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The Supreme Court of India has directed a Noida hospital to form a medical board to assess whether life-sustaining treatment can be legally withdrawn for a 31-year-old man who has been in a vegetative state for more than a decade.
This has come from the bench of Justices JB Pardiwala and KV Vishwanathan who noted the young man's condition that deteriorated over the years, despite care. The medical evaluation is now also required to be presented before the court to decide the plea. The hospital has also been told to submit its report within two weeks.
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The bench said, "We want the primary board to give us a report that life-sustaining treatment can be withheld. Once it is before us, we shall proceed to pass further orders."
This is the case of Harish Rana, whose life changed in 2013 when he suffered severe head injuries after he fell from the fourth floor from his PG accommodation while he was studying at Panjab University. He had been bedridden ever since, and survived on feeding tube. His father filed a petition seeking passive euthanasia under the guidelines Supreme Court had laid down in 2018 under Common Cause judgment. This is the second time the parents have approached the apex court.
Last year, the court also suggested that Rana could receive home-based care with support from the Uttar Pradesh government. The home-based care includes periodic visits by doctors and physiotherapists. The court suggested that in case home care was not feasible, he could be moved to Noida's district hospital. However, his parents have noted that his condition continued to worsen. Family advocate Rashmi Nandakumar also informed the bench that "nothing seems to be working out".
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"He is falling ill quite often and is repeatedly admitted to hospital," she said. The advocate further added that the family only sought passive euthanasia, which is withdrawal of treatment, and not any active intervention.
Justice Pardiwala also read medical reports and observed, "Just look at the condition of the boy. It's pathetic."
The Common Cause ruling refers to a landmark Indian Supreme Court judgment that involves the NGO Common Cause. This is a 2018 case that recognized 'right to die with dignity' and legalized passive euthanasia and living will.
Under the ruling, a request for passive euthanasia must be evaluated by a primary medical board and if the board concludes that treatment could be withdrawn, a secondary board will be constituted to verify the decision before taking a final call.
The registry has been instructed to send Thursday’s order to the Noida hospital and to the office of Additional Solicitor General Aishwarya Bhati.
Rana’s parents have been navigating an incredibly tough journey, caught between differing medical opinions and strict legal requirements. In July 2023, the Delhi High Court declined their request for a medical board, saying Rana did not fall under the criteria for passive euthanasia because he was not on mechanical life support.
The Supreme Court later agreed that he wasn’t being kept alive by machines since he could breathe on his own and was being fed through a tube. But the judges also recognized the overwhelming strain on his elderly parents, who have even sold their home to keep his care going.
By November 2023, the court again suggested that he could be cared for at home, but still did not allow treatment to be withdrawn.
Now, as Rana’s condition worsens and his parents struggle to manage, the court has taken a more urgent stance. It has ordered a thorough medical evaluation to understand whether continuing treatment is simply prolonging his suffering rather than helping him recover.
India permits passive euthanasia under strict guidelines, and legalizes only the withdrawal of life support for terminally ill patients. One of the key cases also includes the Aruna Shanbaug Case (2011).
Shanbaug was an Indian nurse who was attacked and strangled in 1973. This attack left her in a persistent vegetative condition for 42 years until her death in 2015. She was admitted in the same hospital she worked as a nurse, at KEM Hospital in Mumbai. The case was brought by her friend, who petitioned the Supreme Court of India to end her life through passive euthanasia. The court, in a landmark judgment, allowed passive euthanasia, and also set new guidelines for the legality of euthanasia in India.
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The NHS has released fresh guidance on how to manage flu symptoms, setting out four simple steps that could help people recover faster. Influenza, commonly known as flu, is a highly contagious viral illness that affects the respiratory system, including the nose, throat, and lungs. It is marked by a sudden onset of fever, muscle aches, headaches, a persistent dry cough, and extreme tiredness, making it far more serious than the common cold.
Recent data from NHS England shows that in the first week of January, an average of 2,924 hospital beds across England were taken up by patients with flu. This figure reflects a nine per cent increase compared with the previous week.
With flu cases continuing to climb, the NHS has shared several important steps that people can follow to help support a quicker recovery.
In a recent update, NHS England warned that social gatherings during Christmas and New Year may have led to a resurgence of winter illnesses. NHS national medical director Professor Meghana Pandit said: “It is clear that the pressure on the NHS this winter is far from easing, with hospitals once again seeing a rise in patients admitted with flu and other respiratory viruses last week.
“The colder weather is also bringing more vulnerable patients to A&E with breathing difficulties, along with an increase in injuries caused by slips and falls in icy conditions, making this an exceptionally demanding period.”
According to the Mirror, she added: “Staff continue to work extremely hard, with teams across the country doing everything possible to ensure patients receive the care they need. It remains important for people to seek care as usual, and there are still many opportunities to get vaccinated and protect yourself against flu.”
The NHS says flu symptoms tend to appear suddenly and may include:
Children may experience similar symptoms, but they can also have earaches and may appear more tired or less active than usual.
The NHS states: “If you have flu, there are steps you can take to help yourself recover more quickly.”
You should contact NHS 111 or arrange an urgent GP appointment if you or your child have flu symptoms and:
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Cipla, a global name in inhalation therapies, has announced the launch of Afrezza, the world’s only rapid-acting inhaled insulin, in India. The drug is approved for adults with type 1 and type 2 diabetes to help manage high blood sugar levels and represents a notable change in how insulin can be delivered in a country facing a growing diabetes crisis.
For many patients, injecting insulin during long workdays or in public spaces can be uncomfortable or inconvenient. While insulin injections are widely used, awareness around inhaled insulin remains limited. Below, we explain how inhaled insulin works and what it means for people living with diabetes.
Inhaled insulin is a fast-acting form of insulin that is taken as a fine powder through an inhaler. Instead of being injected, it is breathed into the lungs, where it is quickly absorbed into the bloodstream to manage blood sugar spikes that occur after meals. This makes it a needle-free option for adults with type 1 or type 2 diabetes.
It begins working very rapidly, often just before or at the start of a meal, and exits the body sooner than injectable insulin. Because of this, it may lower the risk of insulin stacking and offers greater flexibility around mealtimes. Afrezza is currently the main FDA-approved inhaled insulin available.
The insulin comes as a dry powder and is taken using a small, discreet inhaler with single-use cartridges available in 4, 8, and 12-unit doses. It has been approved by the FDA for adults with type 1 and type 2 diabetes to help control blood sugar rises after meals. “Its absorption into the bloodstream is faster than injectable rapid-acting insulins such as lispro or aspart,” said Dr Hetashvi Gondaliya, as reported by The Indian Express.
Before starting inhaled insulin, patients are required to undergo lung function tests. The insulin itself is identical to the insulin used in injections. What differs is the way it enters the body.
In simple terms, the insulin is not new, only the method of delivery is. Once inhaled, it is absorbed through the lungs, passes into the bloodstream, and helps control the rise in blood sugar levels that happens after eating.
Inhaled insulin is not necessarily better for everyone, but it offers an alternative to injections. It works faster to control post-meal blood sugar levels and may appeal to people who dislike needles. However, it is less efficient than injected insulin, requires a specific inhaler, and is not suitable for all patients.
Studies show that blood sugar control is similar to injectable insulin, but inhaled insulin must still be used along with long-acting basal insulin. It is best viewed as an option rather than a replacement.
According to the National Institutes of Health, inhaled insulin is not appropriate for everyone. It may be considered for adults with type 1 or type 2 diabetes who want a needle-free option or need rapid control of blood sugar after meals.
However, it is not recommended for people who smoke or have smoked in the past six months, or for those with lung conditions such as asthma, COPD, or bronchitis. It is also not approved for children or pregnant women. Lung health and ongoing insulin needs must be carefully evaluated before starting this treatment.
Always consult your doctor before switching to or starting inhaled insulin. Your healthcare provider can help determine whether it is safe and suitable for you based on your medical history and lung health.
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People should be aware of a rare and unpredictable condition called SCAD. Spontaneous coronary artery dissection occurs when the inner layers of a coronary artery split away from the outer wall. When this happens, blood can leak into the space between the layers, leading to clot formation. If these clots grow large enough, they can block blood flow to the heart and cause a heart attack.
Doctors are still struggling to fully understand this condition. The cause remains unknown, and it often strikes suddenly in people who do not have the usual risk factors linked to heart disease. SCAD is most commonly seen in women between the ages of 45 and 53, although it can affect people of any age or gender.
SCAD is an acronym that can refer to different things, but it is most widely used to describe Spontaneous Coronary Artery Dissection. This is a serious heart condition in which a tear forms in one of the arteries supplying blood to the heart, potentially triggering a heart attack. SCAD is also the name of the Savannah College of Art and Design, a well-known creative university in the United States, and an Indian NGO working in the field of social change and development.
According to the British Heart Foundation, SCAD is a condition that “can’t currently be predicted or prevented.” The charity stresses the importance of seeking medical help if symptoms appear, so the condition can be identified as early as possible. Many of the warning signs are similar to those of angina or a heart attack, which can make it difficult to recognise.
The symptoms of SCAD often resemble those associated with angina or a heart attack. These may include:
The British Heart Foundation advises anyone experiencing chest pain or these symptoms to call 999 straight away. One of the dangers of SCAD is that people may dismiss the symptoms, believing they are not at risk of a heart attack. Experts say the condition cannot be predicted or prevented.
Neck pain can sometimes be linked to arterial dissections, which involve a tear in blood vessels supplying vital organs. In such cases, the pain is often sudden, severe, and felt on one side of the neck. It may appear on its own or develop before more serious symptoms, such as those associated with a stroke or heart-related event.
The pain occurs due to damage to the artery wall and should always be treated as a medical emergency. While neck pain is commonly associated with muscle strain, experts warn that, in rare cases, it can signal a much more serious underlying problem.
According to the American Heart Association, neck pain related to arterial dissection may present in the following ways:
Around 80 percent of people diagnosed with SCAD are women, and the condition is known to occur during pregnancy or shortly after childbirth. Because it develops without warning, SCAD is often discovered only after a major medical event, such as a heart attack.
Treatment depends on the severity of the condition. Some patients are managed with medication to reduce the risk of blood clots, while others may require stents to keep the artery open. In rare cases, coronary artery bypass surgery is needed to restore blood flow.
The British Heart Foundation notes that receiving a SCAD diagnosis can be deeply unsettling, especially when it follows an emergency. Many patients report feeling isolated, largely because the condition is so rare and not widely understood.
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