Heart disease continues to top the list as the leading cause of death in the US, claiming around 700,000 lives annually. Now, new research suggests that nearly 50,000 of those deaths could be prevented each year with a simple but powerful treatment approach: combining cholesterol-lowering medications. "The combination therapy is safe and efficacious," said Maciej Banach, the study's first author and professor of cardiology at the John Paul II Catholic University of Lublin, Poland.

High cholesterol plays a central role in the development of heart disease by causing plaque buildup in arteries, which restricts blood flow and can lead to heart attacks or strokes. Statins, which reduce the liver’s production of cholesterol, are already commonly prescribed for patients at high risk. But Banach and his team found that pairing statins with ezetimibe—a drug that blocks the small intestine from absorbing cholesterol—can significantly improve outcomes.

Nearly 20% Reduction In Deaths

According to the findings, patients on the combination therapy saw a 19% reduction in the risk of early death, an 18% lower chance of experiencing a major cardiovascular event, and a 17% decrease in the risk of stroke. The findings were published in the journal Mayo Clinic Proceedings.

Ezetimibe, sold under the brand name Zetia, works differently from statins by targeting cholesterol absorption in the gut rather than production in the liver. The research challenges the traditional view that patients should be monitored on high-dose statins for at least two months before introducing ezetimibe.

Banach’s team based their recommendation on a review of 14 studies involving over 108,000 patients with blocked arteries. Their conclusion is clear: the combination approach shouldn’t be delayed.

“This study confirms that combined cholesterol-lowering therapy should be considered immediately and should be the gold standard for treatment of very high-risk patients,” said study co-author Peter Toth. “Simply adding ezetimibe to statin therapy, without waiting for at least two months to see the effects of statin monotherapy, which is suboptimal in many patients, is associated with more effective LDL goal achievement and is responsible for significant incremental reductions in cardiovascular health problems and deaths.”

The approach is also cost-effective. “It does not require additional funding or reimbursement of new expensive drugs,” Toth added. “In fact, it may translate into lower rates of first and subsequent heart attacks and stroke, and their complications like heart failure, which are extremely costly for all health care systems.”

Cardiovascular disease is responsible for nearly 20 million deaths globally each year, driven by high blood pressure, smoking, obesity, physical inactivity, diabetes, and high cholesterol. In the US alone, an estimated 94 million adults have borderline high cholesterol.

Dr. Benjamin Hirsh, director of preventive cardiology at North Shore University Hospital, said he hopes early combination therapy becomes the new standard. “For very high-risk patients, there is no reason to wait,” he said. "Aggressive reduction of LDL cholesterol is paramount."

A recent independent review suggests that staff who help doctors in hospitals and GP offices, who are called Physician Associates (PAs) and Anaesthesia Associates (AAs), should be renamed "assistants." The review that has been in work since the past year has finally presented its findings and results. The Leng review has been looking into the various aspects of AAs and PAs to understand where there are shortcomings and why must there be changes.

One of the biggest issues that people have with PAs and AAs is confusing them with doctors. The review also recommends that these assistants wear specific uniforms and badges to clearly tell them apart from doctors. Crucially, it states that these assistants should not be the ones to diagnose patients' illnesses.

The UK Department of Health & Social Care called for this review last year due to ongoing debates about the exact roles and duties of these healthcare professionals. When PAs and AAs were first brought into the NHS in the early 2000s, there wasn't a clear plan for how they would fit into existing medical teams. This led to a lot of confusion about what they were supposed to do. Sometimes, when there weren't enough doctors, PAs filled in, even without the extensive training doctors receive, and without proper guidance from supervisors.

The report gives a full picture of the role of Medical Associate Professionals (MAPs) in UK healthcare.

Tragic Cases Highlight Confusion

The review heard from families who lost loved ones after they were treated by PAs, mistakenly believing they were qualified doctors. For example, a young woman died from a blood clot after being seen twice by a Physician Associate who thought her calf pain was just a sprain.

Another family shared how their elderly mother died from an infection after a PA treated her in hospital. While these families do not blame the assistants, they stress the need for much clearer identification and roles. They believe that in stressful hospital situations, patients and families might not fully grasp who is treating them.

Scrutiny And Problems Faced By MAPs

However, the College of Medical Associate Professionals also present the value of MAPs and how the public views them needs to get better. News and social media have sometimes created misunderstandings about what MAPs do and how they fit into healthcare teams. Patients sometimes get confused, thinking a PA is a doctor, even when efforts are made to explain the role. There's a need for clear public education campaigns to help people understand and accept MAPs in the NHS.

The report also highlights that MAPs are facing significant stress and negative feelings because of the current environment, which many call an "anti-MAP campaign." This negativity affects their mental health both at work and at home. They point to media stories, social media attacks, and strict new rules as major causes of distress.

Worryingly, bullying and harassment at work are common. Over a third of qualified MAPs reported being bullied, and many experienced online harassments. A large number of student MAPs also faced bullying during their training. These experiences have led many MAPs to consider leaving their jobs or actually leaving. Women MAPs and those from minority ethnic backgrounds were more affected, making up a larger share of those who left their jobs despite being a smaller group overall in the workforce.

The British Medical Association responds to the review highlighted that the report reveals how NHS England allowed these new roles to grow without properly checking if they were safe. They point to a lack of strong national leadership, no clear accountability, and a failure to listen to concerns raised by doctors, patients, and even coroners (who investigate deaths).

The BMA argues that allowing the roles of doctors and non-doctors to become unclear, even with the help of the General Medical Council (GMC), has been a serious problem. Many doctors, they say, will feel that their earlier warnings were justified.

Key Steps Taken to Improve Medical Assistant Roles

While the proposed name change is a positive step, many in the medical community believe more needs to be done to clearly define what these assistants can and cannot do to ensure safe teamwork in the NHS.

This report makes several important recommendations for Medical Associate Professionals (MAPs), like Physician Associates (PAs) and Anaesthesia Associates (AAs), to make their roles clearer and more effective.

Clearer Rules and More Power

The report strongly suggests creating official rules and standards for MAPs. This will help make sure they are held accountable and that the public trusts them more. Since new rules are already being put in place, this should bring more trust and stability to their roles.

It also recommends giving MAPs the ability to prescribe medicine and order certain X-rays. This change would allow them to do their jobs more efficiently and use their skills better. There should also be national standards for their training after they qualify and for how they can move up in their careers. This will ensure that MAPs across the country receive consistent training and development.

Better Teamwork and Support

The report advises putting more money into planning the healthcare workforce. This will allow for the smart growth of MAP roles, making sure there are enough of them to meet the needs of the NHS. MAPs can actually help improve the training of junior doctors, rather than hindering it.

Better teamwork and strong leadership will help MAPs fit in well, creating a unified healthcare team that benefits both medical staff and patients. The report also suggests doing regular checks using anonymous feedback from patients to keep track of how MAPs are performing and their overall impact.

Supporting MAPs' Well-being

Finally, the report highlights that the well-being of MAPs is a widespread issue within the healthcare system, not just about individual toughness. The rules set by medical groups must be made with the input of MAP leaders and checked carefully to ensure they don't unfairly exclude anyone. Feeling respected and safe at work is extremely important for keeping staff, ensuring patients are safe, and providing good care.

As summers progress in the UK, people are planning out vacations, and a restful summer evening as the long days give plenty of room to do things you wish to even after you finish your work. However, these plans can very well come to an end if you do not take the correct precautions.

The NHS has sent out an important alert because cases of norovirus, also known as the "winter vomiting bug," are higher than usual. Although norovirus, seasonally, is a bigger issue in winter, the rising number of cases prompted the NHS to warn people. In a social media post on platform X, they explained that this highly contagious illness is causing widespread concern, and the NHS is urging people to be aware of its symptoms. They've noted that while norovirus can spread all year round, current numbers are particularly elevated.

Norovirus: Symptoms and Self-Care

Norovirus typically causes diarrhea and vomiting. While these symptoms are very uncomfortable, they usually get better within a couple of days. The NHS advises that for most people, treating themselves at home is the best approach, emphasizing the importance of drinking plenty of fluids to avoid dehydration. Common symptoms of norovirus include:

• Sudden nausea (feeling sick)
• Vomiting
• Diarrhea
• Sometimes a fever, headaches, stomach cramps, and aching limbs

Recent Case Numbers

Recent data from the UK shows a significant increase in reported norovirus cases. Between May 26 and June 29 this year, there were over 16,600 cases, which is much higher than the average for the same period over the past five years.

However, the UK Health Security Agency (UKHSA) has also reported that norovirus cases are now starting to decline and are returning to expected levels after a seasonal peak. Even with this decline, the number of reports in recent weeks was still higher than the five-year average for that same time frame, mainly due to a high number of cases reported earlier in the period.

How Norovirus Spreads

Due to the contagious nature of the virus, one must remember to take correct precautions not to spread them. Even a small, seemingly insignificant move could cause you to become a carrier.

• Don't wash your hands properly after using the toilet.
• Are in close contact with someone who has the virus.
• Touch surfaces or objects that have the virus and then touch your mouth.
• Eat food prepared by someone with norovirus.
• Consume contaminated water or food.

Preventing the Spread

To help stop norovirus from spreading, the NHS recommends some important steps. Always wash your hands thoroughly with soap and water after using the toilet, changing diapers, or before preparing or eating food. It's also important to remember that alcohol-based hand gels don't kill norovirus, so soap and water are essential.

If your clothes or bedding get soiled with vomit or feces, wash them at 60°C (140°F) and separately from other laundry. One must remember to regularly clean shared surfaces like toilet seats, flush handles, taps, and bathroom door handles. You must also try to avoid contact with others as much as possible if you feel unwell.

When to Stay Home and When to Seek Help

If you or your child start showing symptoms of norovirus, it's really important to stay home. Do not go to school, nursery, or work until you haven't thrown up or had diarrhea for two full days (48 hours). This helps prevent the virus from spreading further. Similarly, avoid visiting people in hospitals or care homes during this time. If you or your child have diarrhea that lasts for more than seven days, or if vomiting continues for more than two days, seek medical help.

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.