Horace Greeley said once, “Common Sense is very uncommon!” This is all about the recently published interim report of the extended solidarity trial published in NEJM on 2 December 2020.
The article “Repurposed Antiviral Drugs for Covid-19” reported that antiviral drugs (hydroxychloroquine, remdesivir, lopinavir, interferon) failed to win the race when compared to the placebo, in an assigned group of patients. WHO does not trust drugs like ivermectin, Doxy etc. Many senior microbiologists, intensivists would laugh it out arguing that these drugs would only help in controlling parasitic infestations. Harrington et al., therefore, appropriately chose a title (“A Large, Simple Trial Leading to Complex Questions”) for their argumentative editorial. They wrote- “No intervention acts on two persons in an identical fashion: patients present with different risk factors, are treated in different health care settings, and begin treatment at different stages of illness. In particular, the effectiveness of an antiviral agent can depend on whether a patient presents early (during viral pathogenesis) or later (when immunopathologic conditions or other complications may be more important).” They also pointed out the usefulness of the result of the ‘solidarity trial’ in denying the role of antiviral agents in patients who have entered the second phase of illness described as the cytokine storm. Rightly, they asked “what is a more effective timing for the use of remdesivir, and should it be used in combination with other agents? How is the course of hospitalisation affected by the type and level of care delivered in particular settings?”
This is the question of common sense: why not to use an antiviral agent when the virus is replicating? What role can they play once the war for life has entered a phase where the virus itself has been cornered?
This is the argument extended in the recovery trial against an early use of steroids, so that, not to time it with the viral replication phase. The results of the Recovery trial, however, support the use of the steroids in the late 1st and 2nd week when evidence of lung involvement is evident by rising oxygen requirement and falling SPO2 <95%. In various articles, it has been shown that viral replication in the upper respiratory tract, to a larger extent, is immunologically inert. Once the virus climbs down to the pneumocyte type II cells, its pathological journey starts and gets reciprocated by the dysregulated immunological response sequentially leading to diffuse alveolar damage, inflammatory infiltrates, microvascular thrombosis resulting in a simulating picture of adult acute respiratory syndrome. No wonder, classical findings of rising levels of interleukins 10/6, TNF α, evidence of lymphocyte exhaustion and lymphopenia, come almost hand in hand.
Drugs like Doxycycline and Ivermectin have been used rampantly in every nook and corners of northern-western India. Interestingly, ICMR is playing once bitten and twice shy. Because India was the first country that boldly adopted HCQ prophylaxis and was thoroughly criticised by Americans. The criticism came in the wake of deaths reported in Covid patients receiving HCQ. The analysis says, HCQ and also azithromycin are the potential drugs that may adversely affect the conduction system; at least 60-70% of patients with late-phase Covid, may have myocardial edema, making them a substrate for arrhythmia. Cautious use is needed. It is the CDC that allows almost no medicines in the first week of illness. India has improved in its recovery rate, remarkably from 60% to 95%. How? I keep on talking to many of my friends who were partying hard, and one after another, the whole group became Covid positive. They consulted a local physician and got a prescription of Ivermectin 24 mg, Doxy 100 mg twice a day, Zn, vit D, vit C and even favipiravir, as soon as the report was received, and recovered completely. Many patients presented with anosmia. Those who were treated with the Ivermectin, recovered within 7-10 days. I came to know about this in March but experienced it now when I became Covid-19 positive. Globally, people are experiencing good results of ivermectin use.
Therefore, there is evidence that many repurposed antivirals, antiprotozoal, anti-bacterial drugs have hidden talents to combat Covid-19 at least partially. These drugs are less harmful when one compares them to the 5-10% chance of having serious lung, heart, kidney and brain complications. Probably they need cardiac care, LMWH or antiplatelets, statins for a longer period. In nutshell, patients who recover the second or third phase, obviously are not the fittest to survive.
Jeon et al wrote, “Among the 48 drugs that were evaluated in our study, 24 drugs showed potential antiviral activities against SARS-CoV-2, with IC50 values in between 0.1 and 10 μM, few of them are as follows- tilorone, cyclosporine, chloroquine, mefloquine, amodiaquine, proscillaridin, salinomycin, ouabain, cepharanthine, ciclesonide, oxyclozanide, anidulafungin, gilteritinib, berbamine, ivacaftor, bazedoxifene, niclosamide, and eltrombopag.”
It is common sense that the first 5 days are of viral replication and subsequently a 10% chance of having an immunological vicious storm. Conversely, it is logical to use repurposed antiviral drugs when the virus is replicating and steroid only when the body is brewing cytokines, to bring a storm and lymphocytes in the backfoot.
Vaccines are illusionary, in view of the fact, the duration of trials has been accelerated too fast. Tinkering with the immune system is always a double-edged sword. Oral Polio was introduced in the 70s and fear was expressed about its association with autism. It took >20 years to convince the government in the US. Till now, the flu vaccine is not considered the safest and efficient vaccine for various reasons. We must remember that natural infection has failed to ensure long-lasting immunity. There are articles suggesting that the virus may co-exist with IgG in patients asymptomatic or mildly symptomatic patients.
The writer is a Pediatric cardiologist, Manipal Hospital, Delhi.
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What Does Different Angel Numbers Mean For You In 2022?
Angel numbers have repetition or a sequence in them (222, 333, 4444, 2323). These are used in numerology like tarot card readers, and astrologists use other specific tools. According to numerologists, they convey a special divine message to an individual that you are on the right track.
If you see some series of numbers repeatedly, usually in a pattern of three, it might not be a coincidence but a sign from the spiritual realm. These signals have the power to transform your lives. They are a way angels communicate to us. They can show up as license plate numbers, receipts, house numbers, prices, phone numbers, bank account numbers, etc.
They don’t inevitably come from your birthdays like your life path number. Angel numbers are distinct from what is known as your life path number, which you can obtain by taking your birthday—month, day, and year—down to one number. For example, a birthdate of August 15, 1989, would take 8, 6 (1 +
5), and 9 (1 + 9 + 8+ 9= 27, followed by 2 + 7) to get a life path number of 5 (8 + 6+ 9 = 23, followed by 2 + 3). But if you see your birthday angel numbers, it means the angels are sending unique messages to you and want you to connect to them.
What to do when you see an angel number?
Always take a numerology analysis when you see an angel number. Just feel lucky and think that the message is designed specifically for you. So take it personally and be open to the signals in the future. Give your feedback and be an active participant. Try to track your progress in a diary and keep writing the numbers you are seeing.
What are the meanings of different angel numbers?
Different angel numbers have varied meanings and can be seen in numerous combinations. Let us have a look into the meanings of various angel numbers one by one.
- 666 Meaning (Reflect)
666 angel number tells you that something is distracting you from your goals. You need to re-focus and realign your energies. Something is not visible to you right now, but if you look at the bigger picture, you will be able to understand what you are missing.
- 000 Meaning
It means that new opportunities are on the way. Secondly, you have to be careful of toxic people around you. You just have to focus on the good energy and stay away from negative thoughts. The angels are with you.
- 111 Meaning (Intuition)
It signifies new beginnings. Some new chapters of your life are about to start. It might be in terms of love, money, or any other aspect. You are ready to get engaged in something new and fresh that was on hold for a long time.
- 222 Meaning (Alignment)
When you are about to face major decisions or transitions in your life, this number might appear. It conveys that you have to rethink and re-examine some decisions. Once you are sure of your decision, you will work hard and achieve your dreams.
- 333 Meaning (Support)
It symbolizes that the angels are trying to connect with you. You need to take second thoughts about decisions taken in the past. Besides, you need to get rid of bad vibes around you. In terms of love life, you might find self-acceptance or love in life soon.
- 444 Meaning (Protection)
It conveys you might be in love already. You must stay determined, brave in every field of life, and ready to go. The angel is there protecting you from evil.
- 555 Meaning (Change)
It tells you that it is time for transformation. Change is around the way. A new, better path is developing, and you just need to seize the next few steps.
- 777 Meaning (Luck)
It is an auspicious number that symbolizes that you are ready to get the fruits of your efforts. Be it happiness, blessings, miracles, or a piece of good news. There is some good change on the way.
- 888 Meaning (Balance)
This number signifies material wealth, money, good fortune, and many good vibes. You will also be able to do the toughest of tasks, emerge victorious, and achieve balance in your life.
- 999 Meaning (Release)
The number 9 represents endings, meaning that one life cycle is ending, and a critical fresh phase is originating. The number 9 represents endings.
- 100 Meaning
It is the most positive angel number signifying prosperity, confidence, and success in life. You should follow your path confidently, which will undoubtedly lead to victory. Bad situations are only temporary.
If you notice an angel number repeatedly appearing before your eyes, you can just take it as a sign of backing and affirmation that you’re on the perfect path. Angel numbers ensure our connection with God—they’re a reassurance that someone or something is always listening. So the next time you see an angel number, let it be a remembrance that we are not alone on this planet, divine powers are at work around us, and our lives are in the hands of angels.
6 Amazing Products That Will Surely Cure All Your Digestive Problems
Digestive problems can be disastrous, causing severe discomfort. The digestive tract plays a significant role in human health. It is responsible for the absorption of nutrients and the elimination of waste. Due to different reasons, people suffer digestive problems such as bloating, abdominal pain, cramping, constipation, diarrhea, and gas.
In addition, people with digestive issues may develop health conditions such as Gastroesophageal Reflux Disease (GERD), irritable bowel syndrome (IBS), heartburn, and Crohn’s Disease, which are very detrimental and can lead to serious health problems. The following article will look at some of the few products to help cure digestive problems.
Most people probably take cannabis products for fun or self-satisfaction without understanding some health benefits. Apart from giving you a relaxed feeling and changing your moods, delta 8 THC can be beneficial in treating digestive problems. Delta 8 has excellent effects on the digestive tract and helps reduce any digestive symptoms. For example, delta 8 THC can help treat inflammatory bowel disease, one of the digestive problems that most people suffer. In addition, it helps to reduce stomach emptying, reduce abdominal pain, increase appetite, and minimize bowel movement frequency.
There is a wide variety of delta 8 products to order to treat your digestive problems. People who go through surgeries or are under cancer medication undergo digestive issues such as vomiting and indigestion. Delta 8 can help reduce such symptoms effectively. However, before using cannabis products to treat digestive problems, you need to consult a doctor for a prescription of the appropriate doses to take. Further, if you are under medication with other drugs, you need the best advice regarding the use of cannabis in conjunction with the medicine you are taking.
Taking food and drinks rich in probiotics can be very helpful in easing digestive problems—for example, yogurt made from fermented milk. Yogurt contains probiotics in the form of friendly bacteria that live in the digestive tract and helps to improve digestion and keep the gut healthy. Though probiotics should occur naturally in the body and especially in the stomach, you can boost it by taking foods such as yogurt rich in probiotics. Probiotics help ease digestive issues such as diarrhea, constipation and bloating.
However, you have to ensure that it contains probiotics when buying yogurt. You can get specific about this by looking at the package to ensure it has a live and active culture description. Probiotics in yogurt contain living organisms such as bacteria and yeast similar to those in the gut and play a crucial role in digestion. Taking yogurt as a supplement can help treat digestive problems and improve general digestive health.
Dark Green Vegetables
Fiber plays a vital role when it comes to digestion. Green vegetables are a great source of insoluble fiber. Insoluble fiber is responsible for adding bulk to the stool and quickening its pace through the digestive tract. In addition, green vegetables are also rich in magnesium and are vital in relieving constipation by improving muscle contraction in the gastrointestinal tract. Some of the most popular dark green vegetables that are beneficial to your health and should consider adding to your diet include broccoli, Brussels sprouts, spinach, and other leafy greens.
Further, green leafy vegetables contain sugar that feeds the gut with friendly bacteria, which can help digestion and impair some contagious bacteria that can cause serious illness.
Licorice has been vital in treating many symptoms of indigestion, such as heartburn and acid reflux. Though licorice is very effective, it should only be taken when purified as an unpurified form can lead to serious side effects such as increasing high blood pressure. One of the purified licorices is DGL, as it has no chemicals and does not cause any side effects. However, pregnant women should not take DGL or another licorice supplement without the doctor’s prescription.
Ginger is one of the products that has been widely used to treat digestive problems and other conditions such as stomachaches. In addition, pregnant women experiencing issues such as nausea and vomiting during pregnancy can use ginger which is a very effective natural medicine. You can take ginger in different forms, such as powder, tablets, capsules, or freshly cut roots. However, you should limit the number of doses and take small amounts per day. Ginger helps provide some comfort in the stomach and ease the discomfort caused by gas and constipation.
Glutamine is a natural nutrient found in the body and vital in supporting the intestines and other organs responsible for digestion. Supplementing your naturally occurring glutamine with L-glutamine can help relieve diarrhea caused by surgery, stress, or infections. In addition, l-glutamine can be vital to people who have too many unfriendly bacteria in their digestive system as it helps fight them. People taking cancer drugs or those who have undergone an intestine surgery should take l-glutamine supplements to improve the absorption of nutrients.
In conclusion, digestive problems can cause severe pain to your health and even lead to detrimental health risks. However, you can naturally mitigate this problem by using the natural product regularly to treat them or prevent them.
Infertility: Causes, diagnosis, risks and treatment
WHAT IS INFERTILITY?
Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.
Infertility can be primary or secondary. Primary infertility is when a pregnancy has never been achieved by a person, and secondary infertility is when a woman can’t get pregnant again after having at least one successful pregnancy.
WHAT CAUSES INFERTILITY?
Infertility may be caused by a number of different factors, in either the male or female reproductive systems. However, it is sometimes not possible to explain the causes of infertility.
In the female reproductive system, infertility may be caused by:
• Tubal disorders such as blocked fallopian tubes, which are in turn caused by untreated sexually transmitted infections (STIs) or complications of unsafe abortion, postpartum sepsis or abdominal/pelvic surgery.
•Uterine disorders could be inflammatory in nature (such as endometriosis), congenital in nature (such as septate uterus), or benign in nature (such as fibroids).
•Disorders of the ovaries such as polycystic ovarian syndrome and other follicular disorders.
•Disorders of the endocrine system causing imbalances of reproductive hormones. The endocrine system includes hypothalamus and the pituitary glands. Examples of common disorders affecting this system include pituitary cancers and hypopituitarism.
In the male reproductive system, infertility may be caused by:
•Obstruction of the reproductive tract causing dysfunctionalities in the ejection of semen. This blockage can occur in the tubes that carry semen (such as ejaculatory ducts and seminal vesicles). Blockages are commonly due to injuries or infections of the genital tract.
•Hormonal disorders leading to abnormalities in hormones produced by the pituitary gland, hypothalamus and testicles. Hormones such as testosterone regulate sperm production. Example of disorders that result in hormonal imbalance includes pituitary or testicular cancers.
•Testicular failure to produce sperm, for example, Overheated testicles. Causes include an undescended testicle, a varicocele or varicose vein in the scrotum, the use of hot tubs, wearing tight clothes, and working in hot environments or medical treatments that impair sperm-producing cells (such as chemotherapy). Mumps If occurs after puberty, inflammation of the testicles may affect sperm production.
•Abnormal sperm function and quality, there are conditions or situations that cause abnormal shape (morphology) and movement (motility) of the sperm negatively affect fertility. For example, the use of anabolic steroids.
Environmental and lifestyle factors can affect both male and female fertility such as smoking, excessive alcohol intake and obesity. In addition, exposure to environmental pollutants and toxins can be directly toxic to gametes (eggs and sperm), resulting in their decreased numbers and poor quality, leading to infertility.
DIAGNOSTIC TOOLS USED FOR FEMALE INFERTILITY ARE
•Pelvic examination including PAP smear
•Blood tests like, hormone levels – Thyroid, AMH, FSH and LH
DIAGNOSTIC TOOLS USED FOR MALE INFERTILITY ARE
•Blood test–Testosterone, Thyroid, Genetic blood test for chromosomal abnormality
•Age above 40 years (male) and above 32 years (female)
•Smoking and alcohol
•Not enough exercise
•History of Sexually transmitted Infections (STIs)
•Exposure to some chemicals: pesticides, herbicides, metals, such as lead, and solvents.
•Chemo or Radiotherapy
Treatment will depend on the underlying cause of infertility, in form of
•Surgery: blockage in tube that store and carry sperm (male) or blockage in fallopian tube/fibroid/polyp/endometriosis (female).
a. IUI (Intrauterine insemination): Used long thin tube to place sperm directly into the uterus.
b. IVF (In vitro fertilisation): Harvesting egg at the end of stimulation and placing sperm and egg together in a lab dish. The sperm fertilises the egg. Fertilised egg is transferred into the uterus.
c. ICSI (Intra-cytoplasmic sperm injection): tiny needle, called a micropipette, is used to inject a single sperm into the centre of the egg.
d. Sperm or egg donation
e. Assisted hatching
f. Electric or vibratory stimulation to achieve ejaculation
g. Surgical sperm aspiration
HOW TO PREVENT INFERTILITY
•Eat a well-balanced diet and maintain a healthy weight.
•Don’t smoke, misuse drugs or drink excessively.
•Get treated for STIs.
•Limit exposure to toxins.
•Stay physically active, but don’t overexercise.
The writer is Chief of Laboratory Services (Rajkot, Gujarat), Metropolis Healthcare Limited.
TECHNICAL TRAINING AND SUPPORT ESSENTIAL IN MEDICAL DEVICES INDUSTRY
Arnab Basumallik, Director, Edwards Lifesciences India Private Limited spoke to The Daily Guardian Review about how essential is it to bring in a code of conduct for the medical device industry and the role of government in widening the circle of probity. Excerpts:
Q. How are medical devices characteristically different from pharmaceuticals?
A. As per the WHO study, medical devices vary from pharmaceuticals in the following ways.
• Innovation: Medical devices undergo incremental improvements, with a relatively short commercial life cycle of about 18 months on average.
• Diversity: Medical devices, even in the same category, vary in size, complexity, packaging, efficacy, safety and use.
• Durability: Medical devices have a wide range of durability with extremes ranging from a few minutes for disposable devices to several decades for some implantable devices and medical equipment.
• User: There is often a learning curve associated with the use of medical devices, particularly complex high-tech devices, with a need for technical training and support.
• After service: Medical devices require service and maintenance, unlike drugs.
Even Pharma Bureau under DoP has identified the following characteristics for medical devices, which are quite different from pharma.
• The medical device industry is highly capital intensive and has a long gestation period to develop the market.
• Requires continuous induction of new technologies.
• Requires continuous training of health providers to adapt to new technologies.
• Requires a well-developed eco-system and innovation cycle, which is yet to be fully developed in India, unlike pharma. The med-tech industry depends on imports up to an extent of 86%. Domestic manufacturing is limited to surgical, cardiac stents and general medical devices and consumables.
Q. How essential is it to bring in a code of conduct for the medical device industry?
A. As mentioned above, the medical device industry is continuously evolving with a relatively short commercial life cycle of about 18 months on average. Thus, there is often a learning curve associated with the use of medical devices, particularly complex high-tech devices, with a need for technical training and support. Also, since the technologies are fast evolving, the training of these technologies is often not there in the regular medical university curriculum.
The second most important factor is diversity. Even in the same category, medical devices vary in size, complexity, packaging, efficacy, safety, and use. Hence, it is a regulatory responsibility of the manufacturer of that innovation, to train the clinicians/ healthcare professionals before launching the technologies in the country, to ensure compliant and safe usage of the product on a patient.
Third, the training needs to be hands-on and not just for the clinician but the entire team of healthcare professionals including the diagnostic and biomedical engineering team—till they get used to the handling of the product.
In the pharma code of conduct, there was a limited scope of providing these necessary hands-on training to the clinicians. Further, there was a limitation in providing samples for hands-on training. The definition of healthcare professionals also was limited to a clinician (doctor) only, which needed to be broadened for medical devices—as nurses, technicians, perfusionists, and bio-medical engineers all form an important part of the eco-system along with the team of clinicians
Hence, it was essential to come up with a separate code of marketing practices.
Q. How has the present government been widening the circle of probity?
A. While the draft UCMDPM does allow companies to provide training to the clinicians in suitable facilities, adequate guidelines are provided so that the training and other engagements with the healthcare professionals are carried out in a compliant way, which includes but is not limited to the type/location of facilities to be used, guidelines on the cost of food and travel, record keeping of the engagement. Further, adequate provisions of probity are maintained through a separate committee created under every industry association, to receive, report and do the necessary due diligence in case of receipt of a complaint on the violation.
Q. Is there any difference in code from the global markets or any disadvantage?
A. We do not view any significant disadvantage related to the difference in code from global markets. Various codes of conduct across the countries are considered while creating UCMDMP. Even industry codes created by AdvaMed, EUCOMED, and APEMED are considered. The draft UCMDMP has included the best of the features. It depends on how we implement the code. Considering the diversified nature of the industry, it will require some handholding and training for the companies to adapt to the code. The industry is ready to partner with the Government of India for the implementation of the code.
STAY FOCUSED, MOTIVATED AND HAPPY AT WORK WITH MEDITATION
Keeping a regular practice of meditation can help enhance your mental well-being at work by improving attention, reducing anxiety, and fostering social connections.
Thirty-two-year-old Shruti Mishra had been expecting her Pune-based office to resume work from office early this year. But when the email popped in her inbox, she felt she wasn’t ready. After more than two years of working from the safety and comfort of her home, which meant more time with her six-year-old daughter and more time to look after her health and wellbeing the thought of going back to work made her anxious and nervous. She was suddenly worried about the morning rush hour, deadlines, dealing with toxic colleagues and how her daughter will adjust to her mom not being around all the time? She was worried about her mental well-being.
The mental well-being of employees has always been an area of concern for managers. Many corporations do offer wellness programs—almost 90 per cent of organisations have some employee wellbeing initiatives in place—but the effectiveness and levels of engagement prove to be significant challenges. Returning to physical offices can prove to be a challenge and affect the mental well-being of some employees. Luckily, help is at hand.
MEDITATION FOR A CALMER, SHARPER MIND
Adopting and embracing wellbeing practices such as meditation and mindfulness can be of immense help while navigating this transition and for overall mental wellbeing at the workplace. These are tools to establish greater balance, grounding, and focus on work, in addition to fostering more joy and fulfilment.
Meditation offers that much-needed restorative pause to an overworked mind and a restless heart. When we meditate, we practice concentration, listening, and relaxation. These qualities are vital to our health and happiness, yet increasingly compromised in the rush of day-to-day life. By maintaining a daily practice of meditation and mindfulness, we can enhance our well-being at both home and office. Here are some of the benefits of having a regular practice.
Improves attention: It is the most significant benefit for working professionals. Don’t we all end up scrolling our phones just when we have a tight deadline? Or struggle to be attentive during a long meeting? Science shows that introducing more mindfulness into our lives ultimately influences areas of the brain that are responsible for attention. The more we meditate, the more we strengthen our ability to focus.
Reduces anxiety and negativity: Your next appraisal, deadlines, and your child’s exams clashing with an office event, there are endless triggers for anxiety and negativity. Maintaining a regular mindfulness practise has been shown to decrease the tendency to have intrusive negative thoughts. And multiple studies have now established that regular practice of meditation can alleviate stress and reduce anxiety.
Stronger social connections: Employees with good social connections at work are seven times more likely to be focused on their assignments. Several studies have found a positive relationship between mindfulness and relationship quality.
Better sleep: Restful sleep is the key to being productive at your workplace. In general, meditation practice has been found to facilitate relaxation in the body and calm for the busy mind. It can help you fall asleep too. Meditation has been reported to enhance the levels of melatonin, the sleep hormone.
FOCUS ON THE PRACTICE, NOT REWARDS
Meditation may initially appear overwhelming and confusing. Sitting still for 15 minutes may look as daunting as doing 50 reps of Surya Namaskar. But with practice, it gets easier.
First, you need to trust the process and focus on it instead of thinking of its outcomes. Don’t get affected by the onslaught of thoughts while you are meditating. Let them come and go, just observe your thoughts. It’s natural for you to start the practice with certain expectations of how you are supposed to feel but you gradually transition to a state where just being in that moment, in that state of stillness, becomes bigger than any expectations. This is when the practice starts to change you into a better version of yourself.
MINDFULNESS AT WORK
Once you get familiar with the process, you can meditate any time and literally anywhere. You could be waiting for your cab in the morning or during your lunch break. In addition, here are some simple mindfulness tips to enhance your mental well-being during the workday:
Set an intention: It could be “I will try to stay happy today” or “I will remain calm” or “I will be empathetic at work” … anything that will make you more calm, focused, and joyful.
Take regular breaks: After every two hours of work, take a breather. Have something to drink, walk around, look outside the window or just stretch your limbs. This will help you stay focused and productive.
Perk your senses: Listen to the sounds in the office, smell the scents and aromas around you for 30 seconds. Then open your eyes and focus on a picture on the wall. This will awaken your senses and help you focus better.
Mindful lunch: Take an hour-long break away from your work area. Eat mindfully, without looking at a screen or reading. Experience and relish the taste of your food. Post-lunch, relax for 15 minutes. This will reset you for work.
Release stress: If you start feeling stressed at any point, inhale deeply through your nose. Exhale through your mouth and while doing so imagine that you are exhaling the stress out of you. Repeat this exercise three to four times.
Express gratitude: At the end of the day when you log out, take a moment to reflect on the day. Make a note of what worked well and express gratitude for it. Also, acknowledge what didn’t work out and inspire yourself to try something different the next day.
It is estimated that one-third of your life is spent at work. Your professional life is very much an extension of your personal life and, therefore, you need to prioritise your mental wellbeing at work. Make the most of your time spent in the office and learn to keep a calm and peaceful attitude throughout each workday.
The writer is Global Head, Mental Health, and Wellbeing, RoundGlass, a global Wholistic Wellbeing company dedicated to empowering and enabling people on their well-being journey.
Signs Your Perfume Has Expired and It Is Time to Buy a New One
Do you love to have a collection of perfumes? Having a variety of fragrances can be a good thing and it means that you have a perfume for every occasion. When you are going out with the girls, you have a fun and energetic perfume. Then, when you are going on a day, you can enjoy feeling confident and attractive with an alluring one.
But, one thing you do have to be careful of is that your perfume does not expire. When a fragrance is opened, it can lose its scent over time. So, you have to ensure that you are going to use it. Have you had a perfume for a while and are not sure whether it has expired? Here are some signs you should look out for.
There are Light Base Notes
If you have had a perfume for a while and you know it contains light base notes, it could have expired. This is because light base notes are more fragile, which can mean that they do not last as long as heavier base notes. Thus, if your perfume is citrus or floral, this may apply to you.
Alternatively, if you have heavier base notes in your perfume, you may be able to keep it for longer. For instance, oriental scents are thought to have a long life. Look out for ingredients such as amber. For instance, Emporio Armani Diamonds is an Eau De Parfum that contains amber as a base note. You can view this fragrance here. This might have a longer life than other perfumes that have more volatile ingredients. So, the perfume you buy can affect when they expire too.
There is a Sour Scent
First of all, you are going to know if your perfume has expired if it does not smell like it used to. It might seem less fresh and you might struggle to smell the top notes that you did before when you use it. In addition, there is going to be a slightly sour scent to the perfume. This often happens because oxygen gets into the fragrance. In particular, the top notes can be sensitive to this oxidisation.
So, spray the perfume onto a piece of paper and smell it. This is going to be a very helpful test to know if it has expired. If there is something strange about the perfume and you know it has been open for a while, it might be time to put it in the bin.
The perfume Has Changed Colour
Some bottles of perfume are transparent. In other words, you can see the liquid itself in the bottle. This can be a good thing and it is going to be useful when you are trying to see if the perfume is off. Indeed, the perfume can change colour and it may go darker than it was before. In addition, there might be a yellow tint to the liquid. These are signs that the perfume has oxidized and it is not going to be at its best. The safest thing you can do is throw away the perfume.
When you are shopping for perfume, there may be some that are going to last longer than others. According to experts, those with base notes such as vanilla may have a less volatile formula. In particular, it could mean that the perfume will not oxidise quickly.
It has Been Open Longer than the PAO Number
If you still have the original box or packaging of the perfume, this can indicate whether it has expired. In particular, look out for a period after opening or PAO number. This demonstrates how long you can have this product open before it starts to expire. Often, this is found on a lot of cosmetic product packaging.
If you cannot find this number or you do not have the original packaging, you do not have to worry. Think about when you opened the perfume. Was it more than 18 months ago? This is when you should start to test the perfume and see if it is still the same quality as when you bought it.
Ask One of Your Friends
The truth is, if you are used to a fragrance, you might not know if it smells off. You can become used to it over time. But, perhaps your friend is going to be able to help you out. They can be impartial if they do not own the scent and they are going to be able to tell you if something does not smell right. So, ask one of your friends to help you. You can spray the perfume onto a piece of paper, as well as letting them see the bottom and liquid.
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