how-to-intrapenile-injections

Method of Giving Injection

Intra Cavernosal Injection of Vaso Active Drugs

named as ICIVAD by Rupin Shah
or
Pharmacologically Induced Penile Erection
named as PIPE by Dr. Sudhakar Krishnamoorthy

Alprostadil PGE1 containing Injection
named as CAVERJECT

are all injections to be given in the penis to obtain erection.

The Method of giving the injection is shown in the diagrams.
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medicine-thru-urine-opening-for-erection

MUSE

MUSE may still be a good method for those who do not get satisfactory response to Sildenafil (Viagra) and other tablets to be taken by mouth.

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insertion-in-urethra-to-bring-erection

MUSE
USES:
Alprostadil contained in Muse©
is used to treat erection problems.

MUSE © is Medicated Urethral Suppository for Erection. Alprostadil is inserted in urethra to bring erection. Vivus, Inc.
Dr. Ashok Koparday

It is inserted in the urinary opening at the tip of the penis.
MUSE - Medicated Urethral Suppository for Erection - has lost popularity in market due to the ease of administration of Viagra ©.
SIDE EFFECTS:

1. Penis or testicle-groin pain,
   
2. minor penile bleeding or spotting,
   
3. dizziness, palpitations,
   
4. flu symptoms or headache might occur.

Unlikely side effects: fainting or severe unsteadiness (due to a possible blood pressure decrease). Female partner side effects - vaginal burning/itching is sometimes reported. It is not clear if it is related to the drug.

Thus we have seen TWO methods of administering Alprostadil.
TWO METHODS OF USE
1]This is described in the earlier chapter.
BRAND NAME:CAVERJECT ©= Injecting Alprostadil in the penis.
2]
BRAND NAME: MUSE™
Inserted inside the urethra
MUSE™
RESEARCH
NexMed is developing transdermal forumulations—Alprox-TD(R) for men with erectile dysfunction and Femprox(R) for female sexual arousal disorder. Alprox-TD(R) has been selling in China and in Hong Kong since October 2001 and April 2002, respectively. Two Phase III studies have been completed for this product, and the Company is seeking regulatory approval in the U.S., Canada and Europe.
HOW IS MUSE ACTUALLY USED? see pictures

And here is the rest of it.

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injection-treatement-for-bringing-erection

INTRA PENILE INJECTION OF ALPROSTADIL [also called as PGE1], which is a VASO-ACTIVE DRUG USED FOR BRINGING ERECTION and sometimes used for diagnosis of ERECTILE DYSFUNCTION.
1]
CAVERJECT©

SIDE EFFECTS:

1. mild pain,
   
2. irritation or
   
3. slight bleeding at the injection site.
4. tenderness or swelling of the penis,
   
5. redness/lumps/unusual curving of the penis.
   
6. The erection should last about one hour. If an erection lasts more than 4 hours, it is a medical emergency, since it leads to death of tissues of penis. Seek immediate medical attention.
   

USED FOR DIAGNOSIS
Caverject ©as an Adjunct to the Diagnosis of Erectile Dysfunction:
On the simplest diagnostic test for erectile dysfunction (pharmacologic testing), patients are monitored for the occurrence of an erection after an intracavernosal injection of alprostadil. Extensions of this testing are the use of alprostadil as an adjunct to laboratory investigations, such as duplex or Doppler imaging. 133Xenon washout tests, radioisotope penogram, and penile arteriography, to allow visualization and assessment of penile vasculature.

How to use Caverject©:
HOW TO USE this medication to treat impotence.
This medication is administered by injection into the penis as directed. It is recommended that this medication be used no more than 3 times a week allowing at least 24 hours between uses. You must be trained on proper injection technique for self-injection. Do not change your dose or use this more often than directed. Alternate sides of the penis when injecting and vary the site of the injection. Properly discard needles, syringes and unused solution after each use.

CAVERJECT©Injection is packaged in a one milliliter polyethylene ampoule containing 10.2 or 20.2 mcg per mL of alprostadil, depending on ampoule strength. The deliverable amount of alprostadil is 10 or 20 mcg/mL because approximately 0.2 mcg is lost due to adsorption to the syringe during administration. CAVERJECT©Injection is also available in two milliliter ampoules containing 40.4 mcg/2 mL (20.2 mcg/mL) of alprostadil. The deliverable amount of alprostadil is 40 mcg/2 mL (20 mcg/mL) because approximately 0.4 mcg is lost due to adsorption to the syringe during administration.
Caverject©

The dose of alprostadil should be individualized for each patient by careful titration under supervision by the physician. In clinical studies, patients were treated with alprostadil in doses ranging from 0.2 to 140 micrograms; however, since 99% of patients received doses of 60 micrograms or less are not recommended. In general, the lowest possible effective dose should always be employed. In clinical studies, over 80% of patients experienced an erection sufficient for sexual intercourse after intracavernosal injection of alprostadil. A 1/2 inch, 27- to 30-gauge needle is generally recommended.

Initial Titration in Physician's Office:
Erectile Dysfunction of Vasculogenic, Psychogenic, or Mixed Etiology.
Dosage titration should be initiated at 2.5 micrograms of alprostadil. If there is a partial response, the dose may be increased by 2.5 micrograms, depending upon erectile response, until the dose that produces an erection suitable for intercourse and not exceeding a duration of 1 hour is reached. If there is no response to the initial 2.5-microgram dose, the second dose may be increased to 7.5 micrograms, followed by increments of 5 to 10 micrograms. The patient must stay in the physician's office until complete detumescence occurs. If there is no response, then the next higher dose should be given within 1 hour. If there is a response, then there should be at least a 1-day interval before the next dose is given.

Erectile Dysfunction of Pure Neurogenic Etiology (Spinal Cord Injury):
Dosage titration should initiated at 1.25 micrograms of alprostadil. The dose may be increased by 1.25 micrograms to a dose of 2.5 micrograms, followed by an increment of 2.5 micrograms to a dose of 5 micrograms, and then in 5-microgram increments until the dose that produces an erection suitable for intercourse and not exceeding a duration of 1 hour is reached. The patient must stay in the physician's office until complete detumescence occurs. If there is no response, then the next higher dose may be given within 1 hour. If there is a response, then there should be at least a 1-day interval before the next dose is given.
Maintenance Therapy:
The first injections of alprostadil must be done at the physician's office by medically trained personnel. Self-injection therapy by the patient can be started only after the patient is properly instructed and well trained in the self-injection technique.
Caverject©:
Manufactured for:
Pharmacia & Upjohn Company
Kalamazoo, MI 49001, USA
By:
Pharmacia & Upjohn (Perth) Pty Limited
Bentley, WA 6102, Australia
817 587 102

Other use of Alprostadil in Babies

Alprostadil is used in Congenital Heart Disease to improve blood flow to lungs in babies.

Prostin VR Pediatric Sterile Solution

Prostin VR Pediatric Sterile Solution is indicated for palliative, not definitive, therapy to temporarily maintain the patency of the ductus arteriosus until corrective or palliative surgery can be performed in neonates who have congenital heart defects and who depend upon the patent ductus for survival. Such congenital heart defects include pulmonary atresia, pulmonary stenosis, tricuspid atresia, tetralogy of Fallot, interruption of the aortic arch, coarctation of the aorta, or transposition of the great vessels with or without other defects.

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sideeffects-alprazolam

SIDE EFFECTS:
Drowsiness or dizziness may occur.

Taking place of Diazepam, Alprazolam is easily the highest selling drug world over. Alprazolam relieves tensions, stress. Is Alprazolam a cure?
Dr. Ashok Koparday

Unlikely but serious side effects:

1. mental/mood changes,
2. slurred speech,
3. clumsiness,
4. trouble walking,
5. decreased/increased interest in sex.

Highly unlikely but very serious side effects:

1. yellowing eyes or skin,
2. signs of infection (e.g., persistent sore throat, fever).

Allergic reaction is rare. It includes:

1. rash,
2. itching,
3. swelling,
4. severe dizziness,
   What are the uses of this medicine?
   
   
   USES: Alprazolam is used to treat anxiety and panic disorders. It belongs to a class of medications called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. It works by enhancing the effects of a certain natural chemical in the body (GABA).
   
   
   
   

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Donezepil-Dementia

For Geriatric Use
The Molecule Donezepil is used in the treatment of Dementia as in Alzheimer's disease.[AD]


Levels of certain chemicals that carry messages around the brain (neurotransmitters) are low. This is corrected by Donezepil, which is a reversible inhibitor of the enzyme acetylcholinesterase.
Alzheimer disease (AD) is the most common cause of dementia in industrialized nations. Dementia is a brain disorder that interferes with a person’s ability to carry out everyday activities.

* The brain of a person with Alzheimer disease (see Multimedia file 1) has abnormal areas containing clumps (senile plaques) and bundles (neurofibrillary tangles) of abnormal proteins. These clumps and tangles destroy connections between brain cells.


* This usually affects the parts of the brain that control cognitive (intellectual) functions such as thought, memory, and language.


* Levels of certain chemicals that carry messages around the brain (neurotransmitters) are low.

About 5 million people in the United States and more than 30 million people worldwide have Alzheimer disease.

* The resulting losses in intellectual ability are called dementia when they are severe enough to interfere with everyday functioning.

Alzheimer disease affects mainly people aged 60 years or older.

* The risk of developing Alzheimer disease continues to increase with age. People aged 80 years, for example, have a significantly greater risk than people aged 65 years.


* About 5 million people in the United States and more than 30 million people worldwide have Alzheimer disease. Many others have mild, or minimal, cognitive impairment, which frequently precedes dementia.


* The number of people with Alzheimer disease is expected to rise substantially in the next few decades because of the aging of the population.

The cost of caring for people with the disease is estimated at over $100 billion per year in the United States. The average yearly cost per affected person is $20,000 to $40,000, depending on the severity of the disease.

* The disease affects all races and ethnic groups.


* It seems to affect more women than men.

Alzheimer disease is a progressive disease, which means that it gets worse over time. It cannot be cured or reversed by any known treatment.

Alzheimer disease is a progressive disease, which means that it gets worse over time. It cannot be cured or reversed by any known treatment.

* The symptoms often are subtle at first.


* Over time, people with the disease lose their ability to think and reason clearly, judge situations, solve problems, concentrate, remember useful information, take care of themselves, and even speak.


* Changes in behavior and personality are common.


* People with mild Alzheimer disease usually require close supervision and help with everyday tasks such as cooking, shopping, and paying bills.


* People with severe Alzheimer disease can do little on their own and require complete full-time care.

.

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donezepil-dementia-alzheimer's

[ARICEPT®]
DONEZEPIL is used for the treatment of dementia of the Alzheimer's type.
[ARICEPT® Manufactured in India by Elsai Pharmaceuticals Pvt. Ltd.]

As per the modified COSTART dictionary
frequent adverse events are those occurring in at least 1/100 patients;
infrequent adverse events are those occurring in 1/100 to 1/1000 patients.

SIDE EFFECTS are Cholinomimetic -

1. nausea,
   
2. diarrhea,
   
3. insomnia,
   
4. vomiting,
   
5. muscle cramp,
   
6. fatigue and
   
7. anorexia.

These adverse events are found in 5 % patients. They are often mild and transient.
Nervous System

1. Insomnia
2. Dizziness
3. Depression
4. Abnormal Dreams
5. Somnolence
   

Urogenital System

1. Frequent Urination

Here is the beginning of my post.



Body as a Whole: Frequent: influenza, chest pain, toothache; Infrequent: fever, edema face, periorbital edema, hernia hiatal, abscess, cellulitis, chills, generalized coldness, head fullness, listlessness.

Cardiovascular System: Frequent: hypertension, vasodilation, atrial fibrillation, hot flashes, hypotension; Infrequent: angina pectoris, postural hypotension, myocardial infarction, AV block (first degree), congestive heart failure, arteritis, bradycardia, peripheral vascular disease, supraventricular tachycardia, deep vein thrombosis.

Digestive System: Frequent: fecal incontinence, gastrointestinal bleeding, bloating, epigastric pain; Infrequent: eructation, gingivitis, increased appetite, flatulence, periodontal abscess, cholelithiasis, diverticulitis, drooling, dry mouth, fever sore, gastritis, irritable colon, tongue edema, epigastric distress, gastroenteritis, increased transaminases, hemorrhoids, ileus, increased thirst, jaundice, melena, polydipsia, duodenal ulcer, stomach ulcer.

Endocrine System: Infrequent: diabetes mellitus, goiter.

Hemic and Lymphatic System: Infrequent: anemia, thrombocythemia, thrombocytopenia, eosinophilia, erythrocytopenia.

Metabolic and Nutritional Disorders: Frequent: dehydration; Infrequent: gout, hypokalemia, increased creatine kinase, hyperglycemia, weight increase, increased lactate dehydrogenase.

Musculoskeletal System: Frequent: bone fracture; Infrequent: muscle weakness, muscle fasciculation.

Nervous System: Frequent: delusions, tremor, irritability, paresthesia, aggression, vertigo, ataxia, increased libido, restlessness, abnormal crying, nervousness, aphasia; Infrequent: cerebrovascular accident, intracranial hemorrhage, transient ischemic attack, emotional lability, neuralgia, coldness (localized), muscle spasm, dysphoria, gait abnormality, hypertonia, hypokinesia, neurodermatitis, numbness (localized), paranoia, dysarthria, dysphasia, hostility, decreased libido, melancholia, emotional withdrawal, nystagmus, pacing.

Respiratory System: Frequent: dyspnea, sore throat, bronchitis; Infrequent: epistaxis, post nasal drip, pneumonia, hyperventilation, pulmonary congestion, wheezing, hypoxia, pharyngitis, pleurisy, pulmonary collapse, sleep apnea, snoring.

Skin and Appendages: Frequent: pruritus, diaphoresis, urticaria; Infrequent: dermatitis, erythema, skin discoloration, hyperkeratosis, alopecia, fungal dermatitis, herpes zoster, hirsutism, skin striae, night sweats, skin ulcer.

Special Senses: Frequent: cataract, eye irritation, vision blurred; Infrequent: dry eyes, glaucoma, earache, tinnitus, blepharitis, decreased hearing, retinal hemorrhage, otitis externa, otitis media, bad taste, conjunctival hemorrhage, ear buzzing, motion sickness, spots before eyes.

Urogenital System: Frequent: urinary incontinence, nocturia; Infrequent: dysuria, hematuria, urinary urgency, metrorrhagia, cystitis, enuresis, prostate hypertrophy, pyelonephritis, inability to empty bladder, breast fibroadenosis, fibrocystic breast, mastitis, pyuria, renal failure, vaginitis.

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sex-in-space

Click on the animated image. Have Fun.

Sex of extra terristrial beings. Fun show, now called as Functioa.

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sideeffects-venlafaxine

SIDE EFFECTS: This medication may initially cause

1. dizziness and nausea as your body adjusts to the medication. Other side effects reported include
2. trouble sleeping,
3. nervousness,
4. sweating,
5. loss of appetite,
6. dry mouth,
7. tremor,
8. blurred vision,
9. constipation,
10. drowsiness,
11. change in sexual ability, or
12. anxiety

serious effects:

1. rapid or irregular heartbeat,
2. chest pain, severe headache,
3. painful or difficult urination,
4. muscle cramping,
5. unusual or severe mental/mood changes,
6. seizures.

unlikely but serious side effects occur:

1. black stools,
2. "coffee ground" vomit,
3. easy bruising/bleeding.

Symptoms of an allergic reaction include:

1. rash,
2. itching,
3. swelling,
4. dizziness,
5. trouble breathing.

Here is the beginning of my post.


USES of VENLAFAXINE:
This medication is an antidepressant (serotonin-norepinephrine reuptake inhibitor type) used in the treatment of depression and anxiety disorders (Generalized Anxiety Disorder, Social Anxiety Disorder) in adults.
It works by restoring the balance of natural chemicals (neurotransmitters) in the brain, thereby improving mood and feelings of well-being.
There have been reports of hostility and thoughts of suicide or self-harm occurring in some children using Venlafaxine, hence it should not be used in children.

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sideeffect-paroxetine

Side Effects
Paroxetine:
A]

1. Nausea,
   
2. vomiting,
   
3. drowsiness,
   
4. dizziness,
   
5. diarrhea,
   
6. trouble sleeping,
   
7. yawning,
   
8. constipation, or dry mouth may occur.

B]
Less common serious side effects:

1. loss of appetite,
   
2. unusual or severe mental/mood changes,
   
3. increased sweating/flushing,
   
4. unusual fatigue,
   
5. uncontrolled movements (tremor),
   
6. decreased interest in sex, changes in sexual ability.

C]
Uncommon but serious side effects occur:

1. black stools,
   
2. blurred vision,
   
3. change in amount of urine,
   
4. "coffee ground" vomit,
   
5. easy bruising/bleeding.

D]
Rare side effects:

1. fainting,
   
2. irregular heartbeat,
   
3. muscle pain,
   
4. trouble swallowing,
   
5. unusual swelling,
   
6. seizures,
   
7. tingling or numbness of the hands/feet.
8. Paroxetine may infrequently cause suicidal thoughts or self-harm urges in children or teenagers up to 18 years of age.
9. Males: In the very unlikely event you have a painful, prolonged erection, stop using this drug and seek immediate medical attention or permanent problems could occur.
   

E]
Symptoms of a serious allergic reaction include:

1. rash,
   
2. itching,
   
3. swelling,
   
4. severe dizziness,
   
5. trouble breathing.

In December 2006, FDA's Psychopharmacologic Drugs Advisory Committee agreed that labeling changes were needed to inform health care professionals about the increased risk of suicidality in younger adults using antidepressants.
www.fda.gov/
Source: FDA Press Release #P07–77, May 2, 2007
The U.S. Food and Drug Administration (FDA) today proposed that makers of all antidepressant medications update the existing black box warning on their products' labeling to include warnings about increased risks of suicidal thinking and behavior, known as suicidality, in young adults ages 18 to 24 during initial treatment (generally the first one to two months).


USES:

1. 
   This medication is a selective serotonin reuptake inhibitor (SSRI) used to treate depression,
2. panic attacks,
3. social anxiety disorder (social phobia),
4. and a severe form of premenstrual syndrome (premenstrual dysphoric disorder- PMDD).

SSRI's work by helping to restore the balance of certain natural substances in the brain (neurotransmitters).

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sideeffects-antidepressant-duloxetine

SIDE EFFECTS:

1. Nausea,
   
2. dry mouth,
   
3. constipation,
   
4. loss of appetite,
   
5. fatigue,
   
6. drowsiness,
   
7. dizziness,
8. increased sweating,
   
9. blurred vision, - You may think your eyesight needs correction.
   
10. rash, or itching may occur.
    

Unlikely but serious side effects:

Duloxetine is used to treat major depression and also used to relieve nerve pain (peripheral neuropathy) in diabetics. This medication works by restoring the balance of two kinds of natural substances (neurotransmitters known as serotonin and norepinephrine) in the brain, thereby improving mood and feelings of well-being.

1. unusual or severe mental/mood changes (e.g., anxiety, mania),
   
2. weight loss,
   
3. change in sexual desire and ability,
   
4. uncontrolled movements (tremor),
   
5. difficulty urinating.

Rare but very serious side effects:

1. chest pain,
   
2. stomach pain,
   
3. black stools,
   
4. vomit that looks like coffee grounds,
   
5. easy bruising/bleeding,
   
6. unusual bleeding,
   
7. seizures.

PRECAUTIONS:
This medication should not be used if you have certain medical conditions.

1. severe kidney disease,
2. glaucoma (uncontrolled narrow-angle).
   
   
3. other mental/mood disorders (e.g., bipolar disorder, mania),
4. liver disease,
5. kidney disease,
6. stomach problems (e.g., bleeding or slow stomach emptying),
7. drug or alcohol abuse,
8. seizure disorder.
9. dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery.
   
10. If you are pregnant, this medication should be used only when clearly needed during the first 6 months of pregnancy.
11. Due to possible complications to an infant at birth, this medicine is not recommended for use during the last 3 months of pregnancy.
12. 
    Breast-feeding while taking this drug is not recommended.

Symptoms in Severe Depression:

suicidal thoughts, worsening depression, or any other mental/mood changes, including new or worsening anxiety, agitation, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, rapid speech.

DRUG INTERACTIONS:
Certain medications taken with this product could result in serious, possibly fatal, drug interactions.

1. Avoid taking drugs called MAO inhibitors
   (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine) with or within 2 weeks of starting duloxetine or at least 5 days after stopping it.
2. thioridazine.
3. cimetidine,
4. ciprofloxacin,
5. certain drugs used to treat abnormal heart rhythms (e.g., propafenone, flecainide, quinidine),
6. certain SSRI anti-depressants (fluoxetine, fluvoxamine, paroxetine),
7. other drugs which can cause bleeding/bruising (e.g., thrombolytic drugs such as TPA,
8. anticoagulants such as heparin or warfarin, antiplatelet drugs including NSAIDs such as ibuprofen).
9. Low-dose aspirin (usually 81-325 mg per day) for heart attack or stroke prevention should be continued unless your doctor instructs you otherwise. Aspirin is similar to NSAID drugs, and can increase the risk of bleeding in combination with this medication.
10. drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-anxiety drugs (e.g., diazepam), anti-seizure drugs (e.g., carbamazepine),
11. medicine for sleep (e.g., sedatives), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., phenothiazines such as chlorpromazine, or tricyclics such as amitriptyline), tranquilizers.

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divorce_hazards-1

To
The Editor,
Times of India,
Mumbai
Sir:

90% of men kiss their wife goodbye when they leave the house.
The rest kiss their house goodbye when they leave the wife

Divorce damages social environment. Bonding becomes difficult because 'trust' is contaminated.

Sex hungry roving eyes are added in the society we live.

Sexual desires can be so compulsive that the divorced guy ensnares the gullible by giving false promises. It is late when realization dawns that she has been 'used'.

No doubt risk of sexual harassment at office increases.

Faith in 'Marriage' being a special bond to be coveted and cherished life long goes to the dogs.

Which university is going to sponsor me to study pscyho sexual impact of divorce on on society?

Dr.Ashok Koparday
Mumbai
Top News,
Times Online, UK
The Age, Australia
Melbourne Herald Sun, Australia
Sify, India
All news channels published the study of the damage caused to environment due to divorce.

divorce_hazards-2

In 2005, divorced households in the United States spent as much as 56 per cent more on electricity and water per person than married households and used up to 61 per cent more resources per person than they did before the separation took place.
more than 73 billion kilowatt hours of electricity and 627 billion gallons of water could have been saved in the US.

In the United States, the proportion of divorced households jumped from five percent in 1970 to 15 percent in 2000, and numbers have surged even in China where divorce has not been traditionally as common, the study said.

In 2005, US divorced households spent as much as 56 percent more on electricity and water per person than married households, and used up to 61 percent more resources per person than they did before the separation took place.

If divorced households operated with an efficiency similar to married households, "more than 73 billion kilowatt-hours of electricity and 627 billion gallons of water could have been saved in the US," it said.

Researchers surveyed 3,283 homes in the United States between 2001 and 2005, and found that divorcing households registered a 61 percent increase in the number of rooms per person, compared with six percent increase in households that remained married.
12/3/2007 7:36 PM
90% of men kiss their wife goodbye when they leave the house.
The rest kiss their house goodbye when they leave the wife.
Now they can make the best of a bad marriage in the name of being environmentally friendly.
Scientists have quantified for the first time the extent to which divorce damages the environment. The researchers found that the combined use of electricity across the two new households created rose 53% while water use was up by 42%.
Across America – one of 12 countries studied – divorced households used 73 billion kilowatt-hours of electricity in 2005 that could have been saved if the families had not split up. That is equivalent to about a fifth of Britain’s consumption.
Broken couples also increase demand for housebuilding and infrastructure such as new roads. “The global trend of soaring divorce rates has created more households with fewer people, has taken up more space and has gobbled up more energy and water,” said Jianguo Liu of Michigan University, who carried out the latest research.
The study, to be published tomorrow in the Proceedings of the National Academy of Sciences, found that the average number of rooms per household was between 33% and 95% higher for divorced couples than for married ones.
Liu also calculated that America now has an extra 38.5m rooms in houses and apartments built to meet the demand for more accommodation generated by divorce over the past three decades.
The growth of single-person households is also damaging the environment. Research published in the journal Environment, Development and Sustainability found that:
- One-person households are the biggest consumers of energy, land and household goods, such as washing machines, refrigerators, TVs and stereos, per capita
- They consume 38% more products, 42% more packaging, 55% more electricity and 61% more gas per capita than four-person households
- People living alone create 1½ tons of waste annually compared with a ton by those in households of four or more.

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Wanted-Partner-for-Marriage

Samadhan GIFT.




Samadhan GIFT useful tips about all that you wanted to know about SEX before getting married. The author Dr. Ashok Koparday has over a decade's experience in Relationship Counseling. Samadhan GIFT can be given as a wedding GIFT the moment boy and girl are engaged.



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