Sabtu, 29 April 2017

sexual intercourse


Worried about the sexual side effects of your medication or medications you are considering? Another hall medicine hajar jahanam cair Which are a natural herbal medicine and safe to cope with premature ejaculation. Let's talk about it. It is not uncommon for treatments that help us overcome anxiety, depression, blood pressure, and even a stuffy nose to correlate with sexual difficulties. [Several side effects listed on the screen] then add any physical side effects that may have sexual consequences like

sexual intercourse, frustrating! you're taking the med to improve one aspect of your well-being, and it messes up another. strategy 1 one thing that can help is knowing what actually happens when you swallow the pill. for me, it's reassurance the medication is designed to deal with the problem I have and not to torture me.

plus I learned how various chemicals also affect my sexuality, and I can keep learning from there how to resolve this. strategy 2 ...or prescriber or pharmacist. let them know that you really care about your sexual health and that the side effects matter to you. you might say, "Doc, I want an antidepressant that helps me get out of bed but not one that's going to disrupt my sex life." medical professionals are trained to make modifications -- maybe lower or higher the dose, suggest a different time of day to take them: like after you have sex rather than before. perhaps there's a similar drug with fewer side effects or one that will counteract them. ask. if your provider doesn't care or won't help, please go elsewhere.

strategy 3 one thing some offices are now capable of the is{on screen} with just a cheek swab, it's possible to determine which meds will work best in your body and which ones won't work at all. which is so great, because you don't have to trial and error meds and all of their sexual side effects. you can target treatment and focus on dealing with the sexual side effects of the correct med. strategy 4 have sex a few times before starting a med, or if you've already started one, have sex right now so that you have a realistic picture of your situation. were you turned on mentally and physically? how long did it take to climax, if at all? did you feel satisfied? did your partner or partners observe anything? was it really that bad, or were you psyching yourself out? write it all down.

strategy 5 having a journal is a good way to track what's really happening, and it's also something that you can share with your prescriber. [example journal entries on screen] strategy 6 give the med time, or rather give your body time to adjust to the med. it's possible that sexual side effects will dissipate on their own, so what seemed unmanageable at the beginning might be no big deal after a few days or weeks. strategy 7 when I'm working with clients who struggle with the sexual side effects of their medications,

one of the most important things is to stress re-evaluation of healthy sexuality. they may think that the 15-minute routine they're used to is it and that the meds will or have ruined their sex lives. in reality changes to sexuality for whatever reason are opportunities for sexual enhancement. changes in sexual desire could lead to experimentation with fantasies. trouble becoming aroused could improve your foreplay. difficulty getting or maintaining an erection could mean attention for other body parts. and difficulty reaching orgasm could put emphasis on sensuality like kissing and erotic massage. this strategy and all the ones I mentioned are what sex therapists and clinical sexologists promote. medications can be incredibly beneficial.

I'd hate for you to miss out on the health improvements they offer because you're scared or disappointed about the sexual effects. please do your research, and ask for help. it's possible to have a better life and better sex if you're willing to stay curious. this episode was brought to you by sexual(i)nuts. those of you who believe in and support our efforts to create honest, accessible sex education via patron.




dexamethasone



[ music ] >> the jama network. [ silence ] >> i'm shalender bhasin, professor ofmedicine at harvard medical school. i'm director of the center of clinicalinvestigation and director of research program


dexamethasone, in men's health aging andmetabolism at the brigham and women's hospital in boston, massachusetts. there's growing concern thattestosterone sales have been growing at 20 to 25% annual rate over the past 10 years.


there's also concern whether testosteronetherapy increases the risk of heart disease. this study was designed to determine whethertestosterone therapy increases the progression of atherosclerosis in men who havelow or low normal testosterone levels. the testosterone in atherosclerosis progressiontrial was a randomized placebo controlled parallel group trial in which older communitydwelling men who were otherwise healthy and who had testosterone levels in thelow or low normal range were randomized to receive either placebo or testosterone gel. three hundred and 8 men participatedin this randomized trial. the duration of the intervention was 3 years.


during this period, testosterone levels weremeasured to maintain the testosterone levels in men who were assigned to the testosteronegroup into the middle of the normal male range. the primary outcome of the trialwas atherosclerosis progression. atherosclerosis progression in thetrial was measured in 1 of 2 ways. first, we looked at [inaudible] medial thickness in the common carotid artery asa measure of atherosclerosis. and second we looked at coronary artery calciumusing multi detector computerized tomography to measure coronary artery calcium. another measure of atherosclerosis.


the main finding of the trial was thattestosterone administration over a period of 3 years as compared to placebo did notaffect the rate of atherosclerosis progression. the results obtained from measurementof coronary artery calcium as well as from [inaudible] medial thickness inthe common carotid artery were consistent in demonstrating no affects of testosteroneon the progression of atherosclerosis. the secondary outcomes of the trial were sexualfunction and health related quality of life. testosterone also did not improve either thesexual function or health related quality of life in men who had low normal orslightly low testosterone concentrations. because the trial was powered primarilyfor atherosclerosis progression,


these findings should not be extrapolatedto imply that testosterone is safe with respect to cardiovascular events. also, these findings should not beextrapolated to [inaudible] adult men who have low testosterone levels because ofknown diseases of the testes, the pituitary or the hypothalamus, in whomtestosterone therapy has been shown


dexamethasone

to improve sexual functionand many other outcomes. well, we need much larger trials that are adequately [inaudible] towardcardiovascular disease event rates to address the cardiovascular safety issue.



depressed test



teenage depression actually happens more thanwe think. experts say that one in five teens will access services unlike adults who canask for help, so this is why it's important as a parent of a teen or an adult who is incontact with a teen to know what some of signs and symptoms are. there's a lot of pressurefacing teens today from the natural course of going through puberty to trying to understandwho they are and where they fit in. teenagers


depressed test, express themselves in different ways. forsome teens, if they are feeling depressed, they might isolate themselves or they mightfeel a great sense of sadness. yes, those are symptoms of depression, but there arealso signs to be aware of: increase in irritability,


depressed test

aggression and even rage, loss of interestfrom the things they used to enjoy, problems


as school, low self-esteem, tearfulness orfrequent crying, withdrawal from friends and family, changes in eating and sleeping habits,restlessness and agitation. there can also be a lack of enthusiasm, tired, lack of energy,difficulty concentrating, reckless behaviour.


Jumat, 28 April 2017

cloudy urine



is it bad when your urine is clear? dark yellow urine is a sign of bad dehydration.yellow is normal. and mine is clear. it may simply be so diluted that it looksclear. that’s not bad but a sign of proper hydration.


cloudy urine, when should i be worried? if it is red, to the er you should head. ifit is orange, what rhymes with orange? i think there is a place in wales that rhymeswith orange. if it is a mix of red and yellow, you mayhave an std or ui so you’re a sad fellow.


what would be a mix of yellow and red? red in urine is from blood unless you’retaking some really funky drugs. orange is usually a sign of internal bleeding from abladder infection or std pustules that broke, but it can be from some meds. then my clear urine is a relief. it’s a sign of something healthy. i don’t know if it is healthy. it is a sign that there’s nothing wronglike blood loss. if it is cloudy and clear, you could still have a bacterial infection.


lovely. no, gross. and clear but burning can be a sign of anstd or urinary tract infection in the early stages. does it always lead to bleeding? no, but bleeding is always bad. and if youcan’t pee, that’s cause to go to the er. why would that be an emergency? if you have asthma, the inflammation can constrictthe airways. how bad does an internal infection have to be so that your pipes close up? ok, that’s an emergency.


but if you have clear urine but you know youare dehydrated, then you probably have diabetes.


cloudy urine

oh, great, now i can panic. if it is green, it’s because you had toomuch asparagus. if you have blue urine, you might have gotten it from medications. that’s a rainbow i never hope to see.


clinical depression test



- [voiceover] i wannatake a minute to talk about how clinicians diagnose depression or put in different way, iwanna talk about how clinicians can separate depression from normal and appropriate emotional responses.


clinical depression test, and they do this byusing the dsm-5, which is the diagnostic and statisticmanual of mental disorders, and this manual outlines thecriteria that someone has to have in order to bediagnosed with depression.


and there are nine differentcriteria that i wanna focus on in this video. the first criteria is that theymust have the depressed mood every day for most of the day. and this has to last overan extended period of time. and whether or not someoneactually has a depressed mood is something that can bedetermined with self-report, but it can also bedetermined by observations from people around themor by the clinician.


with depression, we also expectto see a loss of interest and enjoyment in activities that they once found pleasurable. and this also must bepresent for most of the day and over an extended period of time. depression is alsoassociated with a number of cognitive symptoms. and this could include intense feelings of worthlessness and guilt,


so feeling like youwon't amount to anything or not understanding whyanyone would even wanna be friends with you. and of course this canlead them to not going out with their friends andthen feelings of guilt for not calling, and so thiscan kind of become a cycle. people with depression can also have a hard time concentrating. so they might have a hardtime focusing on the things


that they need to do, things like getting their schoolwork done. these problems withconcentration are also associated with an inability to make decisions, and this could be for big life events like choosing a college, but this indecisivenesscan also affect small, seemingly insignificant decisions, things like figuring out what to order


for dinner at a restaurant. another cognitive symptom thatindividuals with depression might have are thoughtsabout death and dying, and this could include havingan actual plan for suicide, but it can also include thinkingabout death more generally or just not wanting to be around anymore. and this next part might surprise you, but depression also has anumber of physical symptoms. it doesn't just impact peopleon a psychological level,


so there could be significantchanges in weight, and that could include eitherweight loss or weight gain. and this can go along witha corresponding increase or decrease in appetite. individuals with depressionmight also develop insomnia, so they might havetrouble getting to sleep, or they might wake upfrequently throughout the night, but it's also possiblethat they might develop the opposite problem.


they might start sleeping too much, enough that it significantlygets in the way of their day-to-day responsibilities. another physical symptomcan be psychomotor agitation or retardation, and let's breakthis one down a little bit. psychomotor agitation is an increase in unintentional movements,so this could include things like pacing around aroom or wringing your hands or tearing and picking atthe skin on your fingernails.


psychomotor retardationis generally the opposite, so this is a slowing down of movements, and i don't mean running in slow motion. it is more like aninability to get out of bed or dress oneself or shower,or maybe a person might feel completely unable to cook for themselves or to return a phone call or an email. and i really wanna beclear that this is not out of laziness.


an individual withdepression might really feel like these tasks are impossible. and individuals with these symptoms are typically pretty confused about this, and they're really angryabout this symptom, and they might feel alot of guilt about it. the last physical symptomi wanna mention is fatigue or a loss of energy orfeeling like they don't have the energy to do the tasks that they like,


much less the tasks that they have to do, the tasks that need to get done. so these are the symptomsof depression as listed in the dsm-5, but they have a few caveats. they have a few qualifiers. the first is somethingthat i mentioned earlier, but didn't really wannarepeat with every symptom, and that's that each ofthese symptoms need to last for most of the day and needto be present nearly every day,


generally for at least two weeks. another thing to note is thatsomeone doesn't need to have all nine of these symptomsin order to be diagnosed with depression. they actually need to have as few as five. but now matter how many symptoms they have and often people do have more than five, they always have to have atleast one of these first two, so they either have tohave a depressed mood


or a loss of interest inpleasurable activities or both. another criteria is that thesesymptoms must cause distress, meaning that they must disrupta person's normal functioning in some way, so maybe they're interfering with someone's work or theirgrades or their social life. and lastly, these symptomscan't have been brought on by another disorder or as aside effect of medication. one last thing that i wanna bring up is that these criteriahave changed over time,


so i've gone over a listof symptoms from the dsm-5, which is the most recent version. but prior to thepublication of that manual, we had the dsm-4. and while most of the symptomsof depression have stayed the same from the dsm-4 to the dsm-5, i want to mention one big change, and that's the bereavement exclusion. so just like we talkedabout how you can't meet


the criteria for depression ifthat depression is brought on by a different illness, it used to be that you couldn'timmediately meet the criteria for depression if thatdepression came after a significantly negative life event. so if someone felt depressedafter the death of a loved one like a parent or child or spouse, they couldn't immediatelymeet the criteria for major depressive disorder.


instead, their experiencewith grief would have to last a lot longer in orderto get the diagnosis,


clinical depression test

and that's something that'sbeen removed from the dsm-5. and of course as our understandingof depression increases, our knowledge about how to diagnose it and how to treat it willalso to continue to evolve.


Kamis, 27 April 2017

athlete's foot



studies show that the main reason people developnail fungus is untreated conditions of athlete’s foot, which is a skin fungus. this athlete’sfoot problem needs to be treated if you want to prevent nail fungus. other conditions wetreat here are dry skin, which we recommend proper moisturizers and emollients. we alsosee psoriasis of the foot, which will also be treated with topical steroid medications.there are also many other skin problems we


athlete's foot, treat here at richardson podiatry center.many times we need to do skin biopsies to


athlete's foot

confirm our diagnosis. rest assured, we willmake a correct diagnosis and treat you properly. if you have athlete’s foot, you can tryover the counter products. however, if these fail, your next best option is to come seea podiatrist. we’ll make a thorough evaluation


and then recommend proper medication for thetreatment of your skin condition.


amoxicillin and alcohol



amoxicillin (amox), also spelled amoxycillin,is an antibiotic useful for the treatment of a number of bacterial infections. it isthe first line treatment for middle ear infections. it may also be used for strep throat, pneumonia,skin infections, and urinary tract infections among others. it is taken by mouth. common side effects include a nausea and rash.it may also increase the risk of yeast infections


amoxicillin and alcohol, and, when used in combination with clavulanicacid, diarrhea. it should not be used in those who are allergic to penicillin. while usablein those with kidney problems the dose may need to be decreased. its use in pregnancyand breastfeeding appear to be okay. amoxicillin first became available in 1972.it is on the world health organization's list


of essential medicines, the most importantmedications needed in a basic health system. it is one of the most commonly prescribedantibiotics in children. amoxicillin is available as a generic medication. it has a wholesalecosts between 0.02 and 0.05 usd per pill. in the united states ten days of treatmentcosts about 16 usd. amoxicillin is used in the treatment of anumber of infections, including acute otitis media, streptococcal pharyngitis, pneumonia,skin infections, urinary tract infections, salmonella infections, lyme disease, and chlamydiainfections. it is also used to prevent bacterial endocarditis in high-risk people having dentalwork done, to prevent streptococcus pneumoniae and other encapsulated bacterial infectionsin those without spleens, such as people with


sickle-cell disease, and for both the preventionand the treatment of anthrax. the united kingdom recommends against its use for infectiousendocarditis prophylaxis. these recommendations do not appear to have changed the rates ofinfection for infectious endocarditis. amoxicillin and amoxicillin-clavulanate havebeen recommended by guidelines as the drug of choice for bacterial sinusitis, but mostsinusitis is caused by viruses, for which amoxicillin and amoxicillin-clavulanate areineffective, and the small benefit gained by amoxicillin may be overridden by the adverseeffects. amoxicillin is occasionally used for the treatment of skin infections, suchas acne vulgaris. it is often an effective treatment for cases of acne vulgaris thathave responded poorly to other antibiotics,


such as doxycycline and minocycline. side effects are similar to those for otherî²-lactam antibiotics, including nausea, vomiting, rashes, and antibiotic-associated colitis.loose bowel movements (diarrhea) may also occur. rarer side effects include mental changes,lightheadedness, insomnia, confusion, anxiety, sensitivity to lights and sounds, and unclearthinking. immediate medical care is required upon the first signs of these side effects. the onset of an allergic reaction to amoxicillincan be very sudden and intense; emergency medical attention must be sought as quicklyas possible. the initial phase of such a reaction often starts with a change in mental state,skin rash with intense itching (often beginning


in fingertips and around groin area and rapidlyspreading), and sensations of fever, nausea, and vomiting. any other symptoms that seemeven remotely suspicious must be taken very seriously. however, more mild allergy symptoms,such as a rash, can occur at any time during treatment, even up to a week after treatmenthas ceased. for some people allergic to amoxicillin,


amoxicillin and alcohol

the side effects can be fatal due to anaphylaxis. use of the amoxicillin/clavulanic acid combinationfor more than one week has caused mild hepatitis in some patients. young children having ingestedacute overdoses of amoxicillin manifested lethargy, vomiting, and renal dysfunction.


women squirting

what does it mean to squirt? a great question. what it means when a woman squirts is thatshe expels female ejaculate fluid, which is not ur...