The market of fairness creams in Pakistan is flourishing and there is no surprise in it at all when they give you promising messages like “FAIRNESS THAT CHANGES YOUR DESTINY” and icing on the cake those TV ads of young girls worried sick of their dark skin and than they use skin whitening creams, which changes their dark color to white miraculously in just  5 to 7 days. After that, they are either shown as brides or receiving appreciations from opposite gender. Unfortunately these TV ads are now also playing with the psyche of males. They show that in order to achieve success ,to marry your dream girl/boy, to gain attention from your friends or to get a job, all you need is “fair skin”.

I look to a day when people will not be judged by the color of their skin, but by the content of their character.

(Martin Luther King)

This is a serious cause of concern for the human right activists with respect to the overt message of the ad and their false claims that a fair skin color is better than all other colors ranging from medium to dark, generating negative values in society, causing emotional distress and hurting the self esteem of both men and women. Recently a petition named “DARK IS BEAUTY” was filed against a famous Indian film star for unfair proclamation . This also raises many questions on our country’s existing advertisement law and consumer protection law which aims to provide customers with COMPLETE protection.

I do agree the messages are quiet catchy indeed, but is the risk of getting a white skin worth it. What they don’t tell us is about the hidden ingredients in it, their side effects and stories that how people are suffering from continuous use of these products.Long term use of any skin whiteners can cause severe pigmentation in areas where you apply it daily.The skin thins out and the area specially around the eyes can have increased pigmentation leading to bleach panda effect. Skin whitening creams usually contains active ingredients such as steroids,mercury and hydroquinone.

“Unfortunately, many skin-lightening creams contain illegal compounds that can damage your health .The most common compounds are high-dose steroids.” (Indy Rihal of the British Skin Foundation).

Steroids although are useful when used in specific concentrations in  skin diseases such as eczema and psoriasis but when used for skin lightening purpose they can cause many side effects such as;

• permanent skin bleaching
• thinning of skin that causes exposed cappilleries and stretch marks
• uneven colour loss, leading to a blotchy appearance
• redness of skin
• intense irritation
• photo sensitivity reactions
• high blood sugar ( yes!! due to steroids)
• increased facial hair growth

Another chemical which is found abundantly specially in local/ household manufactured skin lightening creams, soaps and mascaras  is Mercury. Mercury inhibits the formation of melanin thus lightening the skin but, it is extremely poisonous. World health organization in its report on Mercury in skin lightening products reported that

“Mercury in cosmetics exists in two forms: inorganic and organic. Inorganic mercury (e.g. ammoniated mercury) is used in skin lightening soaps and creams. Organic mercury compounds  (thiomersal [ethyl mercury] and phenyl mercuric salts) are used as cosmetic preservatives in eye makeup cleansing products and mascara”

The type (most hazardous is the organic form ) and concentration of mercury being used is so high that it can directly absorb from skin into blood stream and cause severe side effects The main adverse effect of the inorganic mercury contained in skin lightening soaps and creams is kidney damage.Mercury in skin lightening products may also cause skin rashes, skin discoloration and scarring, as well as a reduction in the skin’s resistance to bacterial and fungal infections.Other effects include anxiety,shyness, depression or psychosis and peripheral neuropathy.

“Exposure to mercury can have serious health consequences, It can damage the kidneys and the nervous system, and interfere with the development of the brain in unborn children and very young children.” ( Charles Lee, M.D., a senior medical advisor at FDA)

The distribution and sale of mercury containing cosmetics is banned in many European countries and FDA allows mercury compounds in cosmetics used around eye area at concentrations at or below 65 mg/kg expressed as mercury (approximately 100 mg/kg expressed as phenyl-mercuric acetate or nitrate).All other cosmetics must contain mercury at a concentration less than 1 mg/kg. There is a need to raise public awareness regarding this matter. Health authorities have to play their role in changing the status of fairness creams from OTC products to strictly prescription only skin products so that its sale and usage can be monitored.

So all of you skin color, clarity and complexion conscious people out there first of all  ” YOU ARE ALL BEAUTIFUL!! “ . Second before buying any product please read the ingredients and if it claims to contain “steroid” “mercurous chloride,” “calomel,” “mercuric,” “mercurio,” or “mercury,” do not buy it and if you are using it than stop using them immediately. If there is no label or no ingredients are listed or is in a foreign language that you can not understand do not buy it. Because you are “WORTH IT” and you deserve to know that what is the magic behind the cosmetic products. So next time before you buy any fairness creams ask you self this question

“Is the manufacturer of this fairness cream really fair ?? and is the risk of getting a lighter skin tone worth it? “

By

Mishal

Nowadays the common issue in our society is depression, being too much fed up of a situation or being unhappy. We assume that our situation will never improve and that the happy sun will never rise. We have to pass the painful time of waiting, not even sure what to expect and in the end we simply give up, we  give up on our hopes, dreams, joys and all the immense opportunities that life has to offers. And then often at times when we least expect it, just like Cinderella’s story in which at the last moment the shoe fits her foot and the story gets a happy ending, thing changes for good and everyone get a happy ending to their situation.

“The world is full of hopeful analogies and handsome, dubious eggs called possibilities”

(George Elliot)

The sun rises and brings with it so many opportunities, if only one could realize and see it. Each and every day has that special moment in it to change the way we think or feel.  Often we don’t realize it, but it may hit us in an instant in which we do our daily chores or it may land in the darkness and quietness of night. But that moment does come, but is felt seldom. That moment has the power in it to change everything around us. For some it comes with new dreams and for others with possibilities on how to achieve them.

But most of us rarely put attention in our everyday life. We have become so  much engage in our daily routine thinking that what we are doing is going to bring a change and not realizing that in fact  our routine has been molded into some sort of a shape and has become something like that of a ritual. We hardly do anything  different.  Each and every day we just miss our moments, our special moments, thinking that it hasn’t arrived today assuming that it might never come and that today is just like yesterday just as yesterday was like that of the day before yesterday.

We do realize that we are in depression but do we really even for a second think about it that why we really are in depression?? Is it even worth it?? What do we really do if we want to achieve something, when we don’t even dream on how to plan it out? We stay unhappy for a single reason that’s bothering us and in that we miss the million things that can make us happy in an instant.

If we could just grab that special moment. These special moments have the power not only to transform dreams into realities but also to make one happy. These special moment is just “ time” , time to sit and ponder and realize that no one can really make us happy or unhappy, no one can really crush our dreams, that it’s up to us, we are in charge of channeling our thoughts.

To see that if Allah can make the sun rise from east, He can also make things better and then leaving everything on Him to patiently and waiting patiently to witness as the magic happens. To have faith that whatever happens, happens for a reason and one day that reason will be apparent and clear and will make perfect sense.

“Pray for what you want, but work for the things you need.”

(Sufi Proverb)

Yes life is going to be difficult, we are going to suffer, but one should always be as much hopeful as that of a person who hears the sound of a train on the platform of a deserted area. Without sufferings hope will never have its full glory, without sadness, no one will ever appreciate happiness and without bad times no one will ever realize importance of good times. If you are going through a tough time be sure that good time is in store for you waiting for you around the corner all you have to do is to look for those special moments in your life that has the power in it to change everything in a blink of an eye and one day you will look back at your life with pride and will say to your self proudly that you did it!!

“Sorrow prepares you for joy. It violently sweeps everything out of your house, so that new joy can find space to enter. It shakes the yellow leaves from the bough of your heart, so that fresh, green leaves can grow in their place. It pulls up the rotten roots, so that new roots hidden beneath have room to grow. Whatever sorrow shakes from your heart, far better things will take their place.  ”                                                

    (Rumi)

By

Mishal

Winters for some ,a relief from the scroching heat and for most an excuse to become couch potatoes. Seasonal affective disorders are common and one of which is most common is Winter depression also known as “winter blues”. Deprsession, mood swings, loss of energy, social withdrawl, oversleeping, lack of interest in activities are all associated with it.

The main cause behind it is a hormonal imbalance of Serotonin (hormone that regulates mood, deficiency of which  results in depression and over production causes mania) and Melatonin (sleep inducing hormone). Due to low temperatures, long nights ,shorter days and lesser sunlight, the balance between these hormones gets disturbbed resulting in depression. As serotonin is released in light and daylight diminishes early in winters, the level of this hormone lowers in the body. This also lowers immunity level and makes us prone to cold and flu.However the levels of melatonin increases- also due to diminishing daylight- and causes feeling of exhaustion and depression which can be there for few days or for the entire winter season.

Michael Terman, director of the Center for Light Treatment and Biological Rhythms at Columbia University Medical Center, notes that winter depression is often spurred by waking up in darkness rather than light, which affects your body clock in a way that he calls “depressogenic.” Paradoxically, then, this means that the end of daylight saving time may initially help those who suffer winter depression, because turning the clock back means it will more likely be light out when you wake up.For people who are prone to the winter blues, Terman suggests trying light therapy. Exposure to bright light, especially upon waking up, has three major positive effects that can relieve depression,

• It keeps the circadian clock in check, preventing it from drifting later than your desired, or workday, sleep period.
• It’s an energizer that gives a morning boost, whether you’re depressed or just sluggish.
• And it has direct antidepressant properties, stimulating the same neurotransmitters (serotonin) as antidepressant medications.

Beating the winter blues is easy and simple there are many things that one can do to combat it. Expose yourself to light by getting up early in the morning and basking in the sunlight for some time. Those who suffer from major depressive disorder may take light therapy indoors. Get more sunbaths, try to sit  near the windows when in resturant or bus, changing your home bulbs to full spectrum also helps.

What we eat has a huge effect on how we feel, so eat healthy. avoid all the refined food items so eat fresh seasonal fruits and food that has good complex carbohydrates like brown rice and multi grain bread.Beware of sweet things, addiction to them is real and can lead to weight gain.

Wear bright vibrant colours like orange, red, purple they help to cheer up and stimulates your energy levels. Wrap up yourself in warm colours like burgundy, black and brown. Go on shopping for buying winter clothes and acessories you wont even feel guilty afterwards for  shopping too much because afterall its essential for winters and also to look trendy and stylish. This way you will be forcing yourself outside hence exposing yourself to sunlight.

Hang out with your friends, make plans for the weekends. A reason for converting the mild depression in to a moderate or sometime sever is because been isolated and nonsocial. So hanging out with your buddies and geting back in your social circle will definitely lift your mood.

Excercise, not only to stay fit and healthy but also to relieve stress. Join a gym or the best way is to go out for jogging. This also increses the release of serotonin and help in decreasing depression level. However, take precautions during exercise through temperature management. If you take out your woolen clothes after exercising, this may cause severe joint pain. So always wear clothes in layers and before leaving gym, wear your woolens.

Most of us want to sleep a little bit more during the winter. But with all we have going on, sometimes sleep is the first thing to go. With a little time management, and some self-discipline, you can meet your shut-eye needs. Aim for 7-8 hours each night, and try to keep your bedtime and waking time consistent. That way, your sleeping patterns can normalize and you’ll have more energy. Try not to oversleep—those 12-hour snoozes on the weekend can actually make you MORE tired.

And last but not the least try to stay relax and happy. As Anton Chekhov said;

“People dont notice whether  its winter or summer when they are happy “

By

Mishal

WHAT IS OUR ROLE AND RESPONSIBILITIES ?? WHAT ARE WE SUPPOSED TO DO?? HOW DO WE MANAGE A PATIENT, WE HAVE NO PRACTICAL TRAINING !! 

Those of us who step in the field of clinical pharmacy, with the vision of saving lives, doing therapeutic drug monitoring, monitoring patients lab report, preventing an adverse drug reaction, working in poison control centers  etc very soon start realizing that not only doing your duty is difficult but is also impossible!! Questions will be raised as to why are you doing this? On whose authority have you been allowed to do this? Where is it written that you are even allowed to do this??

Well I have a GOOD NEWS!! The answer to all these questions are possible now. Punjab Government has recently issued an official notice to all the teaching hospitals of Punjab on the subject of establishing pharmacy services in hospitals, It emphasizes on the importance and role and need of clinical pharmacist and I quote;

“The role of clinical pharmacist is dire need of the day to provide better patient care”

According to this notice the pharmacy services are defined as;

“Pharmacy Services means services rendered by pharmacist in pharmaceutical care, selection, posology, counselling, dispensing, use, administration, prescription monitoring, pharmacoepidemiology, therapeutic goods information and poison control, pharmacovigillance, pharmacoeconomics, storage, sales, procurement, forecasting, supply chain management drug utilization evaluation,drug utilization review, formulary based drug utilization and managing therapeutic goods at all levels including pharmacy, clinic, medical store, hospital or medical institution.”

The pharmacy services on urgent basis are to be implemented in all the hospitals and the treat isn’t over yet. According to this official order Pharmacy department shall be established in each health institution wherein pharmacy services will be provided to the patients.

Six months paid clinical pharmacy training programs  in the hospitals will be arranged for graduate pharmacist.The number of pharmacists has been increased  in hospital as minimum of one pharmacist for fifty bed for each shift.  

Pharmacy and therapeutic committee shall be established in each hospital and will be made functional. Each and every hospital will have to make a formulary. A separate column on the patients chart will be printed for ward notes by the clinical pharmacist. The clinical pharmacist will be deputed in the wards ,where during the ward round with the professors/ physicians and hospital administration shall be mandatory.

Digital pharmacy services such as computerization of inventory, introducing IT facilities such as drug information system like Micromedex and poison control software and a uniform inventory software will be introduced.

The pharmacy department will act as an independent department of the hospital, Adverse drug reaction  reporting system will be establish and in case of an adverse drug reaction the hospital administration will have to be notified immediately. WHO guidelines of storage and distribution of drugs will have to be strictly followed. A proper storage area will be established with temperature and humidity control facilities.

This my dear friends is a golden opportunity for Us to prove that we are in fact the back bone of patient care and an important pillar of health care system. Our goal should be “FASTER,HIGHER,STRONGER” i.e providing fast, efficient and timely pharmacy services to all the patients, with our involvement the standard of patient care should be higher than before and overall the healthcare system should get stronger and better. One of the most important thing is to bear in mind that we have to work in collaboration with physicians and nurses, by following and adopting the multidisciplinary approach, we are all equal, neither we are superior nor inferior. For ultimate patient benefit we will have to work as a team because after all ;

“PHARMACY IS A LIFE SAVING PROFESSION “

By

Mishal

At some point in life sooner or later we all face challenges, adversity, problems, failure and hardships. Hard times will be there for days and weeks and months and may be years. It becomes so difficult  for us to believe that these hard times will ever pass and the way out of it becomes hard to even visualize.

The challenges in life are what makes us stronger and a better person to handle the next round of hard times. If life were easy, what is the whole point? If everything is in our reach then no one would have aim for the  moon in the first place.

“WHEN THINGS ARE BAD, WE TAKE COMFORT IN THE THOUGHT THAT THEY COULD ALWAYS BE WORSE. AND WHEN THEY ARE, WE FIND HOPE IN THE THOUGHT THAT THINGS ARE SO BAD, THEY HAVE TO GET BETTER”

( Malcom S. Forbes )

Difficult and hard times are free of charge lectures ,at the end of which you come out as a strong, determined , capable and a much better person. The strongest steel is forged from the hottest fire, the more heat it faces the stronger it gets. Everything in this world faces adversity, even a tiny seed, a tree, a bird or a butterfly!!

To each and every problem there is always a solution, problem itself asks you ” What do you want from me now?” and before giving up and loosing hope always remember this simple fact “THIS TOO SHALL PASS”

It is said an Eastern monarch once charged his wise men to invent him a sentence, to be ever in view, and which should be true and appropriate in all times and situations. They presented him the words: “And this, too, shall pass away.” So happy times or worst times ,its TIME and time never remain the same. Here are some simple suggestions that might help you to pass through the hard times.

Stop considering your self as a victim , if you start asking yourself “Why Me”  you will eventually build up an idea that may be this life is what you deserve and you will be wasting your time which you could have spend on moving forward and trying to figure out a way out. Instead of thinking why this is happening to you, think how to get out of this situation.Always keep in mind that adversity and hardships causes some people to break and some to break records, so focus on breaking records.

“THE WORLD BREAKS EVERYONE, AND AFTERWARDS,SOME ARE STRONG AT THE BROKEN PLACES.”
(Ernest Hemingway)

No matter how big the situation is, its always something that you can handle. Never think of your problems as huge monsters that can not be dealt with. Never exaggerate your challenge. If you want to free yourself of misery and pain than evaluate your problem, either you will come with a simple solution or the problem itself will get fixed.Often when we look at ourselves in the mirror, we wonder “How the heck did I make it through that?” It’s that little thing called SURVIVAL…..More times than not…you’ll be ok and end up stronger than before after all “WHAT DOESN’T KILL US MAKES US STRONGER”

“EVEN THE DARKEST NIGHT WILL END AND THE SUN WILL RISE”

(Victor Hugo)

Always have faith and patience. Stop worrying all the time and trust that Allah is watching and that He has better plans for us.

“WHEN WORLD PUSHES YOU TO YOUR KNEES, YOU ARE IN A PERFECT POSITION TO PRAY”

(Rumi)

Always keep smiling, which I know is the most hardest thing to do in difficult times, but it has many benefits. It not only decreases the negative feelings but also avoid you an explanation to other asking “what is wrong? Is everything Okay?? ” Surrounding your self with positive people also help. Being continuously surrounded by negative people who will listen to your problems and pain without any positive interest at heart will make your situation much more worse. Instead of pouring your heart out to negative people wait to share it with those who not only will understand but will help you to get through bad times.

(Jessica Biel)

Don’t hold your thoughts, keeping your thoughts and not sharing it with others will effect your health both mentally and physically. Sharing your problems with others, letting it all out help to decrease a pressure from your chest, the listener might not be able to give you an advise on the whole situation, but it surely gives you a chance to see your problems from a different angle.

And finally give yourself time to heal, spend some time alone  before getting back in action to face the world. There is no need to be super powerful and be in  “I’M OKAY” phase all the time.Don’t rush the healing process, as old wounds open easily. Take time to yourself to think and process what you have just been through. If you rush back out into the world and move too quickly there are a lot of chances that you  will fall apart at the seams and be right back where you started emotionally.  If you’re not healthy emotionally, you won’t be physically either.

“THE BATTLE OF LIFE IS, IN MOST CASES, FOUGHT UPHILL; AND TO WIN IT WITHOUT A STRUGGLE WERE PERHAPS TO WIN IT WITHOUT HONOR, IF THERE WERE NO DIFFICULTIES THERE WOULD BE NO SUCCESS; IF THERE WERE NOTHING TO STRUGGLE FOR; THERE WOULD BE NOTHING TO BE ACHIEVED” 

(Samuel Smiles)

By

Mishal