DEPRESSION
Today the menace of depression is going beyond the purview and capacity of specialists, one of whom committed suicide!

Mass and massive depression due to the deprivation of food, shelter, clothes, friends and dignity; is generally ignored, neglected or taken as normal! But depression results not only from such poverty but from failures; and not only from failures; but also from "so called succeses devoid of satisfaction to conscience"!

Can we not verify if NAMASMARAN (the core of TOTAL STRESS MANAGEMENT)can empower us to satisfy our conscience and conquer depression at individual and global levels?


Dr. Shriniwas Janardan Kashalikar

STRESS, REPO AND REVERSE REPO

Increase in repo and reverse repo rates is aimed at reducing inflation and catalyzing growth.

Can inflation come down by reducing relatively very small white money availabile to us, when several times more black money is available for causing inflation? Can this not make us even miserable?

Can industrial growth be catalyzed by mere increase in deposits in the reserve bank; and trying to increase prodction of unnecessary and unaffordable (to majority of us)products and unproductive wasteful marketing gimmicks?

Are we not heading towards recession and depression?



Dr. Shriniwas Janardan Kashalikar

Shivering is a normal physiological response of an individual's sensed temperature and the thermostatic-like response of their threshold zone. Incoming signals of "cold" from the periphery provides the input information to the central control mechanism (hypothalamus) and initiates thermoregulatory responses. When hypothermia develops either accidentally or intentionally induced, the body will immediately try to counteract this disturbance to decrease heat loss by vasoconstriction and piloerection (gooseflesh) followed by shivering, a thermoregulatory mechanism.Febrile shivering is the shaking chill experienced during fever. The observed increase in skeletal muscle activity results in increased heat production until the body temperature reaches the new thermostatic set point.
Temperature reduction therapies have been proven to provide substantial protection against ischemic brain injury and also to slow and prevent brain injury. Induced moderate hypothermia which purposely lowers the body temperature below normal has seen to improve neurological outcome in survivors of cardiac arrest. Traumatic brain injury guidelines recommend mild to moderate hypothermia or normothermia for neuroprotection. But shivering, one of the common side effects seen with therapuetic cooling remains a serious limitation to this therapuetic modality and must be controlled in order to avoid serious physiologic consequences.
A growing body of evidence shows that vigorous shivering can increase metabolic heat production upto 600% above basal level, even in febrile patients. Shivering is not only uncomfortable, it also increases intracranial pressure and has undesirable effect in patients with primary neurological and post hypoxic brain injury. Shivering can double or even triple the oxygen consumption causing hypoxemia, myocardial ischemia in high risk patients because of increased myocardial demand. This has a particularly negative impact on post cardiac arrest patients whose heart has just been resuscitated. Therefore, avoidance of shivering is strongly recommended during hypothermia induction, normothermia or rewarming periods.
Shivering is most likely to occur when the core temperature is 34-36 deg celcius.The ideal goal in shivering management is prevention. Protection of cold sensitive cutaneous receptors from direct cold contact and avoiding skin exposure and contact with cold surfaces and use of warm packs should be the first step to minimize the risk of shivering. In current clinical practice, several sedatives, anaesthetics and opiate drugs and neuromuscular blocking agents are utilized to suppress shivering activities. (in neuro ICU) Many of these agents can compromise airway defense and respiration and they are used for intubated and mechanically ventilated patients only.
Neuroscience nurses often encounter a multitude of challenges managing fevers in their patient population. The efficiency of the cooling modality is critically important since the therapuetic window to implement neuroprotection is very narrow, and " time is brain" The neuro ICU nurse's bedside practice focusses on ease of initiating cooling therapy, the speed of fever reduction, and maintaining tight temperature control. Traditional cooling blankets and even the newer skin surface cooling methods have limited impact on core cooling and also induces shivering which is seen to be detrimental. For patients who need cooling measures specially with neuronal injuries intravascular cooling technology has been shown to be more effective and superior in reduction of visible and subclinical shivering compared to several methods of skin surface cooling and use of antipyretics .It is effective in transferring or removing heat directly within the core thermal compartment via a central venous catheter. This also means less usage of sedatives, neuromuscular blocking agents, opiates etc to prevent shivering thereby promoting better ventilation.
Therefore while considering methods to induce hypothermia and fever control to optimize neurological outcomes, shivering should be anticipated as a normal thermoregulatory response and as far as possible it must be prevented and controlled.

Introduction

There is an increasing number of ASTHENIA (An abnormal loss of strength) syndrome patients in daily practice. Stimulants, tonics, energizers hormones, mood elevators and sleeping pills etc. lead to hangover, drowsiness and false sense of well being and habit formation. Erectile dysfunction, formerly called impotence, is more common in men older than 65, it can occur at any age. An occasional episode of erectile dysfunction happens to most men and is normal. As men age's, it's also normal to experience changes in erectile function. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections.


How does an erection occur?

The penis contains two chambers called the corpora cavernosa, which run the length of the organ (see figure 1). A spongy tissue fills the chambers. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa and is surrounded by the corpus spongiosum.

Erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed.

What causes erectile dysfunction (ED)?
Since an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa.

Lifestyle choices that contribute to heart disease and vascular problems also raise the risk of erectile dysfunction. Smoking, being overweight, and avoiding exercise are possible causes of ED.

Also, surgery (especially radical prostate and bladder surgery for cancer) can injure nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa.

In addition, many common medicines—blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug)—can produce ED as a side effect

Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of ED cases. Men with a physical cause for ED frequently experience the same sort of psychological reactions (stress, anxiety, guilt, depression). Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone.

Nervous weakness.
Psychological tension, confusion or fears.
Venereal diseases.
Hypertension
Diabetic
Blood leakage inside the blood vessels of the penis.
Lack of sex hormones
Multiple sclerosis
Alcoholism and other forms of drug abuse
Certain prescription medications

How is ED treated?
Most physicians suggest that treatments proceed from least to most invasive. For some men, making a few healthy lifestyle changes may solve the problem. Quitting smoking, losing excess weight, and increasing physical activity may help some men regain sexual function.

Cutting back on any drugs with harmful side effects is considered next. For example, drugs for high blood pressure work in different ways. If you think a particular drug is causing problems with erection, tell your doctor and ask whether you can try a different class of blood pressure medicine.

When to seek medical advice

Occasional inability to obtain a full erection
Inability to maintain an erection throughout intercourse
Complete inability to achieve an erection
It's normal to experience erectile dysfunction on occasion. But if erectile dysfunction lasts longer than two months or is a recurring problem, see our doctor for a physical examination

tips to overcome ED

Erectile dysfunction which is a very common complaint can be generally rectified by following few simple steps. Here goes the list of simple but effective tips to rectify erectile dysfunction.

Avoid consumption of alcohol. If you are addicted to alcohol restrict the intake. Alcohol acts on central nervous system and causes erectile dysfunction.
Keep away from smoking. Men who smoke suffer from erectile dysfunction than men who do not. It is evident from researches. Smoking causes formation of plaques in arteries (atherosclerosis) which obstruct the blood flow.
Avoid working for long hours. Take a break from regular routine at week ends and spend time with your partner.
Practice Yoga and meditation regularly to keep away anxiety, depression and stress. Meditation and Yoga are best stress busters.
Do not have the fear of not getting hard erections or do not doubt your ability to satisfy your partner. It will lead to psychological ED.
Happy and comfortable atmosphere at home is very essential to stimulate sexual desire and keep sexually healthy.
Exercise regularly and daily. Brisk walk for 45 minutes is the best exercise which keeps the cardiovascular system healthy. Researches have shown that the incidences of erectile dysfunction are less in men who regularly exercise.
Weight reduction helps to increase testosterone level and increases sexual energy and stamina. Weight reduction helps to keep hypertension and diabetes in control. Diabetes causes erectile dysfunction and anti hypertensive medications may cause erectile dysfunction.
Marijuana, heroin, cocaine etc cause erectile dysfunction. Withdrawing from addiction to the above mentioned substances really helps in increasing erections and sexual stamina.
Reduce the frequency of masturbation. Masturbating twice in a week is ideal. .
Massage whole body with herbal oil at least once in a week. This increases sexual energy and stamina. Body massage (abhyanga) is mentioned as the best aphrodisiac in Ayurveda.
Sleep at least for 8 hours a day. Body gets energized with good sleep.
Do not control natural urges. Empty your bladder before going to bed with your partner.
Take all steps to prevent indigestion and constipation. Indigestion and constipation vitiate doshas and cause diseases. Hard erections will not occur when body is not healthy.
Avoid hot, spicy and bitter foods which imbalance vata . According to Ayurveda imbalanced vata causes erectile dysfunction.
Give a gap of four days between two consecutive intercourses.
Regularly consume Vajikarana Preparations. Vajikarana preparations always keep men sexually healthy.
Give a gap of four days between two consecutive intercourses.

Medicine for ED

Our medicine offers positive advantages in management of Asthenia - stress & strain. Total package of Herbal Medicines, which improves libido, vim, vigour, vitality, nourishes heart, brain keeps sexual strength intact; long lasting, for all ages, especially effective to patients of diabetes, HBP, Heart problems and stress. It will not only strengthen your penis and PC muscle giving you a healthy strong prostate, but will also enable you to have ROCK HARD, throbbing erections that will last long, even after you've climaxed. Minimum 4-12 weeks treatment changes personality of a fatigued individual to fresh- alert-energetic human being with zest and confidence.

www.roymedicalhall.com