ministry reaffirmed that Covid-19 vaccines given in India are safe and effective, and cases of serious adverse events are very rare. The statement highlighted that the vaccines cannot be blamed for sudden death, particularly without scientific evidence.

The ministry claims that disinformation campaigns attributing vaccines to deaths can be harmful. "Scientific experts have reaffirmed that claims associating Covid vaccination with sudden death are untrue and misleading," the official release said. "Speculative reports in the absence of conclusive evidence may undermine public trust in vaccines, which have saved millions of lives."

What Is Sudden Death?

Sudden death is a sudden and rapid cardiac arrest in people who typically are otherwise healthy. Since it happens unexpectedly, there is generally no way to prevent or even anticipate it. Without prompt emergency medical treatment, sudden cardiac arrest invariably leads to fatality.

Identifying Symptoms of Sudden Death

Sudden death normally happens without warning symptoms. In certain situations, though, there are a few warning signs that flash very briefly, such as:

• Near-fainting or dizziness
• Sudden loss of consciousness
• No response to outside stimuli
• Stoppage of breathing
• Skin becomes a bluish or purplish color
• Early detection and emergency treatment are essential, as time is of the essence.

What Causes Sudden Death?

The most common reason for sudden cardiac death is ventricular fibrillation—a life-threatening heart rhythm disorder (arrhythmia) that causes the heart to lose its ability to pump blood effectively. When the heart fails to provide a normal rhythm, blood flow to the body's vital organs, including the brain, is interrupted, rapidly becoming fatal.

Dr Amit Bhushan Sharma, Director & Unit Head, Cardiologist, Paras Health, Gurugram explains, "The recent findings by ICMR and NCDC are both timely and reassuring, clearly showing no direct link between COVID-19 vaccines and sudden cardiac deaths. In most such cases, the root causes are underlying health conditions like undiagnosed coronary artery disease, inherited heart disorders, or lifestyle factors such as chronic stress, obesity, smoking, and physical inactivity. Cardiac arrest can occur suddenly, but there are often prior signs of cardiac issues—such as chest pain or discomfort, shortness of breath, persistent fatigue, heart palpitations, or episodes of fainting—which tend to be gradual and progressive."

"On the other hand, the common post-vaccine symptoms—like mild fever, fatigue, muscle aches, or arm soreness—are short-term and self-limiting, with no impact on the heart's electrical or structural functioning. These vaccine-related side effects are completely different from the symptoms or risk patterns seen in cardiac arrest cases. It’s crucial that we focus on heart health through regular screenings and lifestyle management, and continue to trust vaccines, which have been proven safe and essential in preventing severe COVID-19 outcomes."

Underlying Heart Conditions Associated with Sudden Death

Certain underlying diseases of the heart may predispose a person to sudden cardiac arrest:

Hypertrophic Cardiomyopathy: A genetic condition characterized by the thickening of the heart muscle, typically the left ventricle. It is the leading cause of sudden death in adults under age 50.

Dilated Cardiomyopathy: Characterized by enlargement and reduced pumping function of the left ventricle. Although most cases are not clearly caused by a specific disease, viral infections are sometimes responsible.

Arrhythmogenic Right Ventricular Dysplasia: A genetic disorder in which heart muscle cells are progressively replaced with fatty tissue, primarily found in adults younger than 40.

Brugada Syndrome: An inherited disorder that results in potentially fatal attacks of rapid, irregular heart rhythms (ventricular tachycardia), causing fainting or sudden death.

Long QT Syndrome: A disorder characterized by structural abnormalities in the heart's sodium and potassium channels, causing erratic heart rhythms.

Catecholaminergic Polymorphic Ventricular Tachycardia: An inherited condition in which the heart is unusually sensitive to adrenaline, making it more likely to develop potentially fatal arrhythmias.