OCD-treatment-brain-surgery

Sion Hosptial [Lokmanya Tilak Medical College LTMC] of Mumbai makes a breakthrough by providing DEEP BRAIN STIMULATION for a patient with Obsessive Compulsive DisorderOCD.

Obsessive Compulsive Disorder makes the person repeat simple routines innumerable times, unnecessarily, like washing hands or checking whether the door is locked. People with Obsessive Compulsive Disorder OCD are bothered by the repeated recurrent thoughts (not worries)that they though they know are unwanted are uncontrollable. This uncontrolled compulsive phenomenon causes tremendous anxiety and inconvenience to the patient and to those who stay with them.

Majority of people who have Obsessive Compulsive DisorderOCD show dramatic improvement from compulsive thoughts and chores with medicines like Paroxetine, Clomipramine and other SSRIs. Studies in the use of Deep Brain Stimulation for treatment of Depression, Schizophrenia, Parkinson's disease, OCD are showing promising results.
The NeuroPsyciatric Surgeons who do the surgery using advanced precise surgical methods are optimistic whereas the Psychiatrists who have been treating thousands of such patients are still wary and watchful about the result outcome.
To find about the success of DEEP BRAIN STIMULATION treatment for DEPRESSION read here: Similar treatment for Depression.
Publication: TOI_Mumbai
Date: 25/04/2008
Section: Front Page
Page Number: 1



THE TIMES OF INDIA
Surgery cure for OCD patient
Malathy Iyer | TNN

Mumbai:
Washing hands under a running tap was never enough for Jyoti Salunkhe, a 32-year-old from a village in Jalgaon taluka. She would follow it up with an arcane ritual—filling her mouth with water, spitting it out at four distinct spots on her left hand and another five on her right hand. It would take 50—at times, 90—such rounds of washing hands every day to allay Salunkhe’s fears of contamination.

She would also “wash’’ the “contaminated’’ walls of her home or the village school’s windowpanes. “People would keep asking us why she did such things,’’ her father Jayant Patil said.

The pattern changed drastically earlier this month after Salunkhe became the first patient to undergo neurosurgery in a public hospital in Mumbai to control her obsessive-compulsive disorder. Now, she washes her hands only when needed.

Doctors from Sion Hospital’s new neuropsychiatric surgery service operated on Salunkhe, free of cost, on April 11. The operation was definitely the first for a public hospital, and city doctors said it could be the first such surgery in any Mumbai health establishment.

“We are pleased at how well she has responded to surgery,’’ neurosurgeon Alok Sharma and psychiatrist Nilesh Shah, heads of their respective departments, told TOI.

WHAT IS OCD?
Obsessive compulsive disorder (OCD) is an anxiety disorder characterised by recurrent thoughts (obsessions) and/or repetitive behaviour (compulsions). Handwashing, counting, checking or cleaning are often resorted to in the hope of preventing obsessive thoughts or making them go away. But performing these ‘rituals’ provides only temporary relief and not performing them markedly increases anxiety. FROM OCD TO NORMALCY Jyoti Salunkhe Washed Her Hands 90 Times A Day. Now, After A Surgery, She Has Lost Her Fear Of ‘Contamination’

OCD, as Jalgaon resident Jyoti Salunkhe’s disorder is better known, is among the common mental health problems that affect 3 per cent of the general population. Most patients respond well to medication and psychotherapy but a small percentage like Salunkhe do not and they may need surgical correction.
“When she came to Sion Hospital, referred by a former student now practising in Jalgaon, we kept tabs on how often she would
wash her hands. She clocked between 55 and 90 times a day. But, after the surgery, she has been washing her hands only when necessary (like before meals),’’ Sion Hospital neurosurgery head Alok Sharma said.

Salunkhe’s operation was given the green signal only after a long assessment procedure, spanning days and involving several medical teachers from various departments. “Neuro-psychiatric surgery is only meant for patients who don’t respond to medications or behaviour therapy,’’ Sharma said. “Surgery is often the last resort but can be life-saving as some of the OCD patients get suicidial,’’ Sion Hospital psychiatry head Nilesh Shah added.

Suresh Badamath of Bangalore’s governmentrun Nimhans (National Institute of Mental Health And Neuro-Sciences) appreciated the fact that a Mumbai public hospital was offering neuropsychiatry procedure free of cost for poor patients. But he pointed out that surgery produced only “30 per cent-40 per cent’’ results.

“We use it sparingly. Nimhans has conducted only two such surgeries in the last 10 years,’’ he said. These operations were cleared by a committee comprising experts from the hospital as well as outside.

Badamath feared that surgery, if offered indiscriminately, could emerge as the first choice of patient’s relatives. “And the private sector may have no compunction in going along with that choice,’’ he said. However, for Salunkhe, the surgery has meant a new start and a reunion with her 10-year-old son and husband.
Salunkhe’s OCD showed up at the same time when her husband, under the influence of alcohol, started beating her. Salunkhe’s father, Jayant Patil, said: “My daughter’s mind got affected because her husband used to bang her head against the wall. She has been shuttling between my home and her in-laws’ home for the last 10 years because of this.’’

Her medicines kept increasing. She was given ECT (electric shock therapy) but that failed to improve matters. “She has been on six highpotency drugs for the last couple of years. Doctors said this was the maximum dosage they could allow here but yet there was no improvement,’’ Patil said. He spends about Rs 2,500 a month on the drugs.

For Sion Hospital doctors, the surgery means they have the most wholesome treatment package to offer mental health patients.
Twenty-nine-year-old Mahesh Goradia (name changed) from Mumbai was operated for untreatable aggressive and violent behavior and uncontrolled convulsions. “We targeted the amygdala, an area of the brain responsible for fear and violence, in his case. His aggression, violence and convulsions have stopped,’’ Sharma said.

But don’t neuropsychiatric surgeries have side-effects?
Well, in Salunkhe’s case, there has been no immediate side-effect (like convulsions) and her symptoms seem under control. But Shah had words of caution: “The neurons could reform a few months later and the symptoms could reappear.’’ But the surgical intervention would ensure that Salunkhe’s response to medicines and behaviour therapy was better, he added.

OCD: SIGNS & SYMPTOMS
People with OCD may be plagued by persistent, unwelcome thoughts or images
or by the urgent need to engage in certain rituals. They may be obsessed with
germs or dirt and wash their hands over and over. They may be filled with doubt
and feel the need to check things repeatedly.
TYPICAL OCD OBSESSIONS FEAR of contamination or dirt | REPEATED doubts | KEEPING things orderly and symmetrical | AGGRESSIVE or horrific impulses | SEXUAL images
OCD SYMPTOMS
FEAR of being contaminated by shaking hands with people or by touching objects others have touched HAVING doubts that you have locked the door or turned off the stove REPEATED thoughts that you have hurt someone in a traffic accident INTENSE distress when objects are not orderly, lined up properly or facing the right way IMAGES of hurting your child IMPULSES to shout obscenities in inappropriate situations
RISK FACTORS FAMILY history | STRESSFUL life events | PREGNANCY

THE SURGERY
Neuro-psychiatric surgery involves making lesions in the brain that break the neural circuits that are responsible for these symptoms.
In Jyoti Salunkhe’s case, the area to be treated surgically was first identified with the help of MRI scans; using complex calculations, coordinates were obtained of its exact location.

Doctors use specialised stereotactic neurosurgery equipment, which have sub-millimeter accuracy, to reach and treat the brain’s affected area. Salunkhe’s surgery was done though a 1-cm hole and she was conscious throughout the surgery.

SURGERY VS MEDICINE: THE DEBATE CONTINUES
When Portuguese physician Egan Moniz won a Nobel in the early 1950s, it made a big splash; he won it for developing a new surgical technique called pyschosurgery or surgery for the mentally ill. The infamous lobotomies, in which the patients’ brains were crudely operated and removed, thus become the norm. This continued till the mid-1970s. But, as the concept of patients’ rights came to the fore, there began a movement against psychosurgery. And, for the past 20-30 years, surgery has been trying gain respectability with its newer and minimally invasive methods.
A new nomenclature — neuropsychiatry —has emerged now. “Neuro-psychiatric surgery is done in very few centres in the world,’’ neurosurgeon Alok Sharma, who travelled to Harvard University’s Mass General Hospital to learn it, said. Before starting the neuropsychiatry surgical service at Sion Hospital, Sharma also met India’s first woman neurosurgeon, 75-year-old T S Kanaka from Chennai, who has done pioneering work in this field and offered him useful tips. Neuro-psychiatric surgery has evolved hugely in the last decade to the extent that a Canadian centre is using deep-brain stimulation surgery to treat severe depression. Schizophrenia is another area that neurosurgeons are active in.

DOC SPEAK
OCD has a better prognosis than before, thanks to better medication and psychotherapies. Surgery is a remote treatment only for those who have failed medications and therapies in all permutations and combinations across time. Surgical optimism is not similar to the treatment of a cataract, blocks in the heart or even cancer. OCD can destroy the mental health of the entire family as its compulsive acts can cause continuous agony. Brain surgery should be sought after a serious review by a multi-disciplinary team with pragmatic expectations that the illness cannot be cured but only reasonably controlled.
Harish Shetty | PSYCHIATRIST


Source:

THE TIMES OF INDIA



Dr. Ashok Koparday
_{MBBS, FC SEPI}
Medical Director
Samadhan India

Center for Therapy, Education, Research in

Sex, Marriage, Relationships


Ex. Teaching Faculty

Seth G. S. Medical College and K. E. M. Hospital and

Grant Medical College and Sir J. J. Group of Hospitals

University of Mumbai, India


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Depression-treatment-brain-pacemaker

Deep Brain Stimulation by tiny "pacemakers" inserted in ventral anterior internal capsule of brain improves Refractory Depression.

Only SIX patients were studied
4 of 6 patients showed 50% improvement over 6 months. Study with more number of patients is needed. One in Ten people have Depression in USA
Deep Brain Stimulation also used in OCD, Parkinson's & Epilepsy.

CLICK TO SEE HOW DEEP BRAIN STIMULATION HELPS IN OCD

A small study has found that inserting two tiny “pacemakers” into the base of a depressed person’s brain improved symptoms of their major depression.
TO BOTTOM
The treatment is called deep brain stimulation and utilizes tiny pulses of electricity to block abnormal brain activity, according to researchers.

The researchers from the Cleveland Clinic and Brown University’s Butler Hospital took six patients who had not benefited from various other treatment options, including medication, psychotherapy, and electroconvulsive therapy, and inserted pairs of the tiny electrodes into each of them. Over the course of a year, two-thirds of the individuals had noticeable improvement, the researchers said.

“It was interesting and impressive to see how their lives changed over time,” said Dr. Ali R. Rezai, study author and head of Stereotactic and Functional Neurosurgery at the Cleveland Clinic Foundation. He continued, “they went from being withdrawn and not interacting to going back to work, and showed marked improvement in self-care and social function. They are living their lives much more fully than they were when they were stuck in the grip of depression.”

Another successful study was reported last year in the journal Neuron.

Rezai presented the findings at the American Association of Neurological Surgeons annual meeting in San Francisco this week.
TO BOTTOM TO TOP

The six patients – four women and two men – averaged 48 years old and had bilateral deep-brain stimulation leads implanted in a portion of the brain called the ventral anterior internal capsule. They underwent standardized and detail psychiatric, neuropsychological, and quality-of-life assessments on a regular basis, the researchers said.

After six months, 4 of the 6 showed a 50% or greater improvement, as well as improvements in quality-of-life measurements. Deep brain stimulation surgery has proven effective in the past for people suffering from obsessive-compulsive disorder (OCD), epilepsy and Parkinson’s disease, Dr. Rezai added.It’s not currently understood exactly why the treatment works, but it seems to help the brain resume normal chemical and electrical function. Rezai explained the surgery is reversible and the electrodes can be adjusted without further invading the brain. It is performed under a local anesthetic, and according to Dr. Rezai the changes in patients could sometimes be seen “almost instantly.”

“As we were testing the pacemakers, we could see immediate change in their moods,” he explained, adding that people who had not smiled in years, smiled. “But,” he went on, “this is for people with no other hope. These poor patients had failed everything. I am encouraged by the results, but we need to do more long-term and larger studies.”
TO BOTTOM TO TOP
Dr. Michael Blumenfield, Sidney E. Frank distinguished professor of psychiatry and behavioral sciences at New York Medical College said he is skeptical of invasive treatments with the potential to do more harm than good, especially when there are other readily available effective treatments, but added that he had not seen the study.

He went on to say that while it’s good to look for more and better ways to treat major depression, it’s too often diagnosed improperly.

“Sometimes one thinks one has a simple depression when it is a bipolar depression that needs a mood stabilizer,” he said. “Sometimes the underlying problem is substance abuse, and sometimes when one has resistant depression, the issue has psychological roots, and there is a need for psychotherapy.”

All of the people involved in this study were resistant to other treatment options, Rezai stated.
TO TOP
The World Health Organization (WHO) rates major depression as the major cause of worldwide disability, report the researchers. In this country alone, an estimated 9.5% of the adult population - around 18.8 million people - suffers from a depressive disorder each year. The cost to the American workplace alone is around $40 billion a year.
TO TOP
Source

Surgery for depression?

By Jase Donaldson
Apr 27, 2006 - 9:09:00 AM
Thanks to Insight Journal
© Copyright 2007 Insight Journal Online Magazine.
Insight Journal is a service of the National Center for Health and Wellness, Co.


Dr. Ashok Koparday
_{MBBS, FC SEPI}
Medical Director
Samadhan India
Center for Therapy, Education, Research in
Sex, Marriage, Relationships

Ex. Teaching Faculty
Seth G. S. Medical College and K. E. M. Hospital and
Grant Medical College and Sir J. J. Group of Hospitals
University of Mumbai, India

ASK ON MOBILE

sex-education-in-schools

Sex Education in Maharashtra Schools featured in
THE TIMES OF INDIA
dated 23 Apr 2008, 0358 hrs IST,TNN

THE TIMES OF INDIA
MUMBAI: After much stormy debate on the introduction of sex education in schools, the state government has decided to make the subject compulsory in schools from Standard IX.

Education minister Vasant Purke, announcing this in the legislative council on Tuesday, said sex education would be introduced from the coming academic year.

Purke has other several plans up his sleeve. A few years ago, the Democratic Front government had invited tremendous flak for announcing board exams for Standard Four children and had to drop the idea.

However, Purke on Tuesday announced that board exams were being planned for Standard Seven. The minister also said that the government had plans to bring in a Right to Education bill. This means that every child will have a right to education, and parents who do not send their wards to school could face punishment under the law.

During the debate in the council, the government also admitted that the quality of education was low in rural areas.

Purke announced the introduction of an education audit, saying this would check the quality of education. He also said that agricultural science would be introduced in the school syllabus.



Dr. Ashok Koparday

_{MBBS, FC SEPI}
Medical Director

Samadhan India

Center for Therapy, Education, Research in

Sex, Marriage, Relationships


Ex. Teaching Faculty

Seth G. S. Medical College and K. E. M. Hospital and

Grant Medical College and Sir J. J. Group of Hospitals

University of Mumbai, India


ASK SEX DOCTOR ON MOBILE

how-to-effectively-manage-family-relations

Samadhan

Samadhan Special Skills plays crucial role by empowering you with tools to handle relationships.


IMPORTANCE OF RELATIONSHIPS
Partners who make a real relationship work have certain skills. They know and practice core interpersonal skills, which allows them to form a relationship that can endure, deepen, and grow.

Samadhan Center provides professional program for developing SSS Samadhan Special Skills that help you enjoy healthy marital relationship.

What does

SSS

do?

Samadhan Special Skills help you begin your married life well equipped with nuances in family matrix that need to be handled skillfully to sustain healthy family relations.

What is the right time?

As soon as a girl or a boy get engaged it is recommended that they take the benefit of the SSS program.

Why take up the

SSS

program?

Marriage is not just union of two different human beings, but it is union of two families as well.

Marriage inevitably ushers in Relationship Matrix.
It is important not just to say, “Wish you a happy married life”, but to impart skills for having a quality rich married life. That is what SSS is all about. It is invaluable in establishing healthy relationships for a life time.

What is the benefit of

SSS?
Marriage is a phase where there is a profound change in relationships. Begin new life with SSS so that the First impact can set you on the road to fulfilling relationships. Marriage entails slippery ground of differing expectations and values of life as well as unknown parameters. Marriage can be challenging even to the best amongst us. SSS is a powerful tool to have with you.

SSS program offers tips and tools for those seeking more meaning and healthy closeness in their relationship. A real relationship provides its partners with the opportunity for personal growth, development of the real self, and emotional and spiritual well being. If you have previous experience of bruised relationship SSS helps in relationship healing and opens doors to new promising life.

You get clear explanations, practical skills, insightful background, and a map for healthy journey that is possible in real relationships.

Can those already married benefit from Samadhan

SSS

program?

Learn how to overcome the power of difference, diffidence and shame, which may threaten the level of your satisfaction. The dynamics of difference and shame have the power to set up the development of a false self. The false self defensively refuses to assert the real self. Overcoming the power of these dynamics is the source of transforming unhealthy wounded relationships and individuals into healthy ones.

The Samadhan SSS program rovides professional help in the following areas:

o Assertiveness Skills

o Overcoming Your Anger

o Overcoming Your Partner's Anger

o Overcoming Difference and Shame

o Overcoming Your Anxiety

o Conflict Resolution Skills

o Direct Communication Skills

o Listening Skills



Dr. Ashok Koparday

_{MBBS, FC SEPI}
Medical Director

Samadhan India

Center for Therapy, Education, Research in

Sex, Marriage, Relationships


Ex. Teaching Faculty

Seth G. S. Medical College and K. E. M. Hospital and

Grant Medical College and Sir J. J. Group of Hospitals

University of Mumbai, India


ASK SEX DOCTOR ON MOBILE

sex-positions-free-websites-review

This summary is not available. Please click here to view the post.

infinitely-more-than-sexual-pleasure

आत्मानंद आणी मैथुनानंद

DIVINE BLISS compared to SEXUAL CLIMAX

एक्नाथानी आत्मानंद आपल्याला समजावे म्हणुन मैथुनाच्या आनंदाची
तुलना केली आहे।

गोंदवलेकर महाराज म्हणाले,

"सामान्य माणुस वेग्वेग्ळल्या मारगाने आनंदाचा अनुभव घेतो.
त्यापैकी सगळ्यात उत्तकट अनुभव मैथुनात येतो. त्याच्या िक्तीतरी पट ब्रह्मानंद आहे हे संगण्यासाठी नाथानां ती उपमा द्यावी लागली. उत्कट अनंदाचे याच्यापेक्षा जास्त माप तुमच्यापाशी नाही; याबदल नाथानां दोष कसा बरे देता येइल?"

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sexual-health-other-diseases

Sex n Heart
सेकशुअल

Dysfunctions --> Signal cardiac problems inmen.
*** Love making tells about your guy's heart ***

Though in men sexual dyfunction is a warning signal for coronary artery disease and ischemic heart disease [heart attack] study reports show no such connection between female sexual dysfunctions and heart diseases.

Heart woes only for men. Are you listening sweetheart?

A note of caution: Other diseases can lead to sexual difficulties in women or men, including
diabetes,
obesity,
arthritis and
causes of fatigue such as allergies.
You better know answers to these questions. Socrates's method is the best.
ASK THE DOCTOR
What actions you can take to enhance your sexual and overall health?
How to treat a low sex drive
Is my hubby hooked on porn?
A fine romance but no orgasms
An intimate piercing: pros and cons
Here is the beginning of my post.
Sex is GIVE & TAKE
share tips with others and get helpful advice.
Communicating with your doctor
Although talking with your doctor may not always be easy, it is essential to getting quality health care. Asking questions can help. We can help you understand how some common barriers to good communication can be overcome by asking the right questions.
Keep Looking for More at ASK SEX DOCTOR


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premarital-extramarital-sex-risk3

How to tell your husband/wife is cheating you?
There are at least
15 indicators pointing to infidelity.

Do not miss the article on

SEX AFFAIRS TEENAGERS

LOVE AFFAIR WITH WHOM
The love affair begins with meeting the person who is
[1]known to the family,[usually friend or relative]
[2]staying in neighborhood,
[3]studying in the same institute,
[4]working in same office or vicinity.
[5]acquaintance

ANATOMY OF AN AFFAIR
Love affair begins with 1 eye contact, which conveys attraction. This is the hunting scene. Then one finds occasion for 2 proximity. 3Speaking is the next to begin. 4 Touch, casual and then purposeful, follows.
5Meeting as situation demands, then creating situations for meeting.
Feeling a 6 HIGH when thinking about or talking to the person.

In most affairs it is immaterial whether the other person is married or is going to get married to someone else.

LOVE AFFAIRS: INCREASING OR DECLINING?
The scenario emerging is to meet as friends and share bed for sex, with no commitment to marriage. The focus is unabashed Sexual Pleasure. This is very heady and powerfully intoxicating. Once you have the taste of this it is difficult to leave occasions for sex with who ever is available.
Though love affairs (clandestine relations) existed in the late 1900s now with more women entering college, going to work has enabled opportunities like never before for mating. (sexual meeting)
15 signs to tell if your married partner is cheating.
1
Talking long hours on mobile phone. Exceeding 30 minutes. Certainly more than what a communication of information is required.
2.
Joy radiating on the face while talking on the mobile.
3.
Talking late at nights, early morning or lunch hours.
4.
Naughty SMS going to and from
5.
Working late hours or extra periods in college.
6.
Overnight stay at friends place
7.
Receiving gifts and spending money for gifts.
8.
Having an alibi.
That is having a friend who will say that s/he was with me or
Having an office meeting that needs to be attended.
9.
Remarkable decline in interest for sex with married partner.
10.
Giving (unbelievable) excuses for being late.
11. Friends/Well wishers informing having cited them together where they would not be expected.
12.
Your intuitive sense that suspects something is out of place or happening behind your back. The behavior of the person, and the body language are different to an observant eye.
13.
Becoming supporter and giving logic in favor of, "So what if two people meet,".
14.
Coldness in communication with married partner.
15.
Honestly praising the lover and confiding as things happen so that the married partner knows before some one else tells. This is buttressed by excuses as to how unavoidable and unforeseen all it was.


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premarital-extramarital-sex-risk2

A teenager asked me, "If we take all precautions [SAFE SEX]; both of us are willing, then what is wrong with having sex before marriage?" To this question about premarital sex, I add,

"What is wrong with having extra marital sex between
consenting partners?"



THE TIMES OF INDIA
Mumbai Edition, Page 3, April 1, 2008


TOP
Do not leave without checking How to tell true love?"
Taking all precautions, popularly called as SAFE SEX means ensuring that
sexually transmitted disease [STI or STD] and unwanted pregnancy are avoided. The best method, in case you do not know, is using condom, during sexual intercourse.

Where this question was asked I had gone as Sex Educator. I had not gone to teach morality, but the question was [is] socially and morally relevant.
Since then I have asked this question as a part of my study and research in human sexual behavior to many people, teenagers and adults alike. I let you brood about the question and the answer that pops up in your mind. Let me continue with a riveting news that featured in
THE TIMES OF INDIA Mumbai Edition, on page 3, April 1, 2008;titled
Man [22 years] in love with aunt(23 years) kills uncle (30 years)
THE TIMES OF INDIA


Man in love with aunt kills uncle
1 Apr 2008, 0058 hrs IST,TNN

SMS NEWS to 58888 for latest updates
MUMBAI: A 23-year-old man, who stabbed his uncle to death over an affair with the deceased's wife, was caught by the crime branch even before the offence was registered or the body recovered from a salt pan in Thane on Monday.

The accused, Ashok Harilal Kannojia (22), who hails from Azamgarh in Uttar Pradesh, killed his uncle Keshav Kannojia (30), a tailor, on Sunday using a scissor in Naigaon on Sunday night. Ashok was arrested by the city crime branch and handed over to the Manikpur police station in Thane late on Monday.
TO TOP
"The murder was the result of an affair between Ashok and Keshav's wife, Geeta (23). Ashok, who had come to Mumbai eight years ago, was living with Keshav until two months ago when the latter came to know about his wife's illicit love affair.

A furious Keshav beat up Ashok and kicked him out from his Nalasopara residence. Ashok then rented a room at Meghwadi in Andheri, and was staying there," said crime branch chief Rakesh Maria. However, Ashok was very much in touch with Geeta over telephone. "Ashok says that Geeta had instructed him to kill her husband but to make sure that he was not caught," added Maria.

On Sunday night, Ashok met Keshav and offered him a drink. The duo went to a liquor shop in Jogeshwari. "Later, a sozzled Keshav boarded a train with Ashok who took him to Naigaon, near a salt pan where he allegedly stabbed Keshav with a scissor five times. Ashok then dumped Keshav's body behind the bushes and went to Nalasopara where he spent the night with Geeta," said Maria.

In the morning, Kannojia reached his Andheri residence. In the meantime, sub-inspector Anagha Satusi of the crime branch got information about a suspected murder and he took Ashok into custody from his residence.

Ashok has admitted to having killed his uncle. When the Mumbai crime branch contacted the Manikpur police station in Thane, there was neither any complaint nor were the police aware of the case. Later, the crime branch informed the Manikpur police about the location from where the body was recovered and a case of murder registered.

"Geeta is mother of five children. Ashok told us that he loved Geeta and therefore, killed his uncle," said Maria.

THE TIMES OF INDIA Mumbai Edition, on page 3, April 1, 2008;
Do not leave without checking How to tell true love?"
TO TOP


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viagra-side-effects

|| Drug viagra ® side effects * impotence cure * sildenafil side effects ||
impotence cure

Most common side effect of the impotence drug, sildenafil citrate, Viagra ®, is headache. You will also find resources for further learning.

As a Consultant in Sexual Medicine I find that



Let us tell the world true stories of Viagra side effects.[1]

keywords
impotence drug
impotence drugs
other side effects
sildenafil
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sildenafil side effects
tadalafil
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side effects of viagra ®
hard penis

most people have NO SIDE EFFECTS with Sildenafil Citrate.

NEW SIDE EFFECT of Sildenafil.
The new emerging adverse reaction that you will not find in any text book is that normal people who take Sildenafil as recreational drug or Confidence boosters have difficulty giving up the medicine. Not because it is habit forming, but rather because the erection with Sildenafil being chemically induced tends to be much more than the maximum that one gets as a normal healthy person. The duration of stiffness and the amount of stiffness is more than normal. This enables men to have subsequent successive sexual intercourse with the same partner or with multiple partners.They become the ultimate THE SEX MACHINE in this intimate play. They love to boast about their NEW sexual power. When these people, who are in their 20s or 30s, come to seek treatment to rid themselves of dependency on Sildenafil and to regain normal erections the treatment becomes difficult. No matter what you do the normal erections are not like the chemically induced erection and the male macho ego resists giving up Sildenafil.

Having told what side effects I notice in Clinical Practice, I will turn to the list of side effects that you will find in text book and several other websites.

MORE ABOUT SILDENAFIL (Viagra ®)
The drug Sildenafil Citrate, brand name Viagra ®, also called as the blue pill, was approved by FDA (Food and Drug Administration) for its use in the treatment of Erectile Dysfunction in the year 1998. The most potent, most studied, most sure medicinal drug in the human history of thousands of years, specifically used for the treatment of Erectile Dysfunction in the entire world is none other than Sildenafil Citrate. Thus, Sildenafil is the ONLY drug that has been in use for the LONGEST PERIOD of time (no less than 10 years).
Tip: ED = 'Erectile Dysfunction' is the preferred word, better and more correct than the word 'impotence'.

MENS HEALTH

Sildenafil HARDLY EVER causes major problem.

The common side effects seen in Clinical Practice are given below.
HEADACHE
Moderate to Severe throbbing type of Headache that persists up to 2 days is definitely seen among some people taking Sildenafil. This side effect of severe headache may interfere in work, but does not cause absenteeism in work. Often pain relieving medicine like Acetaminophen (Paracetamol), Tylenol® or Crocin ® is required to counteract headache. Some people describe it as migraine like headache. The wife (partner) is the first person who warns against taking Viagra ® . Such an intense headache that needs discontinuation of the drug (Sildenafil) is NOT COMMON.


More common side effect is head ache or heaviness of head that is bearable, lasts for 4 to 5 hours and neither interfere with sleep nor with the next day chores. Often headache is present when Sildenafil is taken for the first time and thereafter no side effects are noticed.
when Sildenafil is taken for the first time and not thereafter.

FLUSHING OF FACE
Extreme flushing of face (Garmi) is another side effect of sildenafil. It is noticed when Viagra is taken for the first time. This side effect can reduce and become negligible when sildenafil is taken for the 2nd time or later.

STUFFY NOSE
Slight stuffy nose may be noticed.

GASTROINTESTINAL SIDE EFFECT
Nausea, acidity, badan may garmi, peth main jalan are equally common.

VISION SIDE EFFECT
Described by people as 'Blurring of vision' or 'colors appear different to the eyes' is transitory, but can be scary enough to take them to an opthalmologist for an eye check up. When person taking Viagra reads the 'prescription leaflet' that accompanies Sildenafil, sold by whichever brand name, he is more prone to report this finding.
"For this reason, pilots cannot take Viagra® within 12 hours of a flight." [4]
"The most common side effects of VIAGRA are headache, facial flushing, and upset stomach. Less commonly, bluish vision, blurred vision, or sensitivity to light may briefly occur." [2]

Priapism
Erection lasting for over 4 hours is Priapism, which can cause permanent penis tissue damage .

Common

* flushing
* headache
* nasal congestion
* stomach discomfort following meals


Less Common

* abnormal vision including blurred vision, seeing shades of colors differently than before, or sensitivity to light
* bladder pain
* cloudy or bloody urine
* dizziness
* increased frequency of urination
* pain on urination
* diarrhea

Rare

* bleeding of the eye
* convulsions (seizures)
* decreased or double vision or other changes in vision
* prolonged, painful, or inappropriate erection of penis
* redness, burning, or swelling of the eye
* anxiety
source[3]

NITRATES
NOT TO BE TAKEN WITH NITRATES
It causes sudden drop in blood pressure that can drop a person dead.
What are nitrates?
In brief:
NITRATES are medicines commonly used for emergency treatment of
Angina, in your and my language it means, severe chest pain, or
suspected or impending or proven myocardial infarction (Heart attack) or
given as regular medication for Hypertension, (CardioVascular Disease).
WHAT IS TO BE DONE TO PREVENT VIAGRA SIDE EFFECTS

PRECAUTIONS AGAINST SIDE EFFECT
(1)
Always consult Physician and have him prescribe Sildenafil, a pharmacologically potent drug that causes PDE5 inhibition
(2)
Specially if you are 65 or older in age, or have serious liver or kidney problems
point (1) above is important
If you have prostate problems or high blood pressure for which you take medicines called alpha blockers (1)is essential.

(3)
Discontinue Sildenafil and report to Physician. The doctor may adjust the dose or change the medication. The dose of Sildenafil may be reduced by 1/2 (50 mg) or 1/4 (25 mg). Tdadalafil may be tried as a replacement for Sildenafil

(4)
Effective non medicinal methods of enhancing erection can be given by Sex Therapist.

(5)
People having side effects due to Sildanafil will have to use other available options like Vacuum Device or
ICIVAD (Intra Cavernosal Injection of Vaso Active Drug) / PIPE

General Precautions
for those who have any side effect due to Sildenafil is to use minimum required dose. The dose of Sildenafil may be reduced by 1/2 (50 mg) or 1/4 (25 mg). Tdadalafil may be tried as a replacement for Sildenafil or mechanical method like Vacuum Device may have to be used for the treatment.
ICIVAD (Intra Cavernosal Injection of Vaso Active Drug) / PIPE is another alternative.

NOTE
There is nothing like Herbal Viagra. No Scientific Evidence.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Links for further Study
[1] pillz.me/forums/mens_health
[2]VIAGRA ® Official Site - Information on VIAGRA Side Effects
[3] viagra-side-effects.net
[4]howstuffworks.com
[5]Official Prescripition Information

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Nitrates and Sildenafil


Nitrates and Sildenafil, taken together causes

severe drop in blood pressure that can cause death.
Same thing happens with Sildenafil's cousins,
Tadalafil and Vardenafil.



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What would happen if anti anginal medicine Nitrate is taken with Sildenafil?

Sudden life threatening fall in blood pressure occurs.

What we are not discussing in this post?
Side effects or bad side effects or adverse side effects, behavioral side effects or anti-depressant sexual side effects of viagra® or swelling prostrate pain or longterm side effects of viagra® or snorting viagra®.
We are not discussing side effects caused by drug-drug interaction between viagra® and other medicines like paxil®, but only viewing the dangers of interaction of viagra® and Nitrates.

What does the official pfizer site say about Viagra® and nitrates?
IMPORTANT SAFETY INSTRUCTION
If you take any medicines that have nitrates in them (like nitroglycerin for chest pain)—every day or even once in a while—you should NOT take VIAGRA® .

What are nitrates?

What are nitrates used for?
[A] Nitrates are medicines used in the treatment of angina, heart failure as well as [B] treatment of anal fissures. It is used as a
=cream that is applied in chronic anal fissure because chronic fissure does to respond to dietary advice.
[A]Organic nitrites and nitrates, such as glyceryl trinitrate (nitroglycerin), sodium nitroprusside, amyl nitrite ("poppers") are all nitric oxide donors and hence not to be taken with Viagra® /Sildenafil.

What is Angina?
Angina is peculiar kind of chest pain or discomfort. The chest pain may sometimes be mistaken to be due to acidity or gas. However, the pain of
Angina can be differentiated by its characteristics.
Angina Pain
1 Sudden chest pain that may also be felt in the shoulder, arm, jaw, neck, back, or other area
2 Pain that feels like tightness, squeezing, crushing, burning, choking, or aching
3 Pain that occurs at rest and does not easily go away when using medicine

Angina occurs when heart does not get sufficient oxygen. Angina alarms us of the possibility of heart attack (Acute Myocardial Ischemia)
AMI.

Nitrates are more useful in preventing angina attacks than reversing them once they have commenced.
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In what form is the medicine Nitrate available in market?
=Patches of glyceryl trinitrate with a long activity duration are commercially available. Glyceryl trinitrate is also indicated for heart attack (Acute Myocardial Ischemia)AMI and pulmonary edema. It may also be given as a
=sublingual dose in the form of a tablet placed under the tongue or a
=spray into the mouth for the treatment of an angina attack.

Glyceryl Trinitrate GTN is used as a medicine and also as an explosive.

Who are the people likely to get Angina?
The people with following features may get Angina and may need Nitrates.
* Being male
* Diabetes
* Getting older
* Family history of coronary heart disease before age 50
* High blood pressure
* High LDL cholesterol
* Low HDL cholesterol
* Not getting enough exercise
* Smoking
* Obesity

What is the danger if Sildenafil/Viagra® is taken with nitrates medicine?
There is a sudden fall in blood pressure from which survival is difficult.
The official website of Pfizer Inc informs the health care professionals that
VIAGRA® was shown to potentiate the hypotensive effects of nitrates.
How soon can the Medicine Nitrate be given safely after taking Viagra® ?

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Parmacokinetics of Sildenafil 100 mg

When 100 mg oral dose of Sildenafil is given to healthy normal volunteers, the plasma levels of sildenafil at 24 hours post dose are approximately 2 ng/mL. The peak plasma levels of sildenafil is approximately 440 ng/mL.
Although plasma levels of sildenafil at 24 hours post dose are much lower than at peak concentration, it is unknown whether nitrates can be safely coadministered at this time point.(1)
What are the other anti-anginal medicines?
The following is a list of 23 Anti Anginal Medicines.

Refer Wikipedia for details.
A

* Amyl nitrite
* Antianginal

B

* Butyl nitrite

C

* Cyclohexyl nitrite

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We respect your privacy and strictly maintain confidentiality.

D

* Diethylene glycol dinitrate

E

* Ethyl nitrite
* Ethylene glycol dinitrate


G

* Glyceryl trinitrate (pharmacology)

I

* Isopropyl nitrite
* Isosorbide
* Isosorbide dinitrate
* Isosorbide mononitrate
* Ivabradine

M

* Methyl nitrite

N

* Nicorandil


N cont.

* Nifedipine
* Nitroglycerin

P

* PETN
* Perhexiline
* Poppers
* Propylene glycol dinitrate

R

* Ranolazine

T

* Trimetazidine

Clinical Pharmacology of Sildenafil (1)
In the following patients:
---age >65,
---hepatic impairment (e.g., cirrhosis),
---severe renal impairment (e.g., creatinine clearance <30 mL/min), and
---concomitant use of potent cytochrome P450 3A4 inhibitors (erythromycin),
plasma levels of sildenafil at 24 hours post dose have been found to be
3 to 8 times higher than those seen in healthy volunteers.
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license-for-extramarital-sex

Extra in the Extra Marital Affair
लाईसेन्स-फॉर-सेक्स
Along with condom, now the guy may have to keep a contract paper signed by the woman, with whom the guy wants to have sex.















Hey guys, carry "contract paper".

Published on the front page of THE TIMES OF INDIA, Mumbai; Date: April 4, 2008.

Published on the front page of THE TIMES OF INDIA, Mumbai; Date: April 4, 2008.



This is about a breaking news from Australia.
news.com.au Australia, a country where the national news headlines have the following kind of news.
--------2008------
On April 6, 2008, the following National News headers were seen:
Father, daughter have child together
CLICK HERE to see the proud father and his daughter with their baby.
CLICK FOR THE NATIONAL NEWS
A FATHER and daughter have revealed to Australian TV audiences that they are a "loving" couple who have had a healthy child together.
--------OR--------
Dad rapes patient in bed next to sick son

A HOSPITAL has been forced to introduce new security measures after a man visiting his ill son raped a teenage patient in the next bed.
--------2008------

Lovers keep Condom and Contract Papers

Hey guys, do not forget the condom pack and the contract paper when you take your beau out for ravishing sex.
Publication: Times Of India Mumbai; Date: Apr 4, 2008; Section: Front Page; Page: 1
लाईसेन्स-
The News

Have sex, with contract in hand

Melbourne:
Men Down Under will be carrying sex contracts in their pockets, if an Aussie politician has her way.
South Australian MP Ann Bressington has suggested that women should sign a contract before having sex to combat false rape allegations. In a response to proposed laws making it an offence to continue a sex act with a woman who changes her mind about consent, Bressington suggested to parliament that men should carry a sex contract to prevent being accused of rape.

LICENSE

The contract may contain the name and address of the women, with her driver's license number, so that the man can see that the signatures match, clauses that state that the woman has or has not been drinking or taking drugs licit or illicit, whether she is married, whether she has children and whether she consents to being taken to another location to engage in sexual activity.

She also claimed "one-night stands'' and casual relationships would become a "high-risk activity''.
The proposed contract would also include details of the woman's marital status, whether she has children and whether she consents to being taken to another location to engage in sexual activity. "Perhaps this parliament could devise a contract which men could carry around in their pocket, next to their condoms,'' news.com.au quoted her as saying during a speech to parliament.

What if the guy and the woman are drunk?
"There could be a waiver should a man meet up with a woman who has had a couple of drinks before they engage in sexual intercourse.

What will the contract contain?
The contract may contain the name and address of the women, with her driver's licence number, so that the man can see that the signatures match, clauses that state that the woman has or has not been drinking or taking drugs licit or illicit and that she
On a radio show, Bressington confirmed that she thought men should carry sex contracts if the current bill passed both houses of parliament.


What if the guy having a fling with his girlfriend does not have a signed contract with him?
"The bill opens the door to more false allegations that are already occurring. Men will have no defense from women falsely crying rape,'' she said on the radio show.

"This bill makes men guilty until proven innocent and they will have no defence,'' she said. When asked about the contract idea, she said she was serious because it would prevent men being falsely accused.

AGENCIES

Source:

Links
THE TIMES OF INDIA
Mumbai edition
front page news, dated April 4, 2008

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