The health benefits of breakfast... that I miss every day

Breakfast schmeckfast, some of you may say. If you're one of the many breakfast poopoo-ers out there, you probably repeat your reasons why you skip out on a morning meal. Do you say "I don't have time!" or "I'm just not hungry that early"? Two words in response to those two quite common excuses: wake up!

When you shake your head "no" to an AM nosh, you also send a negative message to your body. Here's what you're telling it:

• Nah, I'd rather remain in a mental fog while my brain starves for energy it needs to raise my blood sugar levels that have dipped low while I slept.
• No thanks, I'd rather my muscles continue sleeping even though I have to muscle through a full day of work and responsibilities.
• I'll pass on the kind of nutrients that can help me deal with the day's stress.
• Nope, I actually prefer a slow metabolism. Oh, and throw in some mean cravings for sugar that will send me to the snack machine by midmorning.

Your body needs breakfast, whether you want it or not. Think about it this way: You've been asleep for about 8 hours, during which your body has been on a fast. At the same time, your body has also kept quite busy. You may have been horizontal, but your body worked quietly and diligently to repair the damage you'd done to it earlier in the day, rebuilding tissue and storing away energy in your muscles for tomorrow.

By feeding your body after you've gotten out of bed, you will have more energy and be more alert and able to concentrate, solve problems, handle stressful moments, and to get the physical activity you need to stay fit.

You're also more likely to get your fill of the necessary vitamins and minerals for the day. Folks who eat healthy breakfasts regularly consume less fat and cholesterol on average. Breakfasters also tend to better control their weight and not give into bad-snack temptation. They also reduce their risk of developing insulin resistance, which can lead to diabetes, and have lower cholesterol, which can reduceheart disease risk.

So, what are the components of this must-have meal? A healthy breakfast should provide you with plenty of protein, fibre, and just enough fat to keep you feeling full for a few hours.

To meet those needs, fill your breakfast plate (or bowl) with:

• Lean protein: Protein provides that feeling of fullness that can sustain you until lunchtime without giving in to empty-calorie snacks or sugary sweets. You may think "meat" when you see the word protein, but you don't have to be a carnivore first thing in the morning if you don't want to. In addition to traditional but more fattening breakfast meats, like sausage and Canadian bacon, protein can be had in eggs and in low-fat dairy items like milk, nuts and seeds, and peanut butter.
• Low-fat dairy: Even that half cup of low-fat milk poured over a bowl of granola will supply about 25% of your daily calcium. But don't let your mind stall out at "milk on my cereal" when pressed for dairy options! You could also melt a slice of your favourite low-fat cheese atop a whole grain bagel and crown it with an antioxidant-rich tomato wedge. Reduced-fat cottage cheese or yogurt makes great grab-and-go options, or you can boost their flavour with a handful of blueberries or sunflower seeds.
• Whole grains: You could meet your whole grain quota with a bowl of oatmeal or cereal. Toast two slices of whole grain bread, roll an egg and a slice of low-fat cheese into a whole grain tortilla, or stuff a whole grain pita full of scrambled tofu. In a rush? Toss a few whole grain crackers and a few chunks of low-fat cheese into a baggie and go.
• Fruits and/or vegetables: Fruits seem a more natural match to breakfast appetites - bananas chopped into cold cereal, berries atop yogurt, apples chunked into oatmeal for crunchy texture, a cold glass of orange or mango juice. But there's nothing out there saying you can't fill a pita with stir-fried or steamed veggies and call it breakfast!

A special note about eggs: Eggs developed a bad reputation because of their cholesterol content. But they are a super easy way to start your day off with a protein punch. What to do? As long as you limit the amount of cholesterol you get from other foods, one egg per day is fine. As part of an overall low-fat diet, some evidence suggests eggs eaten at breakfast may even support healthy weight loss because they fill you up and keep you full for the same number of calories as, say, a bagel. If you are still concerned about cholesterol, then use egg whites, which contain no cholesterol.

by

Akshaya Srikanth

Published in MedHeallth

Changing role of pharmacists: Indian scenario

 The Indian pharmaceutical sector has come a long way from being an almost non-existent industry before 1970 to a prominent provider of healthcare products now, meeting almost 95 per cent of the country's pharma needs. The industry today is in the forefront of India’s science-based industries, with wide ranging capabilities in the complex field of drug manufacturing and technology. It ranks very high in the third world in terms of technology, quality and range of medicines manufactured. From simple headache pills to sophisticated antibiotics and complex cardiac compounds, almost every type of medicine is now made indigenously. Playing a key role in promoting and sustaining development in the vital field of medicines, the Indian pharma industry boasts of quality producers and many units approved by regulatory authorities in the USand UK. International companies associated with this sector have stimulated, assisted and spearheaded this dynamic development in the past 53 years and helped to put India on the pharma map of the world. Over the years, the industry has been gaining momentum worldwide.

Redefining the role of pharmacists

Pharmacists play a crucial role in any health system as they are responsible for providing solution related to medication. The rapid growth and diversification of the pharma industry, coupled with the growth of the health sector has thrown open a sea of opportunities for pharmacists. These emerging opportunities have prompted a deeper look into the human resources for the pharmacy sector. The spectrum of pharmacy profession in India is very wide, as it covers a myriad of opportunities in the pharma industry—R&D, manufacturing and retail, healthcare sector, pharmacy education and regulatory bodies. The current availability of pharmacists in terms of pharmacist to population ratio compares favourably with that in a developed country. However, the number of registered pharmacists does not reflect the actual number of pharmacists currently involved in pharmacy practice. The actual number is likely to be much lower due to migration, death, retirement, those getting into other areas of pharmacy profession such as industrial, regulatory, marketing etc.

The demand of pharmacists is further growing with the growth of the industry within the country and outsourcing from abroad. Among the biggest factors fuelling the growth are contract research for pharma R&D and contract manufacturing for global pharma companies. Associated with these are requirement of professionals with expertise in national and international regulatory affairs. The retail sector is witnessing growth due to entry of major retail chains. The growth of national healthcare spending to more than 12 per cent per annum will impact the availability, accessibility and the demand for drugs, which in turn will have a direct impact on the requirement of pharmacists. This will also have an impact on the requirement of hospital pharmacists and those getting into the insurance sector. The shortfall in supply of pharmacists in developed countries such as the US, Canada, Europe etc and lucrative opportunities for employment will give rise to migration of Indian pharmacists to these countries. This will get a further boost with pharmacy institutions getting accredited by foreign bodies. These factors will push the demand for pharmacists.

Besides the demand and supply issues, there are several other areas affecting the pharmacy profession in the country. Pharmacists in India do not have any laid down norms on competencies and quality of services. Unlike many developed countries, there is no system of evaluating a pharmacist’s competency. Hence, the level of competencies and the quality of services provided are likely to vary among Indian pharmacists.

Pharmacists have the potential to fill the gap created due shortage/unavailability of doctors and nursing personnel in health facilities in rural areas. This can be achieved through a policy initiative to redefine the role of pharmacists in the Indian healthcare system so as to better utilise their capabilities.

Pharmacist in the society: Traditional vs modern role

The pharmacy profession is in its transitional state. The health care delivery pattern has been completely transformed and has acquired an all-together different image than what we have been observing traditionally. The present of pharmacy does not lie merely in dispensing of medication, but in the provision of relevant drug information and drug therapy recommendation to the people in the society.

Over a period of time, the pharmacy profession has greatly changed from being focused on managing the production and dispensing of drugs, to being primarily concerned with the safe, effective and appropriate use of medication and enhanced pharmacy services to patients. High technological advancement and information explosion have significantly raised the knowledge and quality level, due to which the pharmacists are now ready to shoulder bigger responsibilities with appreciable sense of sincerity and dedication. The role of pharmacists is now no longer a fixed and rigid one, but has been continuously changing and redefining its meaning and significance in the changing scenario, which is why the bond between a pharmacist and society is becoming stronger day-by-day and acquiring new dimensions.

Pharmacy, as a profession, has been able to make a room for it in the present day society. There are numerous reasons, which are responsible for greater impact and penetration of pharmacists into the societal network irrespective of geographical boundaries. Whether it is a metro city or a remotely located rural area, pharmacists are everywhere, discharging their duties to serve the humanity. The factors responsible for the influential role of pharmacists in the society may be summarised as below:-

1. Thrust on pharmaceutical care to patients - Pharmacists have begun to concentrate on patient care specifically after pharma care had been mandated as a patient centered practice model for pharmacy. Many pharmacists have found themselves challenged by a paradigm shift in their daily practices from product to the patient. Pharma care addresses the patient’s drug-related needs comprehensively through a scheduled outline of tasks, in which the practitioner makes sure that a drug therapy is appropriately indicated, effective, safe, and convenience. Shifting from a dispensing focus to a patient focus has been particularly challenging, which has included offering expanded patient counseling, immunisations, and medication-dependent disease management for persons with certain chronic conditions. Pharmacists are now covering a wide range of clinical and management functions like tracking adverse drug effects, participating in programmes to reduce medication errors, monitoring patients’ compliance with medication use, and conducting medication management programmes.

2. Redesigning the medication-use system - Pharmacists have taken into consideration the need to 're-engineer the medication use system' to reduce preventable drug therapy–related adverse outcomes; to identify well-functioning models and to develop strategies to evaluate and implement additional models; and to encourage inter-professional collaboration. The task is not so easy and they may come across certain kind of problems like lack of patient medical information, patient confidentiality concerns, limited professional communication, multiple approved formularies etc.

3. Continuing professional development (CPD) - Today’s pharmacist believes that professional attitude is an indispensable tool to make the profession just as significant for the society. A pharmacist must maintain his/her competence and effectiveness by keeping up-to-date with changes in pharmacy practice and with relevant knowledge and technology. CPD has been able to bring the society nearer to pharmacists when there comes a question about society welfare.

4. Adherence to pharma code of ethics - Sticking to ethical rules has helped a lot to establish the pharmacy profession as a noble one among the society, and pharmacists are advocating the adherence to the pharma code of ethics more strongly and loudly in the present scenario.

5. Authentic source of pharma information - The information pharmacists give plays a vital role in providing relevant and up-to-date drug information to people as and when required.

6. Adopting new concepts - The changing global scenario has prompted pharmacists to adopt new concepts for the welfare of society. Such concepts include antibiotic pharmacist, retail pharmacist, academic pharmacist, pharmaceutical journalist etc.

Societal network: Enhancing penetration

The need of the hour is that the reflection of the extraordinary good work being performed by pharma professionals should reach the common man, and every segment of society should realise, experience and recognise the beneficial implications of such efforts for the well being of society. Significant strategies and alternatives may be to frequently organise exhibitions and pharmacy fairs for the general public, organise more discussions, talks, seminars and symposia and cover topics directly catering to the society's needs, adequately and appropriately publicise and advertised each and every mass-movement/societal mission launched by pharma professionals so that the rest of the society may also participate and contribute to them, and establish new Pharmaceutical Information Centres (PICs) throughout the nation to impart information about significant pharmaceutical activities to the society.

Education 'wise'

As it has been proposed that chemist shops should have a graduate pharmacist, the existing diplomas should give pharmacists an opportunity to upgrade their knowledge and skills to the level of graduate pharmacists. This task can be undertaken by securing seats in degree courses for those who opt for regular programmes or by developing specifically designed long duration, part-time programmes. Going by the experience of several countries, pharmacy technicians or assistants will be required to assist graduate pharmacists. Therefore, the existing diploma courses should be re-oriented for pharmacy assistants with reduced duration of training. The existing institutions conducting diploma courses should be given the option of upgrading to degree courses or to conduct technician/assistant courses in a phased manner.

In order to cater to both industrial and healthcare aspects of pharmacy, graduate level courses should be separated as B Pharm–Industrial and B Pharm-Healthcare. The curriculum should be re-oriented to fulfill practice requirements in both industrial, as well as healthcare settings.

There exists a mechanism to regularly monitor infrastructure, manpower and other critical inputs for delivering quality education and training, however, Pharmacy Council of India (PCI) and All India Council for Technical Education (AICTE) need to strengthen the implementation of the monitoring mechanism. There also exists a system of teachers training and skill enhancement to develop teaching faculty for short and long-term requirement implemented by AICTE and University Grants Commission (UGC). However, it should be ensured that all teachers in the pharmacy sector should undergo training and skill enhancement on a regular basis. The PCI should initiate measures to make Continuing Pharmacy Education (CPE) programmes mandatory for all practicing pharmacists. This should be linked to periodic renewal of license for practice. PCI should also develop accredited CPE programmes at select centres. The involvement of professional bodies associated with pharmacy besides the PCI will be crucial in establishing and sustaining CPE activities on a long-term basis.

Demand, supply and existing numbers

The government should institute a comprehensive study to map out the existing pharmacy manpower in the country. This data will help in understanding the existing manpower and plan future human resource development. PCI should undertake a drive to update the practice status of registered pharmacists.

Further, licensing should be made compulsory and should be renewed every year or every two years. The renewal would be granted on the basis of certain minimum level of CPE undertaken. This, when enforced strictly, will also help in maintaining and updating data on workforce status in the pharmacy sector. This will help in maintaining an active register of practicing pharmacists.

The orientation of pharmacy courses based on feedback from the industry and health sector professionals should be undertaken on a continuous basis. Promoting affiliation with foreign institutions will also help in updating the curriculum and bringing it to international standards.

PCI should undertake educational planning in order to promote setting up pharmacy institutions in underserved areas so as to remove regional imbalances.

Setting benchmarks

There is a need for establishing benchmarks for availability of pharmacists in different areas of practice, for example, community pharmacists vis-a-vis population, hospital pharmacists as per number of beds etc. This will help in forecasting the future demand. There is also a need for benchmarking performance parameters for services and competency of pharmacists. These benchmarks should be publicised so as make people aware regarding expectations from a pharmacists. This should be supported by a system of monitoring and audit.

Indian healthcare is witnessing a rapid growth and managing the human resources to support this growth will be very critical. The pharmacist is a key component of healthcare and touches patients at every level, from high ended hospitals to the doorstep, where they provide medications in the community. Further, many of them work behind the scenes in areas such as drug research, drug distribution, in regulatory, and teaching and training roles. In order to cater to the growing demand for quality healthcare services in the country, there is a need for concerted efforts from all stakeholder to promote community practice and change peoples perception of a pharmacist from being a trader or shopkeeper to that that of a true health professional as in many developed countries. The pharmacy profession is proving itself as the backbone of the society as far as health aspects are concerned. Pharmacists are establishing new standards of pharma care and redefining their role towards the society. The impact and influence of pharmacy profession has never been recognised and identified so significantly as it is today. The entire credit goes to pharmacists who are now more aware and concerned for the welfare of the society, adopting modern concepts and professional attitude, but not at the cost of pharma ethics, and thus, have been able to penetrate the society, maintaining the traditional sanctity of pharmacy profession.

MENSTRUAL BLOOD BANKING: Scope and Future:

Till date women have been discarding menstrual blood as an unwanted and unsanitary waste. However, a new research has found that menstrual blood is a rich source of stem cells that have the ability to multiply and differentiate into any kind of cells.

Earlier, blood from umbilical cord was regarded as the ultimate reserve for stem cells. Only those who have given birth at anytime of their life were able to preserve the stem cells as they were obtained from umbilical cord. But researchers have now discovered and successfully harvested stem cells from menstrual blood making it possible for all the women including those who have never given birth to preserve stem cells for themselves. The discovery of stem cells in the menstrual blood has given a new meaning to menstruation for women who earlier considered menstruation as nothing but a painful and necessary evil. 

Stem cells have the unique quality of differentiating into any type of cell. As these cells are immunologically immature in nature, they are able to contribute successfully in the cell survival after a transplant. Researchers have harvested stem cells from menstrual blood under laboratory conditions and the harvested cells were successfully differentiated into nerve cells in vitro under lab culture conditions that were controlled. When the differentiated cells were infused into an animal model of stroke, these cultured stem cells reduced behavioral impairments in the stroke model. 

Source from cellecell by Akshaya Srikanth

It is now established that endometrial wall of the uterus has unique quality of regeneration. There is a thick growth of blood cells which are dispelled every month and the uterus prepares a new endometrial lining and prepares itself for pregnancy. The shed blood contains varied cells some of which have regenerative properties. Researchers tried to find out the practicality and feasibility of collecting menstrual blood in order to harvest the stem cells. They performed several types of analysis of the shed blood and found that these cells can not only be harvested but they also differentiated into specific cells like cartilage, neural tissue or adipose tissue. When menstrual stem cells were induced to the adipogenic lineage, chondrogenic or osteogenic lineage, they displayed histological characteristics such as the presence of fat vacuoles in adipocytes or calcium deposits for bone. 

The Menstrual stem cells (MeSC’s) have a great importance for clinical translation of regenerative therapies. The studies demonstrate that these are a unique population of cells that can be safely isolated and can provide us with an expandable source of stem cells from women until they reach menopause. Considering their relevance and importance in treatment of rare diseases including certain neuro disorders, it becomes crucial for women to preserve their menstrual blood in the Menstrual Blood Bank. 

Menstrual Blood Banking enables women to store their menstrual blood under required conditions and preserve it for future. These banks charge minimal annual fee for storage and preservation and allows you to have lifelong benefits from them. Although Menstrual Blood banking is still new and lot of research is still going on menstrual blood, if its benefits are utilized, it can prove to be very beneficial for all women who want to give themselves the gift of good health. The process for collection of menstrual blood is simple; like tampon, a silicone cup is inserted in the vagina on the day of heaviest flow. The cup needs to be placed inside the vagina for at least three hours so as to collect approximately 20 milliliters of blood. This is then poured in the collection kit and is sent back to the menstrual blood bank laboratory where it is processed, frozen and stored. What makes this method user friendly is that it is completely painless and non invasive. Also, any woman who wants to preserve stem cells for future can do so without having to wait for delivery of baby. 

Menstrual Blood Banking has a wide scope as the need for regenerative therapies incorporating cells that can engraft and differentiate is vast. Though Menstrual Stem Cell technology is yet to be utilized in human treatments and therapies, the research has established the beneficial properties of these cells and their potential use in treatment of several medical conditions like atherosclerosis, diabetes, stroke, rheumatoid arthritis, Parkinson disease and many more. Alongside, menstrual blood can overcome the problem of immune rejection during the transplant, allowing the female patients to use their own stem cells for the treatment. Thus, it can be said that Menstrual Blood Banking has a vast scope in future and is the next big thing in the medical world. 

Reference: Multipotent Menstrual Blood Stromal Stem Cells: Isolation, Characterization, and Differentiation by Amit N. Patel, Eulsoon Park, Michael Kuzman, Federico Benetti, Francisco J. Silva, and Julie G. Allickson.

by

Akshaya Srikanth,

Pharm.D Internee