When we hear of any 'heart disease', high blood pressure or chest pain often come to mind. But what if your lips were quietly warning of an undiagnosed, life-threatening heart condition? A rare congenital defect called Ebstein’s anomaly may do just that—and many people don’t even realize it.

This congenital defect in the heart may go undetected for years, until a small indication such as blue or greyish tinting of the lips or nails indicates something much more critical: your blood may be circulating in the wrong direction inside your heart. Our bodies tend to communicate with us in soft, subtle language. A hint of blue in your lips, unexplained fatigue, or difficulty breathing could be more than just everyday exhaustion—they may be clues pointing to a serious underlying heart condition.

What Is Ebstein’s Anomaly?

Ebstein's anomaly is a rare congenital heart defect—i.e., it exists at birth. It occurs in about one out of every 200,000 live births and represents fewer than 1% of all congenital heart defects. Although rare, it is a serious condition that needs to be monitored closely and treated.

The condition mostly influences the tricuspid valve, which is among the four heart valves that govern blood circulation into and out of the heart. In a normal heart, the tricuspid valve directs the blood in the right direction from the right atrium to the right ventricle. The valve in persons with Ebstein's anomaly is deformed and fails to seal correctly, making it possible for blood to pass backward—a situation referred to as regurgitation.

This reversed flow can enlarge the upper chamber (right atrium) and shrink and weaken the lower chamber (right ventricle), decreasing the efficiency of the heart. In the long run, this extra workload may result in heart failure, provided it is not treated.

Symptoms of Ebstein's Anomaly

Although most individuals with Ebstein's anomaly have no symptoms during childhood, others become aware of the condition years after it occurred—usually during tests for irregular heart rhythms or difficulty breathing on exertion.

One of the most subtle yet revealing symptoms? Blue or grey discoloration on the lips and fingernails, which is known as cyanosis. It's a sign of inadequate oxygen flow—meaning not enough oxygenated blood is being efficiently pumped around the body.

What is more concerning is that such discoloration may be less apparent on darker-skinned individuals, so early detection is even more difficult. In most instances, these symptoms are overlooked or blamed on other factors such as cold or tiredness.

Why Is Ebstein's Anomaly Often Misdiagnosed or Missed?

Even with warning signs, Ebstein's anomaly can be overlooked, particularly in people with less severe forms of the condition. Since many of the symptoms are nonspecific—such as fatigue, dizziness, or palpitations—they can be attributed to stress, anxiety, or lifestyle issues.

It is sometimes identified in babies at birth during routine tests, particularly if a heart murmur is heard. A murmur is a whooshing noise caused by turbulent blood flow through the heart, usually picked up by an examining physician with a stethoscope.

Most adults do not receive a diagnosis until much later, usually while being screened for atrial septal defects (ASD) or patent foramen ovale (PFO)—both of which occur commonly in conjunction with Ebstein's anomaly.

Risks of Untreated Ebstein's Anomaly

If left untreated or undiagnosed, Ebstein's anomaly can cause severe complications, such as:

• Enlargement and weakening of the heart
• Heart rhythm disturbances (arrhythmias)
• Increasing heart failure
• Stroke or blood clotting due to pooling of blood

The British Heart Foundation alerts that the reversed flow of blood can put severe wear and tear on the heart muscle over time, causing worsening cardiac function and potentially fatal consequences.

Is there a Treatment for Ebstein's Anomaly?

Treatment of Ebstein's anomaly is based on several factors, such as the severity of the malformation, whether there are symptoms, and associated heart disease. Mild cases might only require follow-up and medication, whereas severe presentations might necessitate surgical correction or valve replacement.

In certain instances, catheter-based interventions can be employed to fix irregular heart rhythms or seal accompanying defects. More complicated cases might involve open-heart surgery, and in extreme situations, heart transplantation is an option.

More sophisticated treatment regimens now also encompass dual immunotherapy regimens and targeted radiotherapy, particularly for patients who could be diagnosed later in life with added complications.

With growing awareness of such unusual congenital cardiac anomalies as Ebstein's anomaly, it is all the more imperative that those affected—and their doctors—take careful notice of these symptoms, particularly if they increase or persist over time.

If you or someone close to you notice symptoms of bluish coloration around the lips, palpitations, or abnormal breathlessness, have a detailed cardiac assessment undertaken. Quick detection and intervention can make all the difference in overall well-being and quality of life down the road.

The approval of Eli Lilly’s Mounjaro (tirzepatide) KwikPen by India’s Central Drugs Standard Control Organisation (CDSCO) marks a significant development in diabetes and obesity management, not only for India but for the world. With the increasing incidence of type 2 diabetes and obesity globally, the launch of a weekly, easy-to-administer injectable has the potential to redefine the way patients and physicians treat chronic metabolic disease.

Type 2 diabetes impacts more than 37 million individuals in the United States alone, with the overwhelming majority treating their condition by blending lifestyle modification and pharmaceutical therapy. Typically, insulin therapies have involved daily injections, which can be unpleasant and result in suboptimal compliance. It is this challenge that has generated innovation within the disease field, with the creation of incretin mimetics—medicines that replicate hormones that play a key role in glucose control and satiety regulation.

The history of incretin mimetics starts in an unexpected place, the venom of the Gila monster, a lizard that can keep blood sugar level steady when it fasts for long periods. This biological oddity led to the development of exenatide (Byetta), the first of a new generation of diabetes medicines. The area has since moved quickly, with newer and more potent agents such as dulaglutide (Trulicity), liraglutide (Victoza), and semaglutide (Ozempic) making their way into the market, several of which are also used to manage weight.

What Sets Mounjaro Apart From Other GLP-1 Drugs?

Mounjaro, or tirzepatide, is the newest innovation. Unlike previous medications that only addressed one hormone pathway (GLP-1), Mounjaro is the first and only drug to engage both GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide) receptors. Both of these hormones regulate blood sugar and hunger, so Mounjaro is a dual-action therapy for diabetes and obesity.

The newly approved KwikPen form is a pre-filled, multiple-dose pen designed for subcutaneous injection. Its easy-to-use design allows accurate dosing and more convenience, with patients being able to self-administer the drug weekly. The pen releases four doses, with a residual amount of liquid left over after each use—a standard aspect that guarantees full dosing.

The clinical evidence backing Mounjaro's approval is strong. In clinical trials, tirzepatide has shown to decrease hemoglobin A1c (HbA1c)—an important measure of long-term blood glucose control—better than many other drugs. For example, in phase 3 trials, weekly tirzepatide decreased HbA1c levels dramatically, with most patients reaching the target level of 6.5% or less.

But most newsworthy of all is the effect of Mounjaro on weight. Patients taking tirzepatide have achieved mean weight losses of as much as 20% of body weight, significantly greater than the outcome with previous anti-obesity drugs. This is especially meaningful considering the high correlation between excess weight, diabetes, and cardiovascular risk.

How Does the Mounjaro KwikPen Work?

Mounjaro KwikPen is a prefilled, single-patient-use, multi-dose pen that delivers 0.6 mL per injection. It comes in six dosage strengths of 2.5 mg to 15 mg and is administered as a small once-weekly injection into the thigh or abdomen. The pen is designed for simplicity and includes a little more than the total amount of usable liquid to permit priming prior to each injection.

For patients, it is simple: a single weekly injection, with a minimal amount of training needed. The side effects of nausea or constipation are frequent but usually mild and short-lived, particularly when the dose is ramped up gradually under doctor's care.

How Does Mounjaro Support Weight Management?

Tirzepatide's dual mechanism assists with regulating appetite and metabolic health in a number of ways:

Appetite Control: By influencing hunger-controlling centers in the brain and slowing down gastric emptying, Mounjaro makes patients feel full for longer and minimize total calorie intake.

Fat Metabolism: Clinical information indicates enhanced fat metabolism and decreased body fat, apart from total weight.

Blood Sugar Regulation: Increased insulin release and lower glucose levels further assist in weight loss by maintaining energy utilization and storage stability.

How Does Mounjaro Help Manage Diabetes?

Perhaps the most important obstacle to successful management of diabetes has been the hassle of daily injections. The Mounjaro KwikPen eliminates this with a once-weekly dosing regimen that studies indicate improves compliance. Patients on weekly regimens in one trial remained with their therapy an average of 333 days, compared with 269 for patients treated daily.

The design of the pen also minimizes the danger of dosing errors and makes self-injection less daunting, particularly for patients new to injectable treatments. Any remaining liquid in the pen after four doses is normal and does not signify a problem—a major relief for patients.

Who Should Consider Mounjaro KwikPen?

Mounjaro is used in adults with type 2 diabetes, especially those who have an excess weight or obesity and are at increased risk of cardiovascular disease. It is also being evaluated for use in a wider range of obesity treatments pending regulatory approval.

In individuals who do not have diabetes, the indications for use reflect those for other anti-obesity medications: a body mass index (BMI) of 30 or more, or 27 and over with at least one weight-related medical condition like high blood pressure or elevated cholesterol.

Vouching for the wave of weekly therapies, recent studies like QWINT-1 and QWINT-3 have shown that once-a-week insulin injections yield equal reductions in A1C as daily regimens with more convenience and better adherence. In QWINT-1, study participants achieved an A1C decrease of 1.31% on weekly efsitora compared with 1.27% on daily insulin glargine. These results support the value of weekly injectables like Mounjaro in clinical use.

Accessibility and Affordability

Though promising, availability of Mounjaro and other such drugs is still a challenge. In the United States, the price can go anywhere from $1,000 to $1,500 for a month, and the treatment for obesity is not covered under Medicare, although some private providers do reimburse. Pricing and insurance coverage in India will be crucial in deciding how widely the KwikPen finds acceptance.

Another concern is supply: the surging demand for incretin mimetics has caused intermittent shortages, especially for the most in-demand formulations. Providing persistent access will be essential as more patients ask for these treatments.

Mounjaro KwikPen's approval in India is not just a regulatory first—it's a sign that the paradigm of metabolic disease care is shifting. With its two-part mechanism, demonstrated effectiveness in both blood glucose control and weight reduction, and patient-centered design, Mounjaro has the potential to be a foundation of diabetes and obesity treatment.

Once primarily linked to heavy alcohol consumption, liver cirrhosis is now increasingly affecting people who have never had a drink. Experts are warning of a silent but growing health crisis driven by unhealthy lifestyles.

A Global Health Concern

According to the World Health Organization (WHO), liver cirrhosis is responsible for more than 1.3 million deaths annually, making it one of the leading causes of death worldwide. In the U.S., data from the Centers for Disease Control and Prevention (CDC) shows that cirrhosis-related deaths have surged by over 65% in the past 20 years. The biggest driver behind this rise? A condition known as non-alcoholic fatty liver disease (NAFLD).

The Lifestyle Connection

NAFLD is caused by fat buildup in the liver unrelated to alcohol use. It's now one of the fastest-growing causes of liver damage across the world. Poor diets, sedentary lifestyles, rising obesity, and increasing rates of diabetes have all contributed to its spread. Studies estimate that nearly 30% of adults globally have NAFLD, and its more severe form—non-alcoholic steatohepatitis (NASH)—is rising especially among younger adults.

What Is Cirrhosis?

Cirrhosis occurs when healthy liver tissue is replaced by scar tissue. This scarring impairs blood flow and limits the liver’s ability to perform its key functions: detoxifying the blood, aiding digestion, regulating hormones, and storing essential nutrients. If left untreated, cirrhosis can lead to liver failure or liver cancer.

Why Are Non-Drinkers Getting It?

The main culprit is the lifestyle we are all leading today. Diets high in sugar, fats, and processed foods, paired with physical inactivity, are leading to fat accumulation in the liver. Over time, this triggers inflammation, liver cell damage, and scarring—ultimately leading to cirrhosis. What makes this more dangerous is that NAFLD often develops silently, with symptoms appearing only in the later stages.

Warning Signs to Watch Out For

While NAFLD and cirrhosis can be symptom-free in early stages, some warning signs include:

• Persistent fatigue or low energy
• Swelling in the legs or abdomen
• Yellowing of the skin or eyes (jaundice)
• Sudden or unexplained weight loss
• Loss of appetite

Doctors recommend regular liver function tests, ultrasounds, and check-ups—especially for those with obesity, diabetes, or high blood pressure.

Everyday Habits That Harm the Liver

Certain lifestyle choices can accelerate liver damage, such as:

• Overeating processed or fried foods
• High sugar intake (soft drinks, sweets, desserts)
• Physical inactivity or prolonged sitting
• Ignoring health issues like diabetes or hypertension
• Crash dieting or taking unprescribed supplements

Can It Be Reversed?

Yes—if caught early. Doctors say NAFLD can be reversed through manageable lifestyle changes:

Eat a balanced diet with vegetables, fruits, whole grains, and lean protein

Engage in at least 30 minutes of exercise daily

Stay hydrated to help the liver flush out toxins

Avoid self-medication and unnecessary pills

Get routine health screenings

A major heat wave is currently affecting the central and eastern United States, with temperatures soaring above 100 degrees Fahrenheit. The US National Weather Service predicts a hotter-than-usual summer nationwide.

Unfortunately, extreme heat significantly increases the risk of dangerous heat illnesses, especially for older adults. Research shows that people over 60 account for most heat-related deaths in the U.S. The World Health Organization reports an 85% rise in heat-related deaths among people older than 65 between 2000 and 2021.

This isn't a coincidence; the aging process and extreme heat simply don't mix well, experts say. Here’s why, and what older people can do to stay safe as temperatures soar.

Why Heat Is More Risky As You Get Older

Even if you're very healthy, getting older makes you more likely to get sick from the heat. This includes conditions like heat exhaustion, where your body struggles to cool down, or heat stroke, which can be life-threatening.

As we age, our bodies naturally lose some of their ability to cool off. Experts explain that older people tend to hold onto more heat than younger people and have to work harder to keep their body temperature steady. Here are three main reasons for this change:

Blood doesn't move as well

When it's hot, your body tries to cool down by sending more blood to your skin and making blood vessels wider to help you sweat. According to a 2020 study published in the Journal of Physiology as you get older, changes in your heart and blood vessels make it harder for your body to move blood efficiently. This makes it tougher to control your temperature.

You sweat less

MedlinePlus explains that as you age, your body also sweats less, which is how it naturally cools down. This happens because your skin gets thinner, and the tiny tubes that carry sweat move closer to the surface. Plus, you lose a protein called collagen, which can squeeze these tubes, making it harder for sweat to get out.

Easier to get dehydrated

The feeling of being thirsty, and the urge to drink, gets weaker over time. Also, your kidneys become less good at keeping your fluids balanced. Studies show that kidney function can start to drop around age 40, meaning older adults are more likely to get dehydrated. On top of that, older people often take medicines, like water pills or sedatives, that can cause dehydration or make it harder to sweat.

Signs to Watch For

Heat illness often starts with a headache. Some people might also experience:

• Dry mouth
• Dizziness
• Feeling very tired
• Confusion
• Heart fluttering

Tips To Avoid Overheating As Older Adults

If you must go out on hot days, make sure you protect yourself from heat and avoid heat illness. Here are some tips according to the National Institute of Aging,

Stay in air-conditioned places

Older adults should try to stay in air-conditioned buildings as much as possible. Closing your blinds or curtains during the day can also stop your house from getting too hot.

Find cooling shelters

If you don't have AC, call your local health department to find nearby cooling centers. Fans can help, but sometimes they're not enough to beat the heat at home.

Drink plenty of fluids

Drink more water than usual to help keep your body cool and hydrated. Drinks with electrolytes, like sports drinks and vegetable or fruit juices, can replace minerals you lose when you sweat. Remember, if you feel thirsty, you're already dehydrated.

Dress lightly and rest

Wear loose, light, and light-colored clothes. Take cool showers or baths if you feel warm. Try not to do anything too strenuous, and get lots of rest until the heat passes.