Hazards of Misuses of Testosterone

Drug should be used judiciously in hypogonadic male adolescent which is not a common disorder. It is being misused more in countries with poor drug regulatory controls, like Pakistan. Recently large published studies have shown the risks of prescribing testosterone to middle aged and elderly men in the USA. It doubled the risk of heart attacks in men of 65 or older and tripled the risk of heart attacks in a group of 48000 middle aged men with previous histories of heart diseases. The heart attacks occurred in both the groups within 90 days of receiving testosterone. The results are revealed in the studies recently published in the on-line journal PLOS ONE. There are many reasons for the misuses of testosterone- the main one being the pharmaceutical companies pushing the notion that their testosterone-boosting products can overcome a supposed disease “called low T”, characterized sexual drive, depressed moods, an increase in body fat and decrease in muscle strength, among other symptoms.
Many of these symptoms to some extent are part of the ageing process or the result of other disorders. In Pakistan practice of misuses of drugs is serious and wide-spread. The promotion of drugs is carried out aggressively through various means like unchecked promotional literature, also with the support and connivance of the Drug Regulatory Authority and many practicing doctors working unethically. In Pakistan there is no control on the prescriptions and sale of drugs.
There are many other adverse effects of testosterone misuses, like causation of prostatic carcinoma or its aggravation, causation of primary liver tumors, liver damage, hyperlipidemia/dyslipidemia, aggravation of hypertension/diabetes mellitus and hypercalcaemia etc. New York Times in an editorial dated 6th February has warned the general public and drawn the attention of the “Federal Drug Authority”, of USA to take measures to prevent testosterone misuses. In Pakistan testosterone like other drugs is misused on a very large scale. Pakistan print and digital media should also create awareness and educate the public about the misuses of drugs and their hazards. The attention of the Government and its Drug Regulatory Authority”, should also be drawn to fulfill their constitutional and moral duty safeguarding and protecting the lives of the people by implementing the provisions of the 1976 Drug Act. The essential drugs many of which are unavailable should be made available while a lot of irrational, harmful drugs including many herbal preparations which have inundated the market should be removed. It is a myth spread by these vested interests that herbal preparations are without any toxic effects. It is untrue- recently there have been a large number of reports of herbal drugs causing severe toxicities including hepatic and renal failure necessitating liver and renal transplants. Of course there are approved herbal drugs which have undergone safety studies which are licensed for use.

Lt Gen. Prof Emeritus Mahmud Ahmad Akhtar
Formal Surgeon General
Pak Army/D.G.M.S (IS)
Rawalpindi. Pakistan.

Colorectal Surgical Unit at DUHS/CHK

Thank you for the introductory detailed article on Colorectal Surgical Unit established at Civil Hospital Karachi affiliated with Dow University of Health Sciences, Karachi published in Pulse International of March 15th2014. I really appreciate it a lot.

Dr. Amjad Siraj Memon FRCS
Consultant Surgeon
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 ADHD seminar at KEMU/Mayo Hospital Lahore

Thanks for the detailed coverage of the ADHD seminar recently held at the Dept. of Child Psychiatry at KEMU/Mayo Hospital Lahore. Earlier we were impressed with the detailed overage dot the 20th National Psychiatry Conference held in Faisalabad. The support from Pulse International and yourself in particular for Psychiatry/ Child Psychiatry is extremely helpful! This will make a difference in advancing this much needed specialty in Pakistan.

Dr. Waqar Azeem
Medical Director & Chief of Psychiatry,
Albert J. Solnit Children’s Center,
& Associate Clinical Professor Yale Child Study Center,
Yale University School of Medicine USA
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 An appreciation

It was heartening to read your comprehensive comments on my book “Observations” in Pulse International of March 15th2014. I am extremely grateful to you for having read this book going through each and every chapter. Your valuable comments on the book and the information it contains are a testimony to your expertise in critical analysis. With lots of prayers.

Prof. Khalid Masood Gondal
CPSP Regional Center,

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