Pioglitazone a controversial drug

Pioglitazone is an oral drug prescribed to patients who suffer from type 2 diabetes mellitus. It reduces the volume of sugar level in blood. Insulin is a hormone that stimulates cells to remove glucose from the blood. People suffering from type 2 diabetes cannot make enough insulin due to which level of blood glucose remains more than normal & the body’s cells respond less to the insulin that gets produced in the body. Pioglitazone acts as an insulin sensitizer & enables cells to become more sensitive to insulin. This helps in discarding more volume of glucose from blood & this drug also lowers the glucose level in blood.

It’s believed that people who consume this drug have increased risk of heart failure, blood cancer & osteoporosis. India had suspended this drug on 18^th June 2013; however this suspension was only temporarily & soon revoked on 31^st July 2013.

Ambrish Mithal, an expert & head of the endocrinology & diabetes department at the Medanta hospital in Gurgaon had said ‘It's grossly overused in this country.’ Chandra Gulhati, editor of MIMS India, states ‘The sales data show that fixed-dose combinations of pioglitazone with other antidiabetics are top-selling in the country. That indicates the drug is being overused & is being used as first-line treatment,’

Annual sales of fixed-dose combinations of pioglitazone with metformin & glimepiride are around INR5 billion. An article published in Times of India by Rupali Mukherjee dated  Jun 27, 2013, 05.16AM IST shares that pioglitazone & its combinational drugs have Rs. 700 crore market in India.

France has already put a stop for selling this drug.

Currently this drug is sole with warnings that the drug cannot be used as a first-line treatment for type 2 diabetes.

Reflections: -

In my opinion Indian Government just wants the health industry that includes hospitals, pharmaceutical industry to boom. Pioglitazone in combination with other anti-glucose drugs has a very big market around Rs. 700 crores that’s why the suspension was revoked. It may sound pessimistic however I don’t hesitate to state that the Government just wants diabetic patients to suffer more from bladder cancer, heart failure & osteoporosis. If people will suffer due to these diseases then they’ll consume more medicines for bladder cancer or heart problems or osteoporosis. This will help the pharmaceutical industry to sell more drugs & eventually boom. If pharmaceutical industry will boom then Government will get more value added tax which it collects from medicines. This will also help people to visit hospitals more times & will help the hospitals to grow. Most of the hospitals are owned by business corporations & thus their business will grow & thus government will eventually make more money from taxes. Many people may die due to bladder cancer & heart failure & that will improve the death rate.

As a Pharmacist I’ve found that most of the diabetic patients consume piaglitazone drug in combination with other drugs. In India due to illiteracy & unawareness most of the people don’t do any survey, search & research about the medicines that they consume. Majority of Indians understand medicine by its brand name & its ingredients or composition remains unknown to them as they never read it. In India onetime doctor consultancy fee is high & due to that patients just get the medicines prescribed from doctors once & keep consuming those medicines without further follow up. In this way doctors don’t get proper feedback from their patients & they continue to prescribe the same medicines.

Many times Pharmacist isn’t the person that dispenses the prescribed medicines. Most of the time medicines get dispensed by normal people who work under pharmacists & these people have little awareness about the toxic effects of this drug & hence they don’t discuss it with the consumers.

Diabetes can’t be treated however it can be controlled & for controlling it one has to consume medicines regularly. Indians have awareness about Homeopathic & Unani medicines. India’s Ayurvedic medicine formulation is also very rich. In case medicines have to be taken throughout life then one should rely on alternative medicines like Ayurveda or Homeopathy or Unani. These formulations have very mild side effects. One should also follow a healthy life style that includes eating a healthy diet, doing yoga daily, exercising regularly, meditating regularly & taking proper rest & sleep.

References: -

1. Mukherjee, Rupali. Govt bans popular diabetes drug and analgin. June 27, 2013. http://timesofindia.indiatimes.com/india/Govt-bans-popular-diabetes-drug-and-analgin/articleshow/20789831.cms (accessed November 14, 2014).

2. Omudhome Ogbru (PharmD). pioglitazone, Actos. http://www.medicinenet.com/pioglitazone/article.htm (accessed November 14, 2014).

3. Sachan, Dinsa. Indian U-turn on diabetes drug ban. August 16, 2013. http://www.rsc.org/chemistryworld/2013/08/india-u-turn-diabetes-pioglitazone-drug-ban (accessed November 14, 2014).

Child/children’s unhealthy eating habits affecting parent’s health

Children are found of eating fried, oily, salty, spicy, foods as they find it delicious. Most of the children who are physically active, play can digest such foods easily. Mostly children even have high metabolic rate compared to their parents. Children even like to eat out in restaurants; I’ve seen mostly children in their teens prefer to eat foods like Burger, Frankie, French fries, different types of chips, Pasta, Pizza, Chinese foods, Vada-Pav non-vegetarian foods, etc. Such foods can have high salt content, & high in calories. Parents don’t like to dishearten their child/children hence they take their child/children to eat out & they also eat the same. This habit generally goes on especially when child/children are in their teens. After that age they don’t prefer parent’s company & follow the same eating habits with their friends. Their parents who reach around 45 to 50 years of age while their child/children grows also may have consumed a lot of junk, oily food or foods high in salt. This lifestyle affects parent’s body as they consume unhealthy food which their child/children were found of. After becoming old it becomes difficult to change food eating habits & the mind keeps craving for rich western food. This can increases their weight & rise in weight can cause health problems like joint pain, blood pressure, cholesterol etc.

In my opinion parents should realise the significance of healthy eating & keep modifying their diet as per their age. They should understand that something that is suitable for their child/children to eat may not be suitable for them. When parents follow their child/children’s unhealthy food eating demands their child/children don’t realise whether they were eating wrong food & aren’t able to change their eating habits once they grow up. This can jeopardise their health. Thus parents should educate their child/children about healthy food eating habits & also eat healthy food as this can inspire their children & encourage them to eat healthy food.

Unexpected heart attacks rising

Now a days many people are getting heart attacks at an early age. This problem is rising in many developing & developed countries.

Heart attack isn’t rare amongst people who live a healthy life style like exercising regularly, don’t smoke, have normal weight & no cholesterol or diabetes. One of the unknown causes of early unexpected heart attack is high stress or tension frequently.

People who are in highly stressful or demanding jobs for long duration or who have a stressful family life or people who struggle daily to meet their needs are more prone to unexpected heart attacks.

Constant stress or tension for long increases cortisol in body. Cortisol is a stress hormone released by adrenal gland that constricts blood vessels. Persistent constriction of blood vessels affects the proper functioning of heart & this can cause heart attacks.

Unfortunately people who have stressful jobs or tension in family try to diverge their mind by watching a movie, going for a long drive, overeating, having stimulants like cold coffee, coffee, alcohol, etc. However such practices don’t do any good to the body.

People who suffer from constant stress shouldn’t hesitate to take help from a counsellor or a psychoanalyst or a psychotherapist or a psychologist or a clinical psychologist or a psychiatrist.

The 9 Avatars of Lord Vishnu & 9 Planets

The 9 Avatars that Lord Vishnu took represents 9 planets according to Maharishi Parashara.

Planets	Lord Vishnu’s Avtar
Sun	Bhagwan Shri Ram
Moon	Bhagwan Shri Krishna
Mars	Bhagwan Shri Narasimha
Mercury	Mahatma Buddha
Jupiter	Vaamana Avatar
Venus	Shri Parasurama
Saturn	Koorma Avatar
Rahu (North Node)	Varaha Avatar
Ketu (South Node)	Matasya Avatar

Planets Maturity age

Just like certain features of a human develop after a certain age, for example a child gets teeth after a certain age or a child starts speaking after a certain age similarly Planets in Astrology start giving their results to the fullest after a certain time from the time of a person’s birth & that is known as Planets maturity age.

The maturity age of 9 planets are mentioned below

Planets	Maturity after birth year
Sun	22
Moon	24
Mars	28
Mercury	32
Jupiter	16
Venus	25
Saturn	36
Rahu (North Node)	42
Ketu (South Node)	48