A nationwide ban on ranitidine, one of India’s most widely used antacids, may soon be on the cards. A confidential report by an expert panel has flagged serious health risks associated with the drug, particularly its potential to cause cancer. Submitted to India’s Drug Technical Advisory Board (DTAB), the findings have triggered deliberations on whether to suspend the manufacture, sale, and distribution of the drug across the country.

The Cancer Risk Behind Ranitidine

The expert committee’s report, accessed by News18, highlights the presence of N-nitrosodimethylamine (NDMA) in several samples of ranitidine tested at the Central Drug Laboratory in Kolkata. NDMA is a chemical impurity classified as a probable human carcinogen. It is considered unsafe when consumed over a prolonged period in concentrations above global safety standards.

Out of the 42 samples tested, 21 were found to contain NDMA levels above 0.32 parts per million (ppm)—the internationally accepted limit. This finding has raised red flags, as it confirms that nearly half the samples exceeded the safety threshold.

What Is Ranitidine and Why Was It So Popular?

Ranitidine, developed in 1981 by Glaxo Holdings Ltd (now GlaxoSmithKline), quickly became a go-to medication for millions around the world. In India, it is widely available over-the-counter under brand names like Rantac, Zinetac, and Aciloc. It is primarily used to reduce stomach acid and treat issues such as indigestion, heartburn, gastroesophageal reflux disease (GERD), and ulcers.

Due to its affordability and easy accessibility, ranitidine became a staple in Indian households. Despite its ban in countries like the United States, Australia, and across Europe due to the NDMA contamination concerns, it has continued to be sold in India.

Global Regulatory Response

Ranitidine first came under global scrutiny in 2019, when international regulators began detecting unsafe levels of NDMA in the drug. The US Food and Drug Administration (FDA), the European Medicines Agency (EMA), and Australia’s Therapeutic Goods Administration (TGA) all pulled the medication from their respective markets.

These agencies took the precautionary step of banning or recalling ranitidine to prevent long-term health risks in the population. They also recommended alternative treatments for acid reflux and ulcers, including other classes of antacids.

India’s Position So Far

While India did not impose an outright ban, the Central Drugs Standard Control Organisation (CDSCO)—the country’s apex drug regulator—acknowledged safety concerns as early as 2019. However, regulatory action remained limited. In December 2024, the government informed the Rajya Sabha that safety concerns were being addressed, though no concrete steps were taken until recently.

A key development came in 2022, when ranitidine was removed from the National List of Essential Medicines (NLEM). This was seen as a soft warning to healthcare providers and the public. The CDSCO also issued multiple advisories but stopped short of a suspension or recall.

What Happens Next?

Now that the expert committee has submitted its findings to the DTAB, the board is expected to review the recommendation for suspending ranitidine. If the board agrees, India may finally join the list of countries that have banned the drug.

In the meantime, doctors and pharmacists may begin advising patients to explore alternative treatments for acid-related disorders. Consumers, especially those with long-term use of ranitidine, are encouraged to consult their physicians and avoid self-medication.

As regulatory bodies weigh their next move, public awareness and medical guidance will be key to ensuring a safe transition away from ranitidine.

Emily Kramer-Golinkoff struggles to breathe easily. Living with advanced cystic fibrosis, she finds everyday tasks like walking and showering draining and difficult.

Cystic fibrosis is the most common fatal genetic disease in the United States, affecting around 40,000 people. Yet Kramer-Golinkoff’s case is particularly challenging because her condition stems from a rare mutation. As a result, the treatments that benefit 90% of cystic fibrosis patients are ineffective for her.

This situation isn’t unique to cystic fibrosis. Across many genetic diseases, major scientific breakthroughs have uncovered hidden mutations behind severe illnesses and led to life-changing treatments. However, for patients with rare genetic variations, therapeutic options remain limited, forcing them to place their hopes in emerging gene therapies.

“We feel pure joy for our friends who have been saved from this sinking ship,” said Kramer-Golinkoff, 40. “But we’re also desperate to join them. It’s incredibly hard to be among the few left behind.”

The difficulty isn’t just scientific—market forces are also at play. Drug companies prioritize developing treatments for the most common mutations to ensure larger markets.

“You need a large enough patient group in a major market for a company to stay interested,” explained Dr. Kiran Musunuru, a gene-editing specialist at the University of Pennsylvania. This results in what he calls “mutational discrimination.”

Charities like Emily’s Entourage, a nonprofit Kramer-Golinkoff helped establish, aim to break these barriers. Their fundraising has fueled early-stage gene therapy research that could benefit patients regardless of their specific mutations.

Although widespread availability of these therapies is still years away, “just having these treatments enter clinical trials provides immense hope,” Kramer-Golinkoff said.

Kramer-Golinkoff’s journey with cystic fibrosis began when she was diagnosed at six weeks old. The disease causes thick, sticky mucus to build up in the body due to a malfunctioning CFTR protein, leading to infections, blockages, and organ damage.

Despite her best efforts, her condition has deteriorated over time. She earned a master’s degree in bioethics, traveled, worked, and built friendships, but eventually developed CF-related diabetes and other complications. The pandemic forced her into isolation with her parents in the Greater Philadelphia area.

“CF is truly a monster of a disease,” she said.

Meanwhile, many others with cystic fibrosis have experienced remarkable health improvements thanks to CFTR modulator therapies that correct the defective protein. These treatments significantly boost lung function, alleviate respiratory symptoms, and enhance overall quality of life.

Unfortunately, these modulators aren’t an option for patients with rare or unknown mutations. Gaps in genetic testing, particularly in underrepresented communities, contribute to these inequities. Research indicates that Black cystic fibrosis patients are more likely than white patients to fall into the group who don’t benefit from available therapies.

To address these disparities, scientists are focusing on “mutation-agnostic” gene therapies—treatments designed to work across all mutations. This strategy is gaining traction in diseases affecting both the lungs and the eyes.

“There’s a strong push to develop these therapies,” said Dr. Garry Cutting of the Johns Hopkins Cystic Fibrosis Center.

Most of the 14 experimental gene therapies for cystic fibrosis aim to deliver healthy CFTR genes directly into patients' cells, correcting the underlying defect regardless of the mutation.

One such therapy, partially funded by Emily’s Entourage, began a clinical trial in November at Columbia University. The goal is to assess the treatment’s safety and effectiveness.

Despite her worsening condition—living with just 30% lung function, diabetes, and lung hypertension—Kramer-Golinkoff remains hopeful.

“You have to make careful choices about how to spend your limited energy,” she said. “But we’re incredibly excited about the promise of gene therapies. They can’t come soon enough.”

When we think of sleep, we often imagine a passive, resting state. However, the brain is remarkably active during certain stages of sleep, particularly during Rapid Eye Movement (REM) sleep. This unique phase, characterized by vivid dreams and increased brain activity, plays a crucial role in maintaining brain health across the lifespan.

Scientists have long known that sleep is essential for memory consolidation, emotional regulation, and cognitive function. But REM sleep, which makes up about 20-25% of an adult’s sleep cycle, appears to be especially important. During this phase, the brain undergoes processes that not only strengthen neural connections but also clear out potentially harmful waste products that accumulate during waking hours.

One significant study published in *Science*, 2013, demonstrated that sleep, particularly REM and deep sleep stages, enhances the brain’s glymphatic system—a network responsible for removing toxins. Researchers found that during sleep, brain cells shrink slightly, allowing cerebrospinal fluid to wash more freely through the brain tissue, flushing out metabolic waste. Accumulation of such waste, including proteins like beta-amyloid, has been closely linked to neurodegenerative diseases such as Alzheimer’s. This study suggests that insufficient REM sleep could impair the brain’s cleaning system, potentially increasing the risk of cognitive decline over time.

Beyond waste clearance, REM sleep appears to play a vital role in emotional health and learning. A study published in *The Lancet Neurology*, 2020, highlighted that REM sleep enhances the brain’s ability to process and store emotional memories. Participants who achieved more REM sleep after exposure to emotionally charged images were better able to manage their emotional reactions the next day. The findings point to REM sleep as a kind of overnight therapy, helping individuals recalibrate emotional experiences and maintain psychological resilience.

Lack of REM sleep, on the other hand, has been linked to a range of mental health issues, including depression, anxiety, and even increased susceptibility to post-traumatic stress disorder (PTSD). Researchers believe that when REM sleep is disrupted, the brain's ability to regulate emotions falters, potentially leading to heightened emotional reactivity and poorer stress management.

Moreover, emerging evidence suggests that REM sleep might be essential for creativity and problem-solving. During REM, the brain forms novel connections between seemingly unrelated pieces of information—a process thought to underpin moments of insight and creative thought. This might explain why "sleeping on a problem" often leads to a clearer solution the next morning.

Given the importance of REM sleep, ensuring healthy sleep habits becomes critical. Experts recommend maintaining a regular sleep schedule, creating a restful sleeping environment, and limiting substances like caffeine and alcohol, which can interfere with REM sleep. Additionally, managing stress through mindfulness, exercise, and relaxation techniques can help promote deeper, more restorative sleep.

In a world that often glorifies sleeplessness and hustle culture, recognizing the profound impact of REM sleep on brain health serves as an important reminder: sometimes, the smartest thing you can do for your mind is simply to get a good night’s sleep.

We have all have experienced fevers, there are many different beliefs about it in different cultures and multiple ways to treat it, ranging from modern medicine to ancient practices. When one has a fever, their body feels warm and weak, they also do not have energy to do extended movements. As fevers are a range, some being slight to others being signs of dangerous conditions, dealing with them can be tricky. Things like fever dreams, conversations and thoughts are often incoherent. There are things called fever hallucinations as well, but why does this happen?

Fever means your body temperature has gone above what's normal. But what's "normal" can be a bit different for everyone and can change based on how active you are and the time of day. Generally, a fever is when your temperature is higher than 99 degrees Fahrenheit in the early morning or above 100 degrees Fahrenheit at any other time.

Do Fevers Make Us More Irritable?

In a 2013 review published in the Journal of Pain and Symptom Management, the researchers found that not only do fevers cause people to feel cold, weak and other bodily sensations, but the participants also expressed emotional changes, vivid dreams/hallucinations.

In one of the interview with a participant from the study, researches noted them experiencing feelings of anxiousness, crabby, angry and frustrated, “Like I said, I think fever is really tied in to how you feel emotionally. Because I know every time I have a fever, I just get snotty, for lack of a better term, because I'm just really agitated.”

“I feel tired. I feel irritable”

How Is Body Heat And Brain Health Connected?

Harvard Heath explains a part of your brain called the hypothalamus acts like a thermostat for your body. When you're healthy, it keeps your body at its usual temperature. A fever happens when the hypothalamus gets set to a higher temperature than normal. This change in the brain's thermostat is usually caused by tiny things in your blood called pyrogens.

According to a 2023 review by Yale School of Medicine heat can change things in the environment, it can also change how our brains work. In a study, researchers found that even small increases in temperature while the brain is active can really change what the brain does, and sometimes these changes can be negative.

Experts from Yale explain that changes in temperature in the brain also affect how our nerve cells (neurons) fire signals. These cells have tiny pumps that give them electrical energy, which they release when the brain is active. The researchers found that if brain cells get heated up too fast, faster than these pumps can adjust, the cells might become more active or less active than usual.

Even tiny temperature changes from brain stimulation can lead to big changes in neuron activity. As neurons get warmer, they can even stop working, and when they cool down again, they can become very easily excited.

Fever Hallucinations and other Psychological Affects

According to an Infections & Chemotherapy 2022 review, fevers can cause febrile convulsions, which is a seizure caused by a fever in young kids. It can also cause confusion, like not understanding where you are, not recognizing your surroundings. It can also cause unstable emotions, conscious and cognitive disturbances like illusions on hallucinations.

These can also be symptoms for things like influenza infections or encephalitis. Like the Yale experts explained even small temperature changes can have such a big impact on brain activity, we need to start paying attention to these small changes. He points out that it's a basic rule of physics that when you send electricity through wires to stimulate the brain, you will create heat, both in the wires and in the brain tissue itself.

Researching more on these matters can help us find better treatments and help doctors change the course of several procedures to help their patients.