The Joint British Societies' Consensus Recommendations for the Prevention of Cardiovascular Disease (JBS3)

Cardiovascular-disease prevention efforts should extend to people with low short-term risk but high lifetime risk of cardiovascular events, according to new CV prevention recommendations released today by the Joint British Societies.

The Joint British Societies' Consensus Recommendations for the Prevention of Cardiovascular Disease (JBS3) puts particular emphasis on lifetime risk and is being launched with an online tool designed to boost the adoption of lifestyle changes early on, thereby reducing CV events down the road. Understanding the "continuum of risk," the authors argue, is particularly important in young people and in women whose 10-year CVD risk is very low but whose lifetime risk is much higher.


Recent National Heart, Lung, and Blood Institute–sponsored ACC/AHA guidelines and an accompanying CV risk calculator have drawn fire for their emphasis on older subjects. In particular, critics say, the guidelines would see too many people on statins just because of their advanced age, and not enough younger people whose risk factors or family history warrant more aggressive interventions.

The ACC/AHA cholesterol guidelines include recommendations to initiate statin therapy in individuals who have LDL-cholesterol levels between 70 and 189 mg/dL and a 10-year risk of atherosclerotic cardiovascular disease of >7.5%.

The JBS3 recommendations, by contrast, use a higher 10-year risk of CVD—"threshold to be defined by [National Institute for Health and Care Excellence] NICE guidance." The draft NICE guidance currently under review (to be finalized this summer) uses a cut point of 10%, down from 20% in the last NICE document, but higher than the 7.5% in the ACC/AHA guidelines, Dr Iain Simpson (Wessex Cardiac Unit, University Hospital Southampton, UK), president of the British Cardiovascular Society and a member of the editorial group for JBS3, explained to heartwire . JBS3 also states that drug therapy can be considered in individuals with high lifetime CVD risk estimated from "heart age and other JBS3 metrics" in whom lifestyle changes alone are considered insufficient by the physician and person concerned.

"Heart age" can be estimated using an online JBS3 calculator that draws on individual age and risk factors. The tool can then also be used to estimate what benefits specific interventions, including lifestyle changes, would have on modifying lifetime risk.

"The 10-year risk tends to depend very much on age and gender, neither of which are modifiable," Simpson said. "It seems slightly illogical to use that as a basis for your cardiovascular risk. It also discriminates against younger people and particularly females who may be at low 10-year risk but at very legitimate risk of cardiovascular events long term. We know that atherosclerosis develops early, so it seems logical that earlier intervention, whether that's lifestyle or drug treatment, is likely to have a greater impact on CV disease in the longer term."

A Lifelong Healthy Heart

Asked why the ACC/AHA guidelines didn't address longer-term risk, Simpson pointed out that the ACC/AHA process, like the NICE guidelines, "are very constrained" by the quality and nature of evidence they are permitted to consider. "One of the differences with JBS3 is that we have produced this as consensus recommendations, rather than formal guidelines. . . . So it's a much more integrated approach, and it allows people to interpret and give expert views on the evidence. There is less [clinical-trial] evidence for using lifetime risk, which is probably why some of the other guidelines have tried to keep away from it on the basis that it may be intuitive; there isn't strong evidence to back up its utility, but it seems to us to be the obvious direction of travel."

The 68-page document tackles lifestyle, childhood and adult obesity, blood pressure, and lipids in primary prevention and in the presence of existing CVD, peripheral arterial disease, diabetes, and other disease settings. All of the recommendations incorporate separate society recommendations for each risk factor, and the specific recommendations will be available on an open-access basis following publication of the paper, Simpson said.

Giving Choices to Patients

In the interview, Simpson stressed the pivotal role of the JBS3 calculator, which he called "a very creative approach to trying to communicate cardiovascular risk."

Currently the calculator is freely accessible to the public but has not been "sufficiently developed" in terms of help screens and interpretation such that it can be "entirely patient-facing." Instead, the idea is that people use the tool in conjunction with a healthcare provider.

The idea is not that the tool will give the user a specific number or arbitrary threshold at which a certain drug therapy or action should be taken, Simpson explained. "What it's doing is giving the choice back to the individual about how they manage their risk, and it's emphasizing the importance of lifestyle intervention and particularly the importance of lifestyle interventions at a young age to invest for future CV health."

After calculating health age, the tool allows for users to change their risk-factor levels—what would happen if they lowered their systolic BP or stopped smoking, for example. "If you make adjustments to your risk factors by lifestyle changes, you may well find that the long-term benefit of doing that will be the equivalent of or potentially greater than intensive drug therapy at a time in the future when you've reached a high short-term CV risk. So it's giving the choice back to the individuals."

This works both ways, Simpson stressed. It could mean that a young woman at very high long-term risk might, after discussing with her physician, decide she wants to take a statin. But by the same token, an older patient in whom a statin is recommended by current guidelines on the basis of age but who otherwise may have optimal risk factors may decide that he doesn't want to start drug therapy—the benefits being too incremental over the short term.

"This is about giving the individual the information to make an informed decision."

The plan currently under discussion with health authorities in the UK is to have the JBS3 tool integrated into the primary-care IT system, such that healthcare providers can use test results already in the patient's record to calculate lifetime risk and heart age, so as to start the discussion on CV prevention

Care For Pemples ON Face

Acne is a skin condition which is characterized by the appearance of red papules or pus filled papules in the face and most often the condition can be seen among the adolescent age group. In most instances the condition would be mild in nature and would occur from time to time and usually does not leave any permanent residues. But, in other instances, acne can lead to scarring and would be an agonizing problem for many who suffer.



Particularly in women, the occurrence of acne is heavily influenced by the alteration and changes in the hormonal pattern and even among males the hormonal influence on acne plays a major role. The underlying mechanism of such influence would be the increase levels of androgen hormones, such as testosterone and dihydrotestosterone, which is being secreted by the ovaries and by the adrenal glands. These hormones will stimulate the oil glands in the face to enlarge and secrete more secretions and thus cause the appearance of black heads and the white heads. If these get more enlarged, the pores that takes the secretions on to the surface of the skin can become blocked as well as get infected by a bacterium known as ‘propionebacterium acne’. By this time, the appearance of red papules and pus would be visible and the term ‘acne’ would be used in describing these swellings.

In science, it is well known that, hormones are controlled by negative and positive feedback and thus if it is possible to introduce a hormone that can challenge the production of the androgens or else disrupts the functioning of the androgens, the hormonal acne can be controlled or even cured. The treatments available for this kind of acne do just that and let us see some of the available treatment options for hormonal acne.

Oral contraceptive pills:

Often known as the pill, the estrogen contained in these tablets will act to reduce the ovarian production of androgen hormones as well as reduce the enzymes which produce certain types of androgens. Apart from these, OCP hormones will affect the available levels of effective androgens as it will stimulate the production of a protein which will bind the androgens making them less effective than in its free form.

Spiranolactone:

This is a synthetic steroid which has shown to be effective against hormonal acne by reducing the effect of androgens by competing for binding sites. As such, the spiranolactone will bind to the sites which are usually occupied by the androgens to exert their effect and thus effectively reduce its influence.

Apart from the above, the facial cleansers which contain benzoyle peroxide can also be useful treatment options as some people do benefit by only using these as well.

Classes In Summer in Schools - Health Risks

Private schools start Class 10 summer classes

Mar 29, 2014, 03.39AM IST TNN[ R Gokul ] Times of India



TRICHY: Even before the Class 10 board examinations are over, some private schools in Trichy have begun classes for the next Class 10 batch. Though the education department has warned against conducting classes in summer, students have to attend the summer classes.

In fact, some private schools commenced the new Class 10 batch the very day after the SSLC examination commenced on March 26. Of about 400 schools in Trichy district, several schools finished the annual examination for Class 9 in advance in order to start the next Class 10 batch. Some schools conduct classes from 8.30am to 4pm, though Sundays are a holiday.

Both parents and students are helpless as they can't object to the decision of the school administrations. However, there are murmurs of protest. "An illusion is created that more time and more effort should be given for Class 10 and 12. Immense pressure is put on students from the beginning. Classes are begun in summer itself despite objection from parents. Schools want to take credit for making students score high in these classes," said Paul Guna Loganath, a motivational trainer.

Loganath added that schools are least bothered about students' relaxation during holidays or vacation. "Students are not allowed to participate in any extra-curricular activities," he noted.

Meanwhile, some schools are planning to begin the classes for the next academic year in the first week of May. A Aarifa, principal of Adam's Matriculation School, Trichy, said classes held for a very limited period during the summer vacation will not affect students. "We are conducting coaching classes to class 10 students for their public exams. As we are cautious about students' health, classes will be conducted only for a few hours," Aarifa said.

Academicians claim that an early start enables schools to complete the syllabus well before the next public exam so that students get time to revise the syllabus. "Vacation should be there at least for three weeks in peak summer so that students can relax. On the other hand, the classes need to be started early so that teachers can give attention to all students," said Fr R Sahayaraj, the correspondent of Jegan Matha Matriculation School, Trichy.

But the Private School Teachers Association is against summer classes. "We are always against holding classes in summer because most schools have not enough facilities to provide additional care to the students to protect them from scorching sun. Moreover, there should not be any forceful attempt to make students study well," said Manoharan, treasurer of the Tamil Nadu Private School Teachers and Officers Association.

Doctors also advise against conducting classes during summer holidays. "First, holding classes in rooms during summer is not advisable considering health issues. If at all it is necessary to conduct classes, there should be proper ventilation and adequate water facility in class rooms. Otherwise extreme education will lead to stress," said Dr MA Aleem, vice-principal of KAP Viswanatham Government Medical College, Trichy.

Meanwhile, education department has warned schools of stringent action. "As per rule, there should be no class from April last week. If they violate rules, they will have to face the consequences. We warned such schools which conducted classes during last summer," said K Selvakumar, chief educational officer (CEO), Trichy.

World Tuberculosis Day 2014 - Reach The Three Million

World Tuberculosis Day - 24 March 2014

The "missed" 3 million

In 2014, the slogan for World Tuberculosis Day is "Reach the 3 million".

TB is curable, but current efforts to find, treat and cure everyone who gets ill with the disease are not sufficient. Of the 9 million people a year who get sick with TB, a third of them are "missed" by health systems. Many of these 3 million people live in the world’s poorest, most vulnerable communities or are among marginalized populations such as migrant workers, refugees and internally displaced persons, prisoners, indigenous peoples, ethnic minorities and drug users.

WHO and the Stop TB Partnership, hosted at WHO, are together promoting World TB Day. World TB Day provides the opportunity for affected persons and the communities in which they live, governments civil society organizations, health-care providers, and international partners to call for further action to reach the 3 million. All partners can help take forward innovative approaches to ensure that everyone suffering from TB has access to TB diagnosis, treatment and cure.

The burden of tuberculosis

World TB Day is an opportunity to raise awareness about the burden of tuberculosis (TB) worldwide and the status of TB prevention and control efforts. The Day is also an occasion to mobilize political and social commitment for further progress.

Progress towards global targets for reductions in TB cases and deaths in recent years has been impressive: TB mortality has fallen over 45% worldwide since 1990, and incidence is declining. New TB tools such as rapid diagnostics are helping transform response to the disease and new life-saving drugs are being introduced.

But the global burden remains huge and significant challenges persist.

In 2012, there were an estimated 8.6 million new cases of TB and 1.3 million people died from TB.

Over 95% of TB deaths occur in low- and middle-income countries. Poor communities and vulnerable groups are most affected, but this airborne disease is a risk to all.

TB is among the top 3 causes of death for women aged 15 to 44.

There were an estimated 500 000 cases and 74 000 deaths among children in 2012.

Challenges

Around 3 million people (equal to 1 in 3 people falling ill with TB) are currently being ‘missed’ by health systems.

There is slow progress in tackling multi-drug resistant TB (MDR-TB): 3 out of 4 MDR-TB cases still remain without a diagnosis, and around 16 000 MDR-TB cases reported to WHO in 2012 were not put on treatment.

Provision of antiretroviral therapy (ART) for TB patients known to be living with HIV needs to increase to meet WHO’s recommendation that all TB patients living with HIV promptly receive ART.

In India

Of the approximately 3 million people who get sick with TB every year in the WHO South-East Asia Region, a third do not get the TB services. On World TB Day, WHO is urging countries to find, treat and cure the “missing” 1 million who do not get TB services, in order to accelerate progress towards zero TB deaths, infections, suffering and stigma.

“Drugs alone cannot beat TB in the community. TB is a condition strongly influenced by low nutrition, poverty, social stigma, environment, rapid urbanization, and large population displacement in many countries, and these are the factors that result in so many unreported cases. “We have made substantial progress in TB, but unless we address the social, economic and behavioural determinants that impact TB, our fight will not be over.”

The Region accounts for 39% of the global burden of TB in terms of TB incidence. India alone account for 26% of the world’s TB cases. It is estimated that about 3.4 million new cases of TB continue occur each year and about 450 000 people died of this disease in 2012; most of these in five countries, namely, Bangladesh, India, Indonesia, Myanmar and Thailand.

WHO South-East Asia Region is on track to achieve the global target of 50% reduction in death rates due to TB (compared with 1990) by 2015. People’s access to TB care has expanded substantially in the Region, and since 2011 all Member States have continued to have at least 89% treatment success rates. Almost 22 million TB patients have been treated in the past 10 years.

Due to good implementation of the directly observed treatment, short course (DOTS), multidrug resistance among newly detected TB cases is relatively low in the Region. Laboratory networks have been strengthened in all countries to better detect TB infections.

A comprehensive package of TB –HIV interventions is now available to over 1500 million people in the Region. Intensified case-finding is steadily increasing at integrated TB–HIV counselling and testing and care centres. India, Indonesia, Myanmar and Thailand — the high-burden countries in terms of HIV — have strong and unique TB–HIV referral and integrated management mechanisms.

However, to reach the hard-to-reach populations in need of TB care, the primary-health care approach is seen as the most feasible way. Public–private initiatives have resulted in increased notification of cases. Community-based TB services are expanding, and have demonstrated cost–effectiveness, higher utilization of services, and better outcomes. Social support that entitles TB patients to community-based poverty alleviation schemes positively impacts treatment access as it brings down social and economic barriers.

TB is curable. With the focus on increased community awareness and community engagement in tuberculosis, reaching the million in need of treatment will be a major step forward in the ultimate goal of eliminating TB.

World Meterological Day 2014

World Meteorological Day 2014

Weather and climate: engaging youth

World Meteorological Day is celebrated every year on 23 March to commemorate the entry into force in 1950 of the convention that created the World Meteorological Organization. The day also highlights the huge contribution that National Meteorological and Hydrological Services make to the safety and well-being of society.

This year's World Meteorological Day theme is “Weather and climate: engaging youth." Today’s youth will benefit from the dramatic advances being made in our ability to understand and forecast the Earth’s weather and climate. At the same time, most of them will live into the second half of this century and experience the increasing impacts of global warming. We should encourages young people to learn more about our weather and climate system and to contribute to action on climate change.


⁠

Unsafe Abortion - How To Prevent

Preventing unsafe abortion

Key facts

Around 22 million unsafe abortions are estimated to take place worldwide each year, almost all in developing countries.

Deaths due to unsafe abortion account for 13% of all maternal deaths. Africa is disproportionately affected, with nearly two-thirds of all abortion-related deaths.

Around 5 million women are admitted to hospital as a result of unsafe abortion every year.

More than 3 million women who have complications following unsafe abortion do not receive care.

The annual cost of treating major complications from unsafe abortion is estimated at $680 million .

Almost every abortion death and disability could be prevented through sexuality education, use of effective contraception, provision of safe, legal induced abortion, and timely care for complications.

Unsafe abortion occurs when a pregnancy is terminated either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both.

The persons, skills and medical standards considered safe in the provision of abortion are different for medical abortion (which is performed with drugs alone), and surgical abortion (which is performed with a manual or electric aspirator). Skills and medical standards required for safe abortion also vary depending upon the duration of the pregnancy and evolving scientific and technical advances.

Women, including adolescents, with unwanted pregnancies often resort to unsafe abortion when they cannot access safe abortion. Barriers to accessing safe abortion include:

restrictive laws;

poor availability of services;

high cost;

stigma;

conscientious objection of health-care providers; and

unnecessary requirements such as mandatory waiting periods, mandatory counselling, provision of misleading information, third-party authorization, and medically unnecessary tests, that delay care.

Scope of the problem

Based on 2008 data, WHO estimates that there are approximately 22 million unsafe abortions annually, resulting in 47 000 deaths, and more than 5 million complications such as:

incomplete abortion (failure to remove or expel all of the pregnancy tissue from the uterus);

haemorrhage (heavy bleeding);

infection;

uterine perforation (caused when the uterus is pierced by a sharp object); and

damage to the genital tract and internal organs by inserting dangerous objects such as sticks, knitting needles, or broken glass into the vagina or anus.

Globally, unsafe abortion accounts for an estimated 13% of all pregnancy-related deaths.

In developed regions, it is estimated that 30 women die for every 100 000 unsafe abortions. That number rises to 220 deaths per 100 000 unsafe abortions in developing regions and 520 in sub-Saharan Africa.

Mortality from unsafe abortion disproportionately affects women in Africa. While the continent accounts for 29% of all unsafe abortions, it sees 62% of all abortion-related deaths.

Who is at risk?

Any woman with an unwanted pregnancy who cannot access safe abortion is at risk of unsafe abortion. Poor women are more likely to have an unsafe abortion than more affluent women. Deaths and injuries are higher when unsafe abortion is performed later in pregnancy. The rate of unsafe abortions is higher where access to effective contraception and safe abortion is limited or unavailable.

Complications of unsafe abortion requiring emergency care

The major life-threatening complications resulting from unsafe abortion are haemorrhage, infection, and injury to the genital tract and internal organs.

Signs and symptoms

An accurate initial assessment is essential to ensure appropriate treatment and prompt referral for complications of unsafe abortion. The critical signs and symptoms of complications that require immediate attention include:

abnormal vaginal bleeding;

abdominal pain;

infection; and

shock (collapse of the circulatory system).

Complications of unsafe abortion can be difficult to diagnose. For example, a woman with an extra-uterine or ectopic pregnancy (abnormal development of a fertilized egg outside of the uterus) may have symptoms similar to those of incomplete abortion. It is essential, therefore, for health-care personnel to be prepared to make referrals and arrange transport to a facility where a definitive diagnosis can be made and appropriate care can be delivered quickly.

Treatment and care

Haemorrhage: timely treatment of heavy blood loss is critical, as delays can be fatal.

Infection: treatment with antibiotics along with evacuation of any remaining pregnancy tissue from the uterus as soon as possible.

Injury to the genital tract and/or internal organs: if this is suspected, early referral to an appropriate level of health care is essential.

Access to treatment for abortion complications

Health-care providers are obligated to provide life-saving medical care to any woman who suffers abortion-related complications, including treatment of complications from unsafe abortion, regardless of the legal grounds for abortion. However, in some cases, treatment of abortion complications is administered only on condition that the woman provides information about the person(s) who performed the illegal abortion.

The practice of extracting confessions from women seeking emergency medical care as a result of illegal abortion, and the legal requirement for doctors and other health-care personnel to report cases of women who have undergone abortion, delays care and increases the risks to women’s health and lives. UN human rights standards call on countries to provide immediate and unconditional treatment to anyone seeking emergency medical care .

Prevention and control

Unsafe abortion can be prevented through:

good sexuality education;

prevention of unintended pregnancy through use of effective contraception, including emergency contraception; and

provision of safe, legal abortion.

In addition, deaths and disability from unsafe abortion can be reduced through the timely provision of emergency treatment of complications.

Economic impact

In addition to the deaths and disabilities caused by unsafe abortion, there are major social and financial costs to women, families, communities, and health systems. In 2006, it was estimated that $680 million was spent treating serious consequences of unsafe abortion (1). An additional $370 million would be required to fully meet the unmet need for treatment of complications from unsafe abortion .

Childhood Obesity

All over world the number of school children who are suffering from obesity has doubled from nineteen eighties and this is more than tripled in the adolescent age group. Therefore, unless remedial actions are being taken, the complications related to obesity would raise in the future population. Among these complications, diabetes and low self esteem leading to reduced production capacity of an individual can be considered as the main disease burdens.
REASONS
There can be many reasons as to why a child becomes obese. This could range from genetic susceptibility, dietary intake, physical activity or else due to certain medical problems. But, among these reasons, most are modifiable and therefore, preventable. When considering these children, it would be correct to state that, they spent almost the same amount of time in school as they do at home. Therefore, the school becomes a second home which now has to play a part in not just giving education but improving the health aspect of these children as well.

For the growing problem of childhood obesity, the schools have been thought of as the best place to intervene effectively as home intervention can vary due to many factors. Thus, the teachers, parents as well as the students themselves need to engage in these activities for it to be fruitful.  There are 10 strategies can be adopted in order to bring about a lasting change in the health aspect of children and let us discuss some of these strategies one by one.

First of all, the strategies are aimed at building a strong foundation within the school in order to carry out the interventional programmes as well as to improve and evaluate while sustaining such implementations. The strategies aimed in achieving such a foundation would be,

1. Address physical activity and nutrition through a Coordinated School Health Program (CSHP).

2. Designate a school health coordinator and maintain an active school health council.

3. Assess the school's health policies and programs and develop a plan for improvements.

4. Strengthen the school's nutrition and physical activity policies.

The second set of strategies are aimed at the ways in which action can be taken and these strategies are listed out as,

5. Implement a high-quality health promotion program for school staff.

6. Implement a high-quality course of study in health education.

7. Implement a high-quality course of study in physical education.

8. Increase opportunities for students to engage in physical activity.

9. Implement a quality school meals program.

10. Ensure that students have appealing, healthy choices in foods and beverages offered outside of the school meals program.

 When looking at these strategies, it is vital that schools are organized in a manner that there is coordination between programmes and the expected overall outcomes. Apart from the focused group of school children, the programmes need to look in to aspects related to the home environment as whatever the plan of action implemented at school, if the child’s home does not support backup, the actions might not get materialized after such pain staking implementation process.

To Avoid Breast Cancer

To Kick off "Breast Cancer".
Nurse your baby.
Wash your bra daily.
Avoid black bra in summer
Do not wear a bra while sleeping.
Do not wear an under wire bra very often.
Always cover your chest completely by your dupatta or scarf when you are under the sun.
Use a Deodrant not an anti perspirant.

Indian Snail Venom Relief Pain

Snail venom proven to reduce pain

An experimental drug made from snail venom has shown early signs of promise in numbing pain, raising hopes in the hunt for new, non-addictive medications.

The drug, which has not been tested yet on humans, was judged to be about 100 times more potent than morphine or gabapentin, which are currently considered the gold standard for chronic nerve pain.

The active ingredient, conotoxin, comes from carnivorous cone snails, which are common in the western Pacific and Indian Ocean.

The marine animals can reach out and stab prey, injecting a venom that paralyzes fish long enough for the snail to eat it up.

Free From Fear About Premature Ejaculation

Premature ejaculation is sexual disorder in which ejaculation occurs early before reaching adequate sexual satisfaction in men and in female while engaging in sexual intercourse. Therefore, the duration in which a person is classified as having premature ejaculation would vary from person to person. For instance, a person might complaint of premature ejaculation within 1 or 2 minutes where another person might complaint of the same even after lasting for almost 20 minutes. But, the fact of the matter is, the problem bothers the person and this can have a damaging consequence for the person as well as his relationships.

There are many methods that are being used in order to treat or prevent a person from getting premature ejaculation, but, none of these measures proves to be 100% effective in each and every person. Additionally, these methods would need motivation and adherence by both the affected person as well as his partner and in certain instances lifestyle modifications would also be useful.

Let us now discuss some of these measures that are useful in avoiding premature ejaculation.

Cognitive behavioral therapy (CBT)

Alteration of the thinking and actions has proven to be effective in many instances and probably be one of the oldest methods used in treating this condition. But, the procedure needs to be practiced for a certain period of time and it should be a gradual buildup rather than an abrupt implementation.

One of the methods used in CBT is the ‘start-stop technique’. In this method, the person is asked to reach climax by means of masturbation or else at the time of having sexual intercourse and as soon as he reaches this point to re-focus the attention to a totally different thought and stop the masturbation process.  If the person was engaging in intercourse, it should be stopped and withdrawn. Thus, with such ‘stop’ action, the person will be able to suppress having an orgasm. The process is to be practiced several times a day or else at his convenience at regular intervals. With time, it will be possible to prolong the duration and thus the time a person enjoys his sexual interaction.

Medications

There are several medical treatment options available for the use of premature ejaculation and some of these methods include giving anti-depressant medications, applying local anesthetic agents in the form of a gel or else as an impregnated condom…etc.

Although these methods have proven to be effective in certain instances, the side effects of its use needs to be discussed with the healthcare provider and it should be started only after measuring the risks and benefits.

Apart from the above mentioned options, there are certain procedures and devices which are being introduced in order to delay the ejaculation time and these methods need to be suggested and implemented with the advice from your healthcare provider

Free From Fear About Premature Ejaculation

Premature ejaculation is sexual disorder in which ejaculation occurs early before reaching adequate sexual satisfaction in men and in female while engaging in sexual intercourse. Therefore, the duration in which a person is classified as having premature ejaculation would vary from person to person. For instance, a person might complaint of premature ejaculation within 1 or 2 minutes where another person might complaint of the same even after lasting for almost 20 minutes. But, the fact of the matter is, the problem bothers the person and this can have a damaging consequence for the person as well as his relationships.

There are many methods that are being used in order to treat or prevent a person from getting premature ejaculation, but, none of these measures proves to be 100% effective in each and every person. Additionally, these methods would need motivation and adherence by both the affected person as well as his partner and in certain instances lifestyle modifications would also be useful.

Let us now discuss some of these measures that are useful in avoiding premature ejaculation.

Cognitive behavioral therapy (CBT)

Alteration of the thinking and actions has proven to be effective in many instances and probably be one of the oldest methods used in treating this condition. But, the procedure needs to be practiced for a certain period of time and it should be a gradual buildup rather than an abrupt implementation.

One of the methods used in CBT is the ‘start-stop technique’. In this method, the person is asked to reach climax by means of masturbation or else at the time of having sexual intercourse and as soon as he reaches this point to re-focus the attention to a totally different thought and stop the masturbation process.  If the person was engaging in intercourse, it should be stopped and withdrawn. Thus, with such ‘stop’ action, the person will be able to suppress having an orgasm. The process is to be practiced several times a day or else at his convenience at regular intervals. With time, it will be possible to prolong the duration and thus the time a person enjoys his sexual interaction.

Medications

There are several medical treatment options available for the use of premature ejaculation and some of these methods include giving anti-depressant medications, applying local anesthetic agents in the form of a gel or else as an impregnated condom…etc.

Although these methods have proven to be effective in certain instances, the side effects of its use needs to be discussed with the healthcare provider and it should be started only after measuring the risks and benefits.

Apart from the above mentioned options, there are certain procedures and devices which are being introduced in order to delay the ejaculation time and these methods need to be suggested and implemented with the advice from your healthcare provider

Treatment for Muscle cramps

Muscle cramps can be defined as a forceful and sustained contraction of a muscle or a muscle group and it can last for as short as a few seconds to about 10 – 15 minutes. These cramps can occur in many instances and could have several underlying causative factors as well. In some instances, it would be difficult to distinguish a reason and if a reason is found, it does not indicate that the person is liable to experience cramps in future such situations as well.

This ambiguity will make it ever more difficult to predict but, it will be possible to predict situations that are likely to cause such an event. When considering the main causes and risk factors for muscle cramps,Dehydration and fluid losses ,Electrolyte imbalance ,Calcium and magnesium deficiencies ,Old age ,Exposure to extreme weather conditions ,vigorous exercises
,Injuries,diabetes,and hypothyroid state.

Although many of us would encounter cramps while engaged in certain activities such as sports, rest cramps can also be experienced especially during the night. This can be seen more frequently among the elderly and an underlying cause would not be apparent in most instances.

Following the occurrence of such a cramping feeling, usually it will last for only few seconds to minutes and will resolve itself. But, the intense pain that it generates can be unbearable and would be sometimes agonizing. The rest pain that occurs in the night will make the patient to be awake from sleep and it is possible for such cramps to recur from time to time or else as a frequent occurrence each day.

When treating cramps, usually, it will almost always respond to stretching exercises and this can be done for even the small muscles in the hands and feet. It would be easier for you to seek help from another person when doing the stretching and it is also possible to do it by yourself if the need arise.

Pulling on the feet using the hands while laying on a flat floor or stretching against a wall are some simple techniques in stretching a muscle group and placing the hands flat against a surface and extending the fingers as widely as possible will make the hand muscle be relieved from cramps in most instances.

Apart from the stretching exercises, correcting any underlying causes will also take precedence in treatment and therefore, taking enough salts and minerals, rehydration with mineral water or using electrolyte supplements can be considered rather important.

As an additional remedy, placing hot or cold packs at the site of a cramp can give relief in certain instances whereas massaging can also bring relief in some forms of cramps.

Rabies controll program is a role model in Tamilnadu

For a state like Tamil Nadu which reports at least 20 rabies deaths a year, the fresh set of guidelines released by the Union health ministry holds promise. The protocol pushes for further use of antibodies to treat patients because they are more effective in preventing the deadly virus.
Readymade antibodies, called rabies immunoglobulins (RIG), can provide immunity a lot faster if injected at the bite spot. "It stops the virus from travelling into the blood stream and reaching the nervous system.
The 'National Guidelines on Rabies Prophylaxis' has stressed on the use of RIG not only in category III bites but also in category II bites if the patient is weak. "If the bite is in the lower part of the torso like the legs or if it is just a surface level bite, we usually administer only the anti-rabies vaccine (ARV). "We consider it grade II if the dog is behaving normally," he added. The ARV given in four doses over 28 days stimulates production of antibodies, and takes at least 14 days to provide immunity.
Although India accounts for nearly 50% of the global rabies mortality, there is no organised national rabies control programme. Rabies control is generally confined to small urban pockets, with minimal intersectoral co-ordination. Tamil Nadu is the first state in India to implement a state-wide, multisectoral rabies control initiative. The CDC Program Evaluation Framework guided the current assessment of this rabies prevention and control initiative in Tamil Nadu. Principle stakeholders were engaged through a series of interviews in order to document policy initiatives, to describe the programme and to understand their various roles. Surveillance data on dog bites were triangulated with vaccine consumption and dog population data to identify trends at the district level in the state. Findings and recommendations were shared at different levels. Rabies control activities in Tamil Nadu were conducted by separate departments linked by similar objectives. In addition to public health surveillance, animal census and implementation of dog licensing rules, other targeted interventions included waste management, animal birth control and anti-rabies vaccination, awareness campaigns, and widespread availability of anti-rabies vaccine at all public health facilities.