Shubhanshu Shukla, the Indian Air Force Group Captain is back on Earth after spending 18 days aboard the International Space Station (ISS). What now awaits is a long list of medical examination to ensure that Shukla and the other astronauts from Poland and Hungary are in good health.

What Are The Post-flight Medical Examinations For Astronauts?

The journey back from space marks the start of a whole new phase for astronauts. Just after splashdown, Group Captain Shukla and his fellow crewmates were helped out of the capsule by SpaceX recovery teams. Once aboard the recovery vessel, they underwent initial medical checks to assess their vital signs and general health.

These immediate tests are part of a broader post-flight health monitoring protocol aimed at studying how spaceflight affects the human body. Since astronauts’ health parameters are recorded before launch, comparing them with post-landing data helps scientists understand the impact of microgravity on various body systems.

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As the pilot of the Axiom-4 mission, Shukla will undergo an extensive series of assessments — from cardiovascular and immune system checks to balance, coordination, and psychological evaluations.

Over the coming weeks, both NASA and the Indian Air Force will monitor his physical and mental recovery closely.

Readjusting to Earth’s gravity is not instant. In space, the lack of gravity leads to muscle weakening, bone density loss, and a fluid shift in the body that can affect circulation and organ function. To counter this, astronauts follow a personalized reconditioning plan designed to help their bodies re-adapt. These programmes focus not only on regaining strength but also on retraining the body’s proprioception — the sensory system that allows us to sense our position and movement, which becomes disoriented in space.

Life in Microgravity: What It Feels Like

Speaking from the International Space Station during the mission, Shukla had shared the strange feeling of disorientation he experienced during his initial days in orbit. “It’s the first time for me, so I don’t know what to expect [upon return],” he said. “The only hope is — I did have some symptoms coming up — so I am hoping that I will not have it going down. Unless and until I get the worst of both worlds and I get it both the times.”

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Many astronauts deal with “space motion sickness” during the early days of their mission. This occurs when the brain receives mixed signals from the inner ear, which is crucial for balance on Earth. Upon return, the challenge reverses — as the body tries to function under the force of gravity again, simple actions like standing or walking can temporarily become difficult.

According to official reports, Shukla and his team will soon be transported to NASA’s Johnson Space Center in Houston for further recovery and evaluation, either by sea or air.

Post-Flight Rehabilitation

As per Polash Sannigarhi, Chief Instructor, Aeromedical, Training Center, Air Force Station Hindan, Ghaziabad, there are many rounds of medical checks that an astronaut undergoes. Being a flight surgeon himself, he writes in the paper, "Post-flight rehabilitation of an astronaut after long duration mission in space: Through the eyes of a flight surgeon" published in 2023.

Post-flight Medical Evaluation

Medical assessments begin within a day of landing (R+1) and cover a wide range of investigations:

Laboratory Tests: Conducted per NASA’s MEDB guidelines to assess biochemical and physiological parameters.

Physical Examination: Daily systemic check-ups by a flight surgeon to monitor overall health.

Anthropometry: Measurement of height and body mass to assess fluid shift and skeletal changes.

Psychological Assessments: Conducted privately by a mission psychologist on R+1 and R+10.

Sensorimotor and Vestibular Tests: Includes dynamic posturography and mobility assessments to evaluate balance and spatial orientation.

Ophthalmologic and Audiological Tests: Exams such as visual acuity, contrast sensitivity, orbital MRI, and audiometry.

Cardiorespiratory Assessment: ECG post-landing and spiro-ergometry on R+5 to assess VO₂ max.

Nutritional, Radiation, and Sleep Assessments: Involves dietary surveys, urine and blood sampling, dosimeter analysis, and sleep quality tracking.

Radiological Imaging: Targeted MRIs and ultrasounds are performed based on clinical indications.

Post-flight Physical Rehabilitation

This begins as early as the first day post-landing and is tailored to individual needs. A multidisciplinary team — including a Flight Surgeon, Physiotherapist, and Exercise Specialist — oversees it.

Initial Days (R0–R+1): Massage therapy for muscle relaxation.

R+2 to R+7: Structured exercise routines, including warm-ups, back and leg activation exercises, gait training, balance drills, and posture work using equipment like resistance bands.

Hydrotherapy (Following Week): Aquatic activities like aqua jogging and ball games mimic microgravity and help recondition muscles in a low-impact environment.

Core anti-gravity muscles such as the multifidus and transversus abdominis are monitored using ultrasound to track structural recovery. Flexibility and proprioception exercises are gradually reintroduced. Astronauts avoid jumping or high-impact activities until deemed fit by the team.

Each day concludes with team reviews to adapt the next day’s plan based on physical response. The program’s primary goal is to return astronauts to their pre-flight physical condition safely, without overexertion or injury.

In a significant move to safeguard public health, the U.S. Food and Drug Administration (FDA) has issued warning letters to seven companies accused of illegally marketing products containing a powerful compound found in kratom, known as 7-hydroxymitragynine (7-OH). These companies have been selling concentrated versions of the substance in forms like tablets, gummies, drink mixes, and energy shots—many of which are available online and in everyday retail outlets such as smoke shops, gas stations, and convenience stores.

What Is 7-OH and Why Is It a Concern?

7-hydroxymitragynine is a chemical compound that naturally occurs in very small quantities in the kratom plant. However, in these commercial products, it is either added in high concentrations or manipulated to raise the levels well beyond natural amounts. The problem? 7-OH is not approved by the FDA for use in any dietary supplement, conventional food, or pharmaceutical drug.

According to the agency, not only does this make these products illegal, but it also raises serious health and safety concerns. The FDA emphasized that the compound has not been proven safe or effective for treating any health condition and warned that consumers using these products are putting themselves at risk.

Illegal and Unsubstantiated Claims

The companies receiving the warning letters were accused of marketing their 7-OH products with unproven claims about treating pain, anxiety, and other medical conditions. Some of these products are being sold as dietary supplements or even regular food items, despite not meeting the legal or scientific safety standards required for such classifications.

The FDA’s main concern lies in how these products are being presented to the public—as safe, natural remedies—when in fact they may be both unsafe and illegal. “People using these products are exposing themselves to substances that have not been proven safe or effective for any use,” the FDA warned in a statement.

The Companies Named

The seven companies that have been sent official warning letters include:

• Shaman Botanicals LLC
• My Smoke Wholesale
• Relax Relief Rejuvenate Trading LLC (also known as RRR Trading or EDP Kratom)
• Thang Botanicals Inc. (doing business as 7ΩHMZ, 7-OHMZ, or 7OHMZ)
• Royal Diamond Imports Inc. (operating Roxytabs.com)
• Hydroxie LLC
• 7Tabz Retail LLC

All seven companies have been given 15 business days to respond to the FDA’s concerns. They are required to outline what actions they will take to correct the violations. Failure to respond or take corrective measures could lead to further enforcement actions, including product seizures or legal injunctions.

FDA Urges Caution

This latest crackdown reflects the FDA’s ongoing concerns around kratom and its derivatives, particularly products containing high concentrations of 7-OH. Consumers are urged to avoid such products and consult healthcare professionals before using any substance marketed as a pain or anxiety remedy.

The agency continues to monitor the market and has signaled it will take further steps if necessary to protect the public from unsafe, misbranded, or illegally marketed products.

For anyone who's been following the meteoric rise of weight-loss injections like Ozempic and Wegovy, one thing is certain: these medications are effective but not for everyone. Now, a new, in-depth study might know why.

Appearing in the journal Diabetes, Obesity and Metabolism, this new research has identified key determinants of who is most likely to thrive on GLP-1 receptor agonists (GLP-1RAs), a drug class that includes semaglutide (Ozempic/Wegovy). Ranging from use duration to body composition, and from metabolic rate to diabetic status, the results yield a finer set of directions for individualized obesity treatment—and may potentially minimize the guesswork that too often vexes patients and clinicians alike.

GLP-1RAs are drugs initially made to treat type 2 diabetes but have produced miraculous outcomes for the treatment of obesity. They function by duplicating a hormone that occurs naturally in the body, which suppresses hunger and controls the blood sugar levels. Semaglutide, the drug behind Ozempic and Wegovy, has assisted individuals in losing an average of 15–21% of their body weight when combined with diet and lifestyle modifications.

Even with all the news-grabbing changes and social media hype, results are all over the place. Some patients lose weight rapidly, others plateau, and some develop side effects such as nausea that cause them to quit cold turkey. The new research, performed at Peking University People's Hospital, sheds some light on why.

Scientists monitored 679 overweight or obese patients who initiated GLP-1RA treatment between November 2022 and October 2024 at an obesity clinic in Beijing. For 12 months, they monitored a range of physical and metabolic factors to determine what characteristics were associated with improved outcomes.

Patients taking GLP-1RAs for extended periods, particularly semaglutide, had higher odds of significant weight loss. But more than how long the patient was on the drug, study authors determined that individual traits mattered substantially in effectiveness.

In particular, individuals who did not have diabetes, had a higher percentage of body fat, larger amounts of skeletal muscle, and a higher rate of basal metabolism were found to be more likely to succeed. Also, higher serum creatinine levels (a marker for muscle mass and kidney function) were associated with improved success.

Role of Muscle Mass and Metabolism

GLP-1s are effective devices, but they need to be combined with muscle-sparing measures. Most patients inadvertently lose lean muscle mass, which can lower metabolism and undermine long-term weight control.

That is, the scale may fall, but what you lose is important. Retaining muscle mass is essential to long-term health and success. Because of this, experts suggest a two-prong approach: savvy, high-protein eating and regular strength training to help maintain lean tissue throughout treatment.

5 Body Traits That Predict If You'll Actually Lose Weight on GLP-1 Drugs

New research is showing that not everyone responds the same way to GLP-1 receptor agonists—and your body’s makeup may be the key to understanding why. Here are five physical traits that strongly predict whether you’ll shed pounds successfully while on these weight-loss medications:

1. Higher Body Fat Percentage

Individuals with excess body fat at the beginning of treatment respond to GLP-1 drugs more favorably. Why? They attack hunger and fat storage, so people with more to lose are more likely to see faster and more dramatic results.

2. Increased Skeletal Muscle Mass

Muscle is not only for power—it burns calories even at rest. Individuals with greater skeletal muscle mass (particularly in the arms, legs, and abdomen) tend to have a quicker metabolism, which can strengthen the actions of weight-loss drugs.

3. Increased Basal Metabolic Rate (BMR)

A greater BMR indicates that your body expends more energy on a daily basis. Individuals with naturally quicker metabolisms are more apt to experience efficient and long-lasting weight loss when taking GLP-1RAs such as semaglutide.

4. Greater Serum Creatinine Levels

This marker is most commonly associated with muscle mass and kidney function. Individuals with slightly elevated (but normal) levels of creatinine—usually an indicator of greater lean body mass—tended to respond more favorably to these drugs.

5. No Diagnosis of Diabetes

Against expectation, individuals with no diabetes experienced more success than those with diabetes. This could be explained by improved insulin sensitivity, reduced metabolic resistance, or fewer pre-existing complications that would interfere with weight reduction.

How Your Diabetes Status Is Important?

The research demonstrated that those without diabetes had considerably higher chances of being successful with weight loss compared to those with prediabetes or diabetes. This could be because of deep-rooted metabolic distinctions or that GLP-1RAs react differently in states of insulin resistance.

Lead researcher Dr. Linong Ji described, "This study highlights the value of metabolic state-matched strategies. Individuals with diabetes can benefit from a different or more combined regimen."

Consistency is key, patients who remained on the drug for a longer period were more likely to lose weight. Those who dropped out early because of side effects, lack of response, or lifestyle interference were far less successful.

This accords with demands from doctors for improved support for adherence. Greater follow-up frequencies, tailored coaching, and symptom control can avert early dropouts.

"Adherence to medication is neglected but equally important as the medicine itself," the authors stated. "Physicians must assist patients in staying on track, especially for the first months or so."

Side Effects of GLP-1 Drugs

Side effects, particularly gastrointestinal such as nausea, constipation, or vomiting, are still the number one reasons individuals drop out of GLP-1RAs. That's where tailoring treatment comes into play even more so.

Take, for instance, individuals who have less skeletal muscle mass. These individuals are likely to be more susceptible to fatigue and muscle wasting, enhancing dropout risk. Tweaking dose schedules, incorporating physical therapy, or emphasizing diet quality can all help mitigate these problems.

The global rise of drugs like Wegovy isn’t just hype. These medications are proving to be some of the most effective tools we’ve ever had in the fight against obesity, a condition affecting over 650 million people worldwide but what this new study makes clear is that weight loss is not one-size-fits-all, even with powerful drugs. Body composition, muscle mass, metabolic health, and individual biology all play a role.

For doctors, that equates to taking a precision medicine approach—tailoring treatments based on an individual's profile, instead of simply dosing all patients the same.

And for patients? It's a reminder that medications such as Ozempic and Wegovy can be remarkably powerful but only as part of an integrated, personalized plan that values the complexity of your body.

GLP-1 medications are revolutionizing weight control, but as this study reveals, success is not arbitrary success is individual. Understanding what influences results can enable more individuals to achieve potential through progress.

Breast cancer is one of the most treatable cancers when caught early. Yet, a significant number of women remain unclear about one of the most crucial tools for early detection: the mammogram. A new survey by the Annenberg Public Policy Center (APPC) reveals just how persistent and widespread the confusion is over when women should start getting screened. Despite updated national guidelines recommending mammograms beginning at age 40, nearly half of the adults surveyed in the US are either misinformed or confused.

The US Preventive Services Task Force (USPSTF) issued a revised recommendation in April 2024, advising that women at average risk of breast cancer begin screening mammograms every other year starting at age 40. This update rolled back an earlier guideline that suggested beginning at age 50, a shift that aligns more closely with what other medical bodies have long recommended.

The American Cancer Society, for instance, has consistently recommended that women aged 40 to 44 have the option to begin annual screening, with stronger guidance to start annually from age 45. By age 55, women can shift to screenings every other year.

But with a history of back-and-forth on these guidelines, public understanding hasn’t caught up.

"Confusion can arise when medical guidance about detection or treatment changes," said Kathleen Hall Jamieson, director of the APPC. “Our data suggest that the recommendation that such screening ordinarily start at 40 years old is not yet widely enough known.”

The APPC’s April 2024 survey sampled over 1,600 U.S. adults. The results were telling:

• Only 49% correctly identified age 40 as the right age to begin biennial mammograms for women at average risk.
• A notable 10% said screenings should begin at age 20, while 21% selected age 30. 8% said 50, and 11% admitted they were unsure.

Even more telling: this level of awareness remained unchanged from a previous survey conducted before the updated guidelines were published. So while the medical advice evolved, public understanding stood still.

Is Misinformation Creating Confusion?

Women aged 40–49 were the most informed demographic in the survey—72% of them knew screenings should begin at 40. But awareness dropped significantly among younger groups. Only 37% of women aged 18–29 knew the correct age to begin mammograms and a concerning 27% of that group mistakenly thought the correct age was 30, while 16% didn’t know at all.

This gap in understanding matters because younger women especially those with family history or genetic predisposition, may need to start even earlier.

What Are Mammograms?

A mammogram is a low-dose X-ray that captures detailed images of breast tissue, capable of identifying cancers before any physical symptoms appear.

In women with a BRCA1 or BRCA2 gene mutation who are referred to as "high risk" or with a history of radiation to the chest between ages 10 and 30, screening may start as early as age 30 and include annual breast MRIs alongside mammograms.

Modern technology has made the process quicker and less painful. Better compression paddles, 3D mammograms, and AI-assisted readings now reduce both discomfort and the chance of error.

Despite technological improvements, mammograms are not infallible. Their accuracy ranges between 85–90%, and performance can dip in women with dense breast tissue.

Contrast-enhanced digital mammography (CEDM) is another newer innovation helping radiologists identify tricky cases. The integration of artificial intelligence is also streamlining diagnostic accuracy.

Does 'Abnormal' Mammogram Mean Cancer?

An abnormal mammogram result doesn’t necessarily mean breast cancer. It simply means something unusual has been spotted and warrants further testing, which could include a breast ultrasound, MRI, or even a biopsy.

In the US, follow-up care is typically swift, with guidelines in place to ensure patients are informed and supported. However, disparities in healthcare access especially for uninsured or not populations still persist.

The APPC survey’s findings highlight a deeper issue, how public health communication is struggling to keep up with shifting medical guidelines. When official recommendations change, the burden of clarity shouldn’t fall solely on the individual. It requires coordinated messaging across healthcare providers, public health agencies, insurers, and the media.

While mammograms are widely available in the U.S., access isn’t always equitable. Low-income communities and communities of color often face hurdles ranging from cost and insurance barriers to logistical challenges like transportation or time off work.

Breast cancer remains one of the leading causes of cancer death among women. Early detection significantly improves outcomes, but only if women are aware and empowered to begin screening at the appropriate time.

If you're approaching 40, talk to your doctor about when to begin screening especially if you have additional risk factors. Don’t wait for symptoms to show up.