Vitamin B – A Healthy Eating Habit

You are what you eat. This is based on the saying ‘As you sow, so you reaps’. Whether you feel richer by a million, stay young longer or just keep fit, to be in glowing health, be able to bounce back unharmed by any momentary misfortunes and to spread cheer to all, or remain crippled all your life – your body and mind needs a well balanced, carefully planned diet rich and adequate in required, proteins, carbohydrates, minerals and vitamins. It must be remembered that if the body is deficient in any one or more of these vital elements, its miraculous and delicate clock work mechanism will be thrown out of balance and the system will be crippled and left limping. You may suffer poor eyesight due to Vitamin A deficiency an overweight disfigurement may be due to lack of protein or iron in the diet or the feet can be sore and painful for lack of Vitamin E.

All the different factors are interdependent and work together to keep body and mind healthy. For example, healing qualities of Vitamin A are enhanced by intake of Vitamin E. Lecithin helps vitamin A, D, E K and fat to be absorbed in the body.

Another instance is the marvelous Vitamin B- Complex, which is synergistic. That is, the balance between the B Vitamins, (over 20 are known and more are being discovered) is the most delicate, too much of one can cause deficiency of another. The vitamin B group has been tested and has been proved to play a vital role in the maintenance of good health, staying of ageing processes and even changes in the personality. So let us look at the vitamins that make us what we are.

It is this group of Vitamin B, unfortunately, that we modern people are very deficient in. Vitamin B are naturally present in liver, Brewer’s yeast, molasses, whole wheat cereals and breads, heart, kidneys, rice bran, muscle meats, egg yolk, bean peas, honey, mushrooms etc.

In the Vitamin B Complex, Niacin (B3): is sometimes termed the “courage vitamin”. It is effective is pellagra, “nerves” depression, schizophrenia, loss of appetite, diarrhea due to lack of hydrochloric acid.

Pyridoxine (B6): is a nerve relaxer, anti stress vitamin, effective in trembling, play (Parkinson’s disease, nausea, water retention in pregnancy, migraine, headaches, excessively oily skin, airsickness, it is especially effective with magnesium.

Some deficiency symptoms are bad breath, irritability, headaches “nerves” abdominal cramps, fouled smelling gas, rash in the genital area, hemorrhoids, diarrhea, vomiting, dandruff, soreness in the lips and mouth, eczema on the face and scalp, dry hands insomnia.

Pantothenic Acid: “Anti-stress vitamin” especially when antibiotics are taken, with burns and severe injuries, effective in premature grey hair, wrinkled skin. Fat and sugar conversion with energy is not possible without it – dieters should take steps to take it to prevent gout and arthritis.

Deficiency symptoms are hypoglycemia, headaches dizziness, depression, gas constipation, stomach ulcers, allergies asthma and insomnia.

PABA: prevents graying of hair, mental depression and is required for conception.

Inositol helps prevent baldness indigestion, hardening of arteries by reducing cholesterol.

Cholorine: this influences longevity, helps in shortness of breath and heart pain, cirrhosis of the liver, stomach ulcer, muscular dystrophy. A deficiency has been found to cause cancer in animals. This is also present in Lecithin.

Biothin: deficiency symptoms are evident in dry skin, scaly scalp (eczema), heart pains, and depression in animals, stunted growth and cancer.

Folic Acid: Effective in large cells anemia and weight gain. Deficiency symptoms are fatigue, dizziness, depression, shortness of breath, important during pregnancy.

B10: deficiency symptoms are fatigue, sore mouth, neuritis, menstrual problems, waking difficulties.

An interesting experiment carried out at Mayo foundation revealed that volunteers fed on a diet deficient in Vitamin B, Thiamine, showed adverse personality changes. The volunteers become inefficient, quarrelsome, mentally slugging and depressed. They later developed fatigue, constipation, mumbles of hands and fee, insomnia, as also low blood pressure, neuritis with pain in carves and legs and lack of hydrochloric acid in the stomach. Volunteers became exhausted and could not work. These volunteers were kept on a diet of white bread, cornflakes, polished rice, potatoes, sugar, skimmed milk, cheese, butter, gelatin, canned fruits and vegetables, cocoa and coffee.

The diet sound very familiar in Asia, where refined, preserved, pack aged, fast foods have replaced natural wholesome foods, due to industrialization, pressurized modern lifestyle and non availability of fresh foods due to transportation delays etc.

The volunteers of the Mayo Foundation test, where restored to normal health, mental alertness as soon as they were administered dosages of Vitamin B – lack of this vitamin had led to forgetfulness and poor judgment. Pyurvic and lactic acids accumulate in the brain cells which become toxic, adversely affecting the personality with mental depression, mental confusion, moodiness, forgetfulness, inability and irritability.

Even with mild storage of niacin amide cause weepiness from depression. Dizziness, tension, irritability and recurring headaches, diarrhea, inflammation of the intestinal tract with rectal and anal soreness are other debilitating symptoms. Fortunately these can all be rectified quite satisfactorily with the introduction of niacin and a diet of vitalizing food stuffs.

Tests putting volunteers on restricted and near starvation diets lacking in vital proteins, vitamins and minerals led to apathy which was the first sign of mental depression, followed by boredom lack of concentration and loss of confidence, frustrations, strong irritations and even loss of mental balance, lack of sense of humor mistrust, resentment, suspiciousness, self doubt, feeling of persecution and martyrdom, mental confusion, and morbid indefinable fears were some of the personality characteristics that developed and were evident in people subject to or fed on poor, nutrient deficient diets. Our diet that is high I carbohydrates, fats, sugar and short of or absent in proteins, vitamins and minerals have contributed to low efficiency and personality of the malnutrition of worker

It has been proved that a mere deficiency of Vitamin B produces a mild form of mental and emotional disorganization. It is also known that adequate nutrition is closely related to the ability of a person to think constructively. Poor nutrition can cause mental illness and even suicidal tendencies. An absence of niacin in the diet can produce strong psychotic illness. Dr Hoffer I Saskatchewan has used Vitamin B3 (niacin) for treatment of schizophrenia with a great cure rate. Full fledged neurosis can result with a deficiency. So, we now know that Vitamin B1 is essential for the integration of the personality. “Even the so called natural breakdown in old persons can be slowed down and their mental faculties kept bright and alert if their nutrition is ample and well balanced, According to Dr Mae Millnan, “Adequate quantities of food according to a person’s need, rich in essential Vitamins and Minerals can be all that will be required to make for either bouncing, tension and stress free living or one of crippling with malnutrition of body and mind”. It is evident that the type of person you are and the health & life you enjoy are very dependent on what you eat. How necessary it is then for us to know what to eat, how much is necessary and in what combinations.

Human Toxicity Of Insecticides

The pyrethroids are composed of natural pyrethrins, which are isolated from chrysanthemum flowers, as well as newer synthetic materials. Older pyrethroids (e.g., pyrethrins and tetramethrin) degrade too rapidly in the environment to be used in agriculture. They are used in buildings, and because of their general safety, they are even applied to humans to control lice. Newer pyrethroids have greater chemical stability (e.g., permethrin and deltamethrin), which allows their use on many types of field crops. Another important use of permethrin is application to mosquito netting. Intoxication by pyrethroids develops rapidly (in 1 to 2 minutes), and involves a rapid loss of normal posture and movement called “knockdown.” Pyrethroids affect nerve impulse generation throughout the entire nervous system. Multiple nerve impulses occur when only a single one was expected, and there is an increased release of chemical neurotransmitters as well. These actions result in convulsions, prostration, and death.

Sabadilla, an extract from the seeds of a tropical lily, is used in home gardens and organic farming operations. It degrades rapidly in the environment, and causes signs of intoxication, and has a mode of action similar to that of pyrethroids. Sabadilla extract has low toxicity to mammals. The tobacco compound nicotine has been used as an insecticide for over 200 years. It is especially effective against sucking insects, such as aphids, and has excellent contact activity. Related compounds are neonicotinoids (e.g., imidacloprid), which have similar insecticidal activity, but are less toxic to mammals. Nicotine and imidacloprid mimic the action of acetylcholine, which is the major excitatory neurotransmitter in an insect’s central nervous system. The action of acetylcholine is stopped by the enzyme acetylcholinesterase, which rapidly breaks down acetylcholine. Nicotine and imidacloprid are also neuroexcitatory, but do so persistently, since they are not affected by acetylcholinesterase. Overstimulation of the nervous system often leads to convulsions, paralysis, and death.

The organophosphorus (OP) and carbamate insecticides are used to control a wide variety of insect pests. The acute toxicity of the OPs and carbamates varies, and many of them have high mammalian toxicity. These compounds react chemically with the active site of acetylcholinesterase, producing a blocked enzyme that cannot degrade acetylcholine. The concentration of acetylcholine then builds up and hyper excitation occurs. The signs of intoxication include restlessness, tremors, convulsions, and paralysis. Blockage of acetylcholinesterase by OPs is persistent, and recovery of the enzyme takes many hours or even days. The mode of action of the carbamates is similar, except that enzyme blockage is less stable and recovers in a matter of minutes. Among insects, carbamates are particularly toxic to hymenoptera, such as honeybees.

Organochlorines represent one of the oldest groups of synthetic insecticides, with only biodegradable materials such as lindane and endosulfan still used in pest control. High mammalian toxicity was common with organochlorines, but a newer compound, fipronil, has improved selective toxicity toward a variety of insect pests. These insecticides cause hyper excitability and convulsions by blocking the inhibitory neurotransmitter γ ‐aminobutyric acid (GABA). Normally, GABA has a dampening effect that maintains normal nerve activity. Blocking the effects of GABA removes inhibition, leading to hyper excitation of the nervous system and convulsions. Deet is an important insect repellant. This compound is applied to skin or clothing, and repels biting flies (e.g., black flies and mosquitoes). Deet acts on the sensory nerves, causing insects to avoid treated surfaces.

Ryania consists of the powdered stem of the tropical shrub, Ryania speciosa. The extract contains ryanodine and related compounds, and has a low toxicity to mammals. The powder is used as a stomach poison on vegetables and fruit. Ryanodine induces paralysis in insects by direct action on the muscles, resulting in sustained contraction and paralysis. Avermectins are a group of closely related compounds isolated from the fungus Streptomyces avermitilis that are used to control the parasites of humans and animals, as well as arthropod pests in crops. They have fairly high mammalian toxicity, but their movement into treated leaves, oral activity against insect pests, and rapid breakdown in sunlight are all favorable properties. In insects and worms poisoned by avermectin, inactivity and flaccid paralysis occur from its relaxing effect on muscles.

These compounds vary, from the natural product rotenone (from Derris or Lonchocarpus root, used to control vegetable and fruit insects) to the synthetics sulfluramid and hydramethylnon (used to control mites and cockroaches). Interestingly, the highest acute toxicity to mammals is caused by the natural product rotenone. These compounds affect the production of adenosine triphosphate (ATP), the energy storage molecule of the cell that is produced by mitochondria, the “powerhouse” of the cell. The disruption of energy metabolism and the subsequent loss of ATP result in a slowly developing toxicity, and the effects of all these compounds include inactivity, paralysis, and death.

Insects exposed to diflubenzuron and related compounds are unable to form normal cuticle (skin) because their ability to synthesize it is lost. Thus, the cuticle becomes thin and brittle, and is unable to support the insect or to withstand molting, a process requiring the shedding of the old cuticle, as in metamorphosis. Diflubenzuron and other chitin synthesis inhibitors have extremely low mammalian toxicity and are used against termites. Methoprene and fenoxycarb mimic the action of insect juvenile hormone in molting and reproduction, and have low toxicity to mammals. Exposure at molting produces deformed insects having mixed larval/pupal or larval/adult morphologies, and they disrupt reproductive physiology in adults to effectively serve as a method of birth control. Tebufenozide acts by mimicking the effects of the insect hormone ecdysone, which along with juvenile hormone controls the initiation of a molt. Exposure to tebufenozide induces a premature molt that traps the insect in its old cuticle. This compound is especially effective against caterpillars.

The bacterium Bacillus thuringiensis forms an internal crystal that contains a number of insecticidal protein toxins. When eaten by the insect, the crystal dissolves in the midgut, the toxin mixture is released, and the proteins are cleaved into active forms. The toxins bind specifically to midgut cells and assemble a pore that leads to disintegration of the cells, gut paralysis, and death. B. thuringiensis strains have toxins specific for caterpillars, beetles, or flies. They have little or no effect on mammals.

In mammals DDT and related organochlorines have effects on the endocrine system, including the disruption of thyroid hormone synthesis and mimicking of the effects of estrogen. Liver cancer has also been observed in mice exposed to these substances, and there has been one claimed association between exposure to DDT and breast cancer. Epidemiological studies show a consistent connection between exposure to pesticides and the occurrence of Parkinson’s disease in rural populations. A well-documented effect of some OPs is organophosphorus-induced delayed neuropathy, a slowly developing degeneration of the leg nerves that results in irreversible limping. A specific hazard of pyrethroids is paresthesia, a tingling or burning sensation in exposed skin. Ladybugs are natural predators of aphids, mealy bugs, and leaf hoppers and may be introduced into a garden environment as a nonchemical pest-control method.

There is considerable interest in developing genetically enhanced, insect-specific viruses or crop plants that would replace conventional chemical insecticides. Corn, cotton, and potatoes have been engineered to express B. thuringiensis toxins to control chewing insects. Although this approach has worked effectively for controlling some pests, others not targeted by the B. thuringiensis toxin must be controlled by other means. Sex pheromones, chemicals that attract one sex of an insect to the other, also have uses in pest control. They are often utilized with traps to monitor the number of pest insects in an area, and when applied in the field at higher levels, they can disrupt reproduction or egg laying.

Biological control involves the introduction of predators and parasitoids to attack pests. The extent of control using this technique varies and can be quite good in some cases, but unforeseen ecological impacts occur when imported species attack nontarget organisms. Chemical insecticides remain an important tool for managing insect pests of humans, animals, and food and fiber crops. Compounds that are persistent in the environment are no longer used, and the amounts sprayed have dropped from kilograms per acre to grams per acre of active ingredient. Future compounds and technologies will seek to maintain high levels of effectiveness with a reduced impact on the environment and human health.

Promise From a Mother's Heart

Many years ago, my mother made us a promise that changed our lives forever.

Now that I'm also a parent, I've come to see my mother's promise as a kind spiritual umbilical cord to bring new life to me and to my other siblings from our humble beginnings.

Life's Difficulties

Being the 4th sibling in the brood of 5, we were raised by our mother all by herself since our father has no steady means of living. Since her meager income from selling women's undergarments, we're still competent that all of us could still go to school. We lived in a shanty made of old galvanized metal sheets salvaged from a decomissioned foundry and with the help of my father's friend; The once old foundry was turned into a bungalow that serves as our haven. Having an electricity source that time is a luxury that we could not afford that we have to finish our school's homework before dawn and the gasera (kerosene lamp) is the only source of light coming night time. More so that the source of our water comes from a leaking residential water pipe is short lived; After having been discovered by its owner that he had the damaged pipes repaired immediately. Having nothing much of life's basic needs drives my mother to make night also a day. At my very young age, I saw life's difficulties through the eyes of my mother. She would often tell us that there's nothing wrong to be born poor but to die out of poverty is unacceptable.

Being the only breadwinner in the family, my mother has to leave our house before sun rise entrusting all of us to our eldest sister and before dawn, we would all be together partaking what has been prepared by my ate (eldest sister) on the table After saying the grace before meal. Everything was going almost as a routine that by the time my mother arrived at the house, I could tell if her day is a success by the pasalubong (presents) that she will buy from a nearby carinderia (eatery). But this success happens only on a few occasions that I could count it only in one hand. More often than not, our meal would always be a loan canned goods from the neighbor's sari-sari store (retail store). Pork and chicken for a meal could mean only one thing – special occasions such as birthdays, Christmas and New Year celebration. I remember one time how my father with the help of my older brother catches a hen that by chance wrongly entered our house. That time, we had our mouths greased by the cooking oil from a sumptuous chicken meal.

Making Both Ends Meet

With the family's meager source of income, my mother knew that she has to work doubly hard to make both ends meet. With the help of my eldest sister, my mother would go to Divisora ​​market on early mornings to buy vegetables and sell it to our neighbors. This newly found livelihood provides steady means of income; Barely making that we can eat eat 3 times a day. Thus, realizing it as a better alternative livelihood, she left her garments selling job and focus instead on selling vegetables. Hardship in life knows no ages. Barely only 7 years old; While most children of my age are playing with toys, vegetables loaded in a basket has been my favorite toy every morning roaming street after street. While during school break, I would end up selling ice buko (frozen grated coconut with milk) and bibingka (rice cake) I got from a trader using my school ID as business collateral. Every night without missed, I would often see my mother talking to God through her prayers and often that I heard her saying, "Panginoon, tulungan Mo po kami" (God, please help us).

Test of Times

Whilst our life is still no bed of roses despite the passing of years, the turn of events in our family life is something kid of my age could not understand. Endless nights I would see my mother sobbing in one corner of our house, beaten black and blue by my father every time he gets drunk. All that I can do together with my other siblings was to comfort our mother in her time of despair. I developed the fear every time my father leaves home to be with his buddies for I know what would happen next when he arrives after his drinking spree.

Days had passed into weeks and months and I lost the count. But one thing I can never forget was the time when my mother could no longer bear the beatings from my father. She bought us out of the house; All 5 of us while my father was drunk and sleeping. With nowhere to go, she has no choice but to distribute the 4 of us to our respect ninongs and ninangs (godparents) taking only with her my eldest sister. I vividly remember crying and pleading with my mother not to leave me but with a heavy heart, she made me a promise, anak, pangako, babalikan kita at ang mga kapatid mo kapag maayos na ang lahat "(son, I promise, I will Come back for you and your other siblings when everything is okay) At that time, I knew that my mother's heart bleeds to watch me as she and my ate (eldest sister) disappear down the corner of the street. How long we were separated from my mother; all I knew was that everyday seemed to be eternity.

Reunited at Last

Mother's promise to her child is a promise from a pure heart that can never be broken. True to her promises, one by one she collected us and reunited at last. Though there has not been much of a change in our life but that moment I saw my mother and the rest of my siblings is more than what I can ask for. Determined not to be separated again from one another, the 5 of us promised to help our mother even more. I for one become a collector of bets after school and have to divide my time collecting kanin-baboy (hog feeds) from our neighbors to feed our hogs. With hard works and collective efforts, our life changes a bit better and we had the first taste of life's little luxury when we purchased our first appliance – an electric fan that costs 450 pesos. My eldest sister's first paycheck ended up as a down payment for a black and white television set while the meager earning from selling vegetables was used to purchased a Class B freezer at a factory price that ever give us the queue to diversified our goods selling fish and Meat. My youngest sister never to be outdone had her own share of business – selling ice and ice candy. For the first time we experienced a bit of life's little pleasure and still as I normally see from her, I would see my mother talking to God and saying still the same prayer, "Oh, God please help us."

My Teen age days

Years gone by and I was in the prime of my teenage years. Having been unexposed to people of opposite sex other than my sisters, I was often mistaken as suplado by my girl classmates. High school life proves to be the most memorable stage of my life for it was the stage I was able to build and extend relationship outside my family. It was the time I started to court girls and my mother is a very capable partner of keeping my childhood secrets away from the girls I bought home.

When I was in college, I landed a part time job flipping burgers at a fast food restaurant in Makati. I worked in the morning and study in the evening. Hard work and perseverance to succeed has always been in my mind. Barely a year since joining the company, I was promoted to Junior Manager Position since being still an under graduate. I finished my Engineering Degree in college and landed in good company after graduation. At night, I could still see my mother praying but that time, few words has been added to her old litany, "Oh, God please help my children in their work and studies."

I got Wed

In my teen years, I happened to change my misfit image for the gloss of popularity, whatever the cost. Having the financial freedom, I shrugged off any contradictions and believed that to have a "good" testimony, like so many of the dramatic ones I had heard, that I had to have a "past."

At 24, I got married to a workmate, with my mother initially not relish on my plan. My marriage relationship immediately bears me a son and my mother with her joy ballooned with the arrival of a grandson. That time, my mother's nightly litany has grown a few more words adding her grandson in the list.

My Ups and Downs in Life

My career continues to flourish that I end up jumping from one company to another and so as the number of our kids. We spend our lives lavishly trying to savor good things in life that I have never experience before. We spend more than what we can save. My initial car was bought through bank loan but my career continued to flourish that I just found my self buying my second car in cash on top of the one issued to me by the company where I worked. At times, my only problem then was – where to park my all my rides.

Year 2005 comes the most devastating time in my career. I have to leave my high paying job because of disagreement with my boss. With no savings come that rainy day, I transferred to another job that pays me relatively lower and without any perks. We were facing then the biggest question that I have to answer – can I still afford my children's education? My eldest son and daughter were studying at an exclusive school for boys and girls respectively while the third one is enrolled in a Catholic School. Our marriage relationship succumbbs to the test of times. And there at that time where my life seems so low, I found my self in the arms of my mother helping me and my wife to pick up splinters of our broken dreams.

There I was retold by my mother's promise to God from her heart – which she would always pray for me and my family as long as she lives. A promise that she would never break like the promise she has made the first time we were separated.

Now, we are slowly picking the paces of our once fragmented hopes and dreams but my greatest hope is for me to respond to God's given gift to me – my mother. As my children grow, I will tell them that God has a plan for all of us in our lives, and He intervened to protect us at all times. I will tell them the way God's grace intervened to touch the spiritual deadwood that characterized our family tree, grafting in a new branch – one that is naturally alive.

And I will tell them how it all began with a mother's promise from the heart.

The Medical Benefits of Acupuncture Are Too Numerous To Count

There are many medical benefits of acupuncture as acupuncture has been used for millennia to treat the symptoms of many diseases and health conditions as well as to promote good health and well-being.

To determine the medical benefits of acupuncture in the treatment of your condition you must speak with a qualified practitioner of acupuncture. He or she will want to know your entire medical history including any allergies you have and what illnesses and injuries you have suffered in the past. Only after knowing these things can a potential form of treatment be decided on?

Acupuncture works by triggering the release of endorphins and serotonin in the brain and central nervous system. These chemicals, endorphins and serotonin have a strong affect on a persons mood and the feelings they have, they can make you feel up, down, in pain or happy and pain free.

The traditional method behind the treatment is to accentuate the flow of “qi”, which is believed to be the bodies natural flow of energy. Today qi is used more like a metaphor and acupuncture is one of the most well known, and most widely used treatments in a complementary fashion.

* What is acupuncture used for?

Acupuncture has been used for a wide variety of medical conditions for a few millennia, today we use acupuncture for medical conditions like asthma, high blood pressure, pain, headaches, digestive problems and women’s menstrual problems.

According to the World Health Organization (W.H.O.) there are a number of health problems that can be improved upon by the use of acupuncture. These conditions are broken down into respiratory diseases, bronchopulmonary diseases, eye disorders, disorders that affect the cavity of the mouth, orthopedic disorders, gastrointestinal disorders and neurological disorders.

The respiratory diseases that acupuncture can help include acute sinusitis, acute rhinitis, acute tonsillitis and the common cold. Acute bronchitis and bronchial asthma are both bronchopulmonary diseases that acupuncture has been shown to have great results in treating.

The eye disorders acupuncture helps include acute conjunctivitis, cataract that has no complications, myopia, and central retinitis.

The mouth cavity disorders acupuncture helps include toothaches, gingivitis, pharyngitis, and pain or discomfort that sometimes takes place after a tooth is pulled. The orthopedic disorders acupuncture helps include periarthritis humeroscapularis, tennis elbow, lower back pain, rheumatoid arthritis and sciatica.

Acupuncture also improves gastrointestinal disorders as well as neurologic disorders. The gastrointestinal disorders it helps include hiccups, gastroptosis, spasms that take place in the cardia and the esophagus, gastric hyperacidity, acute and chronic gastritis, chronic duodenal ulcer, acute bacterial dysentery, acute as well as chronic colitis, constipation, diarrhea, and paralytic ileus.

The neurologic disorders it helps include headaches and migraines in particular, facial paralysis, trigeminal neuralgia, peripheral neuropathy, meniere’s syndrome, intercostals neuralgia, nocturnal enuresis, paralysis after an apoplectic fit, neurogenic bladder dysfunction, and paralysis that is caused by poliomyelitis.

* How is acupuncture done?

Acupuncture is carried out by hundreds of small needles being inserted into special points in the body, these points are known as acupuncture points and are located along meridian lines where qi is supposed to flow likes streams, rivers and seas.

In the body there are hundreds, if not thousands of acupuncture points, all of which are related to different medical conditions and used for alleviating different symptoms.

The points are found by an acupuncture therapist feeling for pulses in the body, mostly around the organs, this will help them determine which acupuncture points to use.

Atherosclerosis: Are Your Arteries Blocked?

Atherosclerosis or arteriosclerotic vascular disease (ASVD) is a clinical condition identified by thickening of the arterial walls due to the accumulation of cholesterol chiefly the low density lipoproteins. It is a syndrome affecting arterial blood vessels due to which they become hard. The hardening of arterial walls is due to the formation of multiple plaques. The atheromatous plaque is composed of three components chiefly, atheroma which is a nodular accumulation of soft material in the center of large plaques, followed by cholesterol crystals and calcified components. Atherosclerosis is a chronic disease that can remain asymptomatic for decades and the plaques may be stable or unstable. Stable atherosclerotic plaques tend to be asymptomatic and are loaded with extracellular matrix and smooth muscle cells while unstable plaques contain macrophages and foam cells along with extracellular matrix that are liable to rupture.

The soft plaque ruptures suddenly resulting in the formation of thrombus that obstructs blood flow causing death of tissues within 5 minutes. This event is known as infarction. If same process occurs in the arteries supplying brain then it is termed as a stroke. Atherosclerosis is a slow disease characterized by hardened and clogged arteries resulting 75% deaths all over the world due to cardiovascular strokes. 80-90% of Americans over the age of 30 die of heart attack caused by clogging of the arteries. Fat, cholesterol, calcium and other substances are responsible for the formation of plaques that make the arteries hard and obstruct blood flow resulting in heart attack. If the arteries that bring oxygen-rich blood to the heart are blocked then the person may suffer from chest pain, coronary artery disease or heart attack. Lowering the blood pressure, minimizing bad cholesterol levels and consumption of a healthy diet with enough proportion of fruits and vegetables, losing excessive body weight, quitting smoking and alcohol intake and regular exercise can minimize the risk of atherosclerosis.

Signs and symptoms

In majority of the cases people suffering from atherosclerosis don’t have visible symptoms unless 40% of the arteries become blocked. The symptoms depend upon the fraction of arteries clogged with plaque. The most common symptoms of the coronary artery disease include chest, abdominal, back, jaw or shoulder pain, shortness of breath followed by weakness and perspiration. Cerebrovascular disease occurs due to narrowing of arteries of brain. The symptoms include weakness or paralysis on one side of body, problem in speaking, loss of vision in one eye, muscle weakness, dizziness, loss of balance and severe headache. Peripheral artery disease occurs when the arteries supplying the oxygen-rich blood to the arms and neck are clogged. The symptoms comprise pain, aching, numbness of limbs, cramps, hair loss, thickened nails, gangrene, and smooth, shiny skin surface.

Causes

The main cause of atherosclerosis is yet not known but it is believed that the inflammatory response initiated in the arterial walls due to excessive deposition of low density lipoproteins or bad cholesterol molecules causes this disease. When LDL molecules invade the cells they become oxidized by the action of free radicals forming toxic substances and atheroma appears. The LDL molecules are identified by the presence of heavy core carrying cholesterol to all parts of body. The immune system of the body becomes activated when the arterial wall is damaged by the LDL molecules and immediately releases macrophages and T-lymphocytes to absorb the oxidized-LDL molecules thus, forming foam cells.

The white blood cells of immune system are not able to process these LDL molecules for a long time so they start accumulating on the arterial walls making them hard. This hard covering of cholesterol results in narrowing of the arteries so the blood flow obstructs and blood pressure increases. Some researchers believe that atherosclerosis is the result of the infection caused in the smooth muscle cells of heart for example, chickens suffer from atherosclerosis when they are attacked by Marek’s disease herpesvirus. Herpesvirus infection of the smooth muscles of heart causes cholesteryl ester (CE) accumulation. The accumulation of cholesteryl ester results in atherosclerosis. Infection with cytomegalovirus is also associated with the cardiovascular disease.

Risk factors

A number of anatomical, physiological and behavioral risk factors are known to be associated with atherosclerosis. The risk factors may be classified as congenital or acquired, modifiable or non-modifiable, classical or non-classical. Modifiable factors include diabetes or impaired glucose tolerance, high serum concentration of LDL or low concentration of high density lipoproteins. The LDL: HDL ratio becomes greater than 3:1. Tobacco smoking also increases the risk of stroke by 200%. Hypertension, vitamin B6 deficiency and elevated serum C-reactive protein concentration are other modifiable factors. The non-modifiable factors include, advanced age, male sex, familial history of coronary artery disease or atherosclerosis or genetic abnormalities like familial hypercholesterolemia. The uncertain factors include, obesity, hypercoagulability, post-menopausal estrogen deficiency, high intake of saturated fats, intake of trans fat, high carbohydrate intake, increased levels of triglycerides and homocysteine.

There is a very close relation between the dietary fat and atherosclerosis. The American Heart Association and the American Diabetes Association and the National Cholesterol Education Program recommend low intake of fat in the diet as it is atherogenic. Professor Walter Willett suggests that intake of unsaturated and polyunsaturated fats can reduce the risk of heart attack. The exact role of dietary oxidized fats in humans is not yet understood. Laboratory animals when fed on dietary fats developed atherosclerosis. Laboratory rats when fed on the DHA-containing oils showed significant accumulation of phospholipid peroxide in blood, liver and kidneys. In a study rabbits were allowed to feed on heated soybean oil and they developed symptoms of atherosclerosis.

Pathophysiology

Atherogenesis is the process of formation of atheromatous plaques identified by the deposition of fatty substances in the subendothelial spaces of arterial walls. The development of athermatous plaques is a slow process and it may take several years to flourish well as it is acted upon by a number of factors like cellular processes and other vascular events. One recent theory suggests that the leukocytes especially the monocytes begin to attack the endothelial lining of the arteries for unknown reasons resulting in the formation of athermatous plaques.

Cellular processes

The beginning of athermatous plaque is identified by adherence of the monocytes on the endothelial lining of arteries followed by their migration to the sub-endothelial spaces resulting in activation of macrophages. The presence of oxidized lipoprotein molecules in the arterial walls or elevated levels of glucose act as key factors for formation of athermatous plaques but real causes are not known. Fatty streaks may or may not be present. When the low density lipoproteins present in the blood plasma get oxidized in the endothelial wall of the arteries then the risk of cardiovascular disease increases. A complex series of biochemical reactions participate in the oxidation of low density lipoproteins for example, enzymes like Lp-LpA2 and presence of free radicals in the endothelium. Inflammatory response is the primary symptom that arises when the wall of the blood vessels is attacked. Monocytes enter the arterial wall through the blood stream and start adhering to it and the redox signaling factors like VCAM-1 accelerate the process. Here the monocytes differentiate into macrophages that ingest the oxidized LDL molecules. These oxidized LDL molecules finally get converted into foam cells and the arterial wall now gets loaded with high lipid concentration. These foam cells finally die and propagate the inflammatory process.

Calcification and lipids

The vascular smooth muscle cells surrounding the athermatous plaques show the presence of intracellular microcalcifications. As the cells die, extracellular calcium accumulation occurs between the muscle wall and outer portion of atheromatous plaques. The low density lipoprotein particles are responsible for delivering cholesterol to the wall of the blood vessels. For the stimulation of macrophages cholesterol must be released from the low density lipoprotein molecules so that the inflammatory response may be produced. The process is hampered if high density lipoproteins remove the cholesterol from the tissues and send them back to the liver. Foam cells and platelets encourage proliferation of smooth muscle cells which in turn ingest lipids and finally get transformed into foam cells. A protective fibrous cap is usually formed between the fatty deposits and artery lining. These caps produce enzymes that cause enlargement of the arteries.

Visible features

Two types of athermatous plaques are identified. First is the fibro-lipid plaque characterized by the presence of lipid-laden cells underneath the intima of arteries. The endothelium has a fibrous cap surrounding the atheromatous core of the plaque. The core consists of lipid-laden cells with high concentration of cholesterol, cholesterol ester content, fibrin, proteoglycans, collagen, elastin and cellular debris. In advanced plaques the core is marked by the presence of extracellular cholesterol deposits that form cholesterol crystals. The periphery of the plaques is characterized by the presence of younger foam cells and capillaries. The plaques cause tremendous damage when they rupture. The second type of atheromatous plaques is the fibrous plaques also present under the intima and are responsible for the expansion and thickening of the arterial wall. The fibrous plaques are rich in collagen fibers, precipitates of calcium and very rarely lipid-laden cells.

Due to the presence of atheromatous plaques the muscular portion of the arterial wall forms small aneurysms. The muscular portion of the arterial wall however remains strong although it is remodeled to compensate for the atheromatous plaques. The atheromas present within the walls of the vessels are soft, fragile with very little elasticity. The arteries constantly expand and contract with each heart beat. The calcium deposits present on the outer portion of the atheroma and muscular wall result in loss of elasticity and cause stiffening of the arteries. In advances stages the calcium deposits are easily visible in the computerized tomography (CT) or electron beam tomography (EBT).

Rupture and stenosis

Although the disease is very slow and takes years to flourish completely it may become dangerous if the atheroma ulcerates causing immediate blood clotting at the site of atheroma ulcer. This causes enlargement of clot that obstructs blood flow. A complete blockage of the arteries results in the development of ischemia of myocardial muscles thus, increasing the risk of heart attack. If heart attack is not fatal then the fibrous organization of the clot in the lumen may lead to stenosis or closure of the arterial lumen in the successive years. Stenosis is a slow but progressive process but ulceration is a sudden event.

Diagnosis

Stenosis can be detected by angiography and stress testing. These methods generally focus on the detection of narrowing of arteries but not on the atherosclerosis disease. Human clinical studies have indicated that severe symptoms occur in the areas of heavy plaques. Plaques finally rupture leading to occlusion of the arterial lumen within few minutes causing permanent debility and even death. Ruptured plaques are sometimes known as complicated plaques. The extracellular matrix of the lesion breaks and exposes the thrombogenic material resulting in the formation of thrombus. The thrombus so formed grows in size, travels downstream and occludes a narrow artery. Once the artery is blocked blood and oxygen are not able to pass through it causing death of the cells followed by necrosis and poisoning. Serious complicated plaques can damage the organ tissues resulting in severe problems.

Greater than 75% lumen stenosis of the bigger arteries is considered as the hallmark of cardiovascular disease by the medical experts as the symptoms of angina or chest pain are detected by the stress testing. Atheroma plaques are responsible for most of the problems associated with heart. In order to cause a cardiovascular disease any artery of the body can be clogged but severe narrowing of arteries that supply blood to the critically important organs is considered as the key factor of the disease. Obstruction of blood flow in the arteries supplying heart muscles result in heart attack. Obstruction of blood flow in the arteries supplying brain causes stroke. These events are life changing and can result in permanent impairment of organs involved as the lost heart and brain cells do not grow back to significant extent.

Over the last few decades techniques other than angiography and stress testing have been developed that can detect atherosclerotic disease more easily and with greater accuracy. These methods include both anatomic detection methods and physiologic measurement methods. The anatomic methods include coronary calcium scoring by using computerized tomography, carotid intimal media thickness (IMT) measurement by ultrasound and intravascular ultrasound (IVUS). However, the physiologic methods include lipoprotein subclass analysis, HbA1c, hsCRP and homocysteine detection. The metabolic syndrome combines both anatomic and physiologic methods. Both anatomic and physiologic methods have many advantages for example, anatomic methods can detect some aspects of the actual atherosclerotic disease before the symptoms may appear. Physiologic methods are however, less expensive and can slow down disease progression. Apart from advantages these methods are also coupled with disadvantages like anatomic method is very expensive like the IVUS while the physiologic methods do not track the current state of the disease.

Treatment

Healthy lifestyle choices are helpful in the prevention and treatment of atherosclerosis. A medial expert may prescribe drugs to lower blood cholesterol levels as well as control blood pressure. Nutrition and dietary supplements can be associated along with the medications. Some herbs have given positive results in lowering blood cholesterol levels as well as in reducing the risk of heart disease. Commonly prescribed cholesterol lowering drugs include statins that are easy to take and have little or no interaction with other drugs. Their side effects include myositis, joint pain, stomach problems and liver damage. Individuals suffering from liver disease as well as pregnant females must not take statins. Niacin is also used to lower blood cholesterol. It is effective in increasing the HDL levels but the side effects include redness of skin, headache, stomach problems, dizziness and liver damage. Niacins should not be taken without the prescription of the doctor. Bile acid sequestrants are also used against the elevated levels of blood cholesterol. The common side effects associated with them include bloating, constipation, and heartburn. Individuals with high levels of triglycerides must not take these drugs.

The common blood pressure lowering drugs include beta blockers that slow down the heart beat and reduce the proportion of stress reducing hormones in the body. Angiotensin converting enzyme (ACE) inhibitors block the formation of angiotensin in the body and thus, prevent narrowing of the blood vessels. As the blood vessels relax the blood pressure is lowered. Calcium channel blockers block calcium from entering the arteries thus resulting in the relaxation of blood vessels and lowering of blood pressure. Side effects include constipation, nausea and headache. Angiotensin II receptor blockers (ARBs) are used for blocking the effects of angiotensin formed in the body resulting in the lowering of blood pressure. Diuretics help an individual to get rid of excess water and sodium from the body. This results in declination of blood volume and lowering of blood pressure. Sometimes drugs of these classes can be combined depending upon the condition of the individual. Blood thinning drugs like aspirin, heparin, warfarin are used to prevent the formation of blood clots.

Both surgical and nonsurgical procedures may be used depending upon the narrowing and blockage of the arteries. Nonsurgical procedures include angioplasty which is used for the widening of the narrowed arteries followed by atherectomy which includes removal of plaques from the arteries. Surgical procedures include bypass surgery and endartectomy used for the removal of plaques from the carotid and peripheral arteries. Healthy diet can help in reducing the elevated levels of blood cholesterol, lower blood pressure and control obesity that are the risk factors for the cardiovascular disease. A number of herbs have also given promising results in lowering the cholesterol levels for example, hawthorn, garlic, olive leaf extract, guggul, red yeast rice and psyllium. Acupuncture may also help in reducing the risk of heart attack. It can be of help to the individuals who want to quit smoking. Homeopathy can also help in reducing the risk of heart disease.

Preventive care

A person can remain free from the risk of heart disease by quitting smoking, regular exercise for about 30 minutes in a day. Eating healthy foods like fruits, vegetables and whole grains that are low in saturated fat but high in fiber content. A normal body weight is maintained. Reduction of stress and lowering of blood pressure also help in staying away from the risk of cardiovascular diseases.

Towards a GloCal Engineering

In this contemporary time, the most dynamic and evolving area is engineering. Such an observation may seem at first to be a mere fairness but closer considerations of its impacts in medicine, entertainment, energy and surgery will rapidly dispel any such dismissive judgment.

Engineering is transforming all fields. Future medicine looks as a field where robots will seamlessly help doctors and surgeons get patients to work quicker and healthier. The future of global energy looks promising because engineers are breaking barriers daily in the quest to deliver affordable, efficient and clean sources of power.

From entertainment to security, nothing is spared. Today's wars are technology wars fueled by engineering geniuses acquired, advanced and processed over centuries. The bravery of a modern warlord is the engineering feat of someone who may never have to shoot. We are living in an era where discovery is not celebrated, not because they have become easier, but because they are happening regularly.

Engineering practice has changed so much and in a radical form from what it was a few decades ago. The global energy problem is engineering problem. The global health challenge is engineering problem and daily engineers are faced with burdens to solve major world problems. While the politicians enact the energy bills, the engineers make the energy practicable available.

The bold and optimistic challenge to help engineer bio-grade artificial human organs is an assessment that managing what Nature gives us has limitations. Why not get a new artificial brain if the one that exists is troublesome enough?

But these advances pose serious ethical challenges which the engineers are not providing answers. In most cases, that is not their job; Someone has to regulate them and put them on the path of keeping sanity on this earth.

But regulating these activities is unfortunately not easy. One technology could do well but could also be harmful. In this case, the problem is not the technology, but the application and usage. It is like saying because nuclear technology could kill en mass, it must be parked in hospitals where they are used in many critical treatments.
But for a moment, let us leave the technical aspect of engineering progress. I am already aware that many cotton farmers in Sudan could be out of jobs if some of the experiments on lab production of cotton in universities in US and European schools work out. We could be creating security crises where the commodity market is destroyed because nanotechnology has provided alternatives to rubber, cotton and hosts of other materials. People will be out of jobs and crises will start everywhere.

My concern is the disparity in engineering development between the developed and developing world. The rich nations are pushing the limits while the poor are not contributing much. It is not that they do not want to contribute, they want but the environment does not enable them. We lose their ideas and perspectives, unfortunately.

Can the future of engineering be structured so that these people can get on the pathway of creativity and innovation? Can the world and technical associations provide an effective system where boys and girls in developing countries could help solve the global engineering challenges? How can this be done? In short, how can companies begin to give people at the bottom of the pyramid opportunities to shape the products that are designed for them?

The same problem that has undermined our abilities to resolve major poor people's diseases is what is affecting the ability of the world to provide technology in ways that the poor people can use them. Exporting Smartphone to people that just need the simplest phone is not a great strategy. When you stay in top European universities and craft an aids project that will be implemented in Botswana without understanding what they need is similar to exporting many products we see in developing nations that do not meet the real needs of those customers.

Malaria remains a disease because there is no money to be made as only the poor suffer it. Polio has the same problem. Tuberculosis is the same. Why? Because those that engineer drugs consider business before quest to save lives. So why not have a system where engineering goes global and local at the same time?

Answering, understanding and managing emerging developments of meeting the needs of every customer, broad and specific, in the highly fragmented world market will define the future of engineering. It will show our readiness to solve the word's problems. It will make engineering fresh before all global citizens. It is going gloCal- having a world global strategy, but acting local in each market or community. It means helping people solve local problems with global ideas.

If we begin to do that, we have the possibility of solving these problems. It is so shameful that in a world of so much knowledge, many are very poor and dying. We have solved the refrigeration problem in Boston, but in a small village in Ghana, the citizens have no light and refrigerators do not have any value there. So, can we say we have indeed solved how to preserve food?

The global food problem is an engineering problem. Even in Africa, they have enough during the harvesting season. But immediately that season is gone, many became hungry because they could not reserve the excess. So, you have a system where a man that thread away a basket of excess fresh tomatoes a month before is looking for a canned logo for his family. What if he has maintained the fresh ones? We need solutions.

Now is the time to redefine what engineering research is. People at the bottom of the pyramid are not interested in nanotechnology and genome project. They just want simple ways to live and if governments, usually not their governments, can understand that there are many research and engineering challenges in these areas by providing simplicity through engineering, everyone can look at engineering future with optimism.

My African kinsmen care not if you can travel to Mars and yet can not assist them to reserve the mangoes that they harvested to last longer and feed their families. So while the Mars race is on, they expect the governments to fund ways to help them store their food. If that happens, they can confidently look at the future of discovery and engineering with optimisms. A little support and devoting the engineering powers of the advanced nations could eliminate many problems.

There are engineering challenges across the developing nations and it is time we put resources to solve them instead of being obsessed with sending private ships to the moon.

I hate to recognize the political problems, because in my understanding, a political problem is also an engineering problem. Engineering will solve all human problems. Let US put all the aids money they give the doctors in Africa and send some of their best minds from MIT, Johns Hopkins, Berkeley, GaTech, Michigan and Stanford on engineering missions in Africa. Suddenly, there will be solutions to food preservation and we can reduce global poverty as everyone that grows up in Africa knows that our problem is not production, but preservation.

Engineering must be global and yet adaptable to local needs- we need gloCal engineering for the future. Let engineers be engineers, irrespective of boundaries and make this world a better place. Until then, many will not understand why they matter.

Evolution – The Devil Is in the Details (Part Three of Six)

Are mutations the driving force in evolution? Is that feasible? Let's do a bit of detective work and see if we can answer these questions.

Considering all the activity in the cell – and we have only looked at a small part of it – it appears that a good number of things could go wrong in the operation. That is an understatement. Geneticists call these errors: saltations, mutations, mutants, sports, or "freaks". Those who write or speak on evolution typically refer to them as mutations. We find two basis types: gene and chromosome mutations.

Gene mutations occur when nucleotide sequences are altered in the DNA helix. One nucleotide base is substituted for another, or sometimes a base is added or deleted. What happens?

Let's say one nucleotide is substituted for another. That's the most common gene accident. If the first adenine (A) molecule of a GAA codon was to mutate into a uriacil (U), it becomes a GUA codon. The upshot of this change is that we now have a sequence coding for a valine amino acid instead of a glutamic acid.

This simple, one nucleotide base substitution causes sickle cell anemia. Distorted sickle cells get stuck in tiny blood vessels preventing blood cells from carrying oxygen into the body.

That is so remarkable, it bears repeating. If just one microscopic nucleotide out of three billion goes astray, you could die. That example is not unique. Other nucleotide changes result in consequences varying from negligible to lethal.

Gene mutations are nucleotide accidents. Sometimes a nucleotide is missing or one is repeated or duplicated. That can throw the whole gene out of kilter. A single missing nucleotide can result in a missing protein. If the protein remains, it is likely to be a huge malfunctioning entity. Deformity or death is the most likely prospect for any individual with one or more deleted nucleotide bases. Adding or duplicating a nucleotide in the DNA sequence would reek equal havoc.

A deletion of one or more nucleotides is the gene mutation equivalent of removing the back of your watch and unscrewing one or more of the tiny screws inside of the watch. Would this "screw deletion" likely improve the watch's performance, or harm it? Or would you be surprised if the watch ran at all?

An addition of one or more nucleotides is the gene equivalent of removing the back of your watch and jamming in one or more extra tiny screws. Would that help, hurt, or destroy the watch? And a substitution of one or more nucleotides is the gene mutation equivalent of removing the back of your watch and replacing one or more screws with screws of a different size or even something other than a screw. Once more, it's a pretty sure bet that the change will be detrimental for the watch.

A DNA mutation is nothing more than a mistake, an error jammed into the DNA sequence. Any tampering with what makes a living thing tick is likely to kill or maim it. Occidentally, a gene mutation is neutral. Rarely is it beneficial. Seventeen years of fruit flies prove it. (We will address both beneficial mutations and the fruit fly experiment in future articles.)

In addition to gene mutations, we also find chromosomes mutations. We know that a gene is nothing more than a section of DNA which codes for one or more trains – color of eyes, skin, hair, or length or shape of the nose, ears, etc.

Often a single human character depends upon a combination of several genes. You and I have about 100,000 genes in our bodies. They are organized into 46 chromosomes. Looking at it from the top down, we can say, chromosomes are collections of genes which in turn are collections of DNA sequences.

Chromosomes come in pairs. Normally the male and female each contributor one member to each pair. The number, size, and organization of chromosomes vary among species. At the low end of the totem pole, bacteria have only one chromosome. At the high end of the spectrum, many species have more chromosome than we do. Butterflies have more than 100 pairs, while ferns show more than 600 compared to the 23 pair found in humans.

Changes in the number, size, or organization of chromosomes are called chromosome mutations. Two chromosomes may fuse into one; Or one breaks into two; Egypt a chromosome duplicates itself or is deleted. On rare occasions, the whole chromosome rotates 180 degrees at the same location.

Then again, one or more genes will break off one chromosome and join another. Geneticists call this rearrangement "crossing over." A pair of chromosomes exchange a section of one or more genes. Linkage between the genes suddenly and dramatically changes.

Traits which were once closely linked became separated and vice versa. Physical hits are seen in new combinations with greater variety. Sure, variety is the spice of life. But how does this type of mutation fit into evolution? It does not. A mishap at the chromosome level does not crank out new exercises. It sincerely reshuffles old ones. We can not go from bacteria to humans by scrambling chromosomes. It is just another dead end for macroevolution.

Our brief look at mutations really has not cleared anything up. Naturalists, you may remember, say that mutations are the driving force behind evolution. Of course, natural selection lops off the rough edges, but mutation is the spark plug – the creative source for engineering new species.

But when we look at the two types of mutations, however seems promising. Gene mutations produce diseases, monsters, or death, with an incidental neutral result. It is suggested that although on rare rare occasions, something beneficial might occur. That does not seem too encouraging for the bacteria to man scenario.

Even less promising are chromosome mutations which are certainly mix already existing characteristics. So what makes evolution tick?

We will continue our study of mutations with "Mutations: Facts and Figures": see Evolution: The Devil Is in the Details (Part Four of Six.)

Symptoms and treatment for Swine Flu disease

Symptoms of swine flu are similar to those of seasonal flu. These would include very high fever that keeps appearing occasionally, persistent coughing, running or stuffed nose, sore throat, severe body aches, chills, extreme tiredness and fatigue, vomiting, diarrhea that recur more often than they would in the case of seasonal flu. If you have a more severe form of swine flu, pneumonia and respiratory failure would be experienced as well. If your child is suffering from swine flu, makes sure you do not allow her to interact with other children as swine flu is highly contagious. Also make sure you call your pediatrician who will continue to check your child thoroughly in order to prescribe the right medication. In fact this should be provided in the initial stages it self as waiting till later will only worsen the condition of the child, so checkout the causes for the swine flu to take precautions at proper time

Those who regularly suffer from seasonal flu as well as generally have a bad health condition tend to fall prey to swine flu easily than others. These groups of people would quite naturally include pregnant women, patients suffering from chronic health problems and also those with obesity problems. There are some severe symptoms of swine flu and the moment these are noticed we recommend you rush to a doctor immediately as it is definite that your condition has definitely deteriorated from the earliest stages to later ones. These frightening symptoms would include fast and troubled breathing, the colour of your skin turning bluish or grayish, not being able to drink enough fluids, persistent vomiting, wanting to sleep more than usual, too much irritability and other familiar flu like symptoms such as cough and fever.

You should keep in mind though that if your child has a running nose or wet cough, there are lesser chances of him suffering from swine flu. Swine flu tends to dehydrate your body. In that case your child might be suffering from sinus infections, seasonal allergies, common cold or strep throat. Do not confuse any of these with swine flu.

Here are some key facts that you might find useful to know.
– Swine flu will mostly spread if you are in contact with the respiratory secretions of one already suffering from swine flu, also sneezing and coughing near you might be the cause.
– Those suffering from swine flu are highly contagious a day before and seven days after they begin to get sick from the symptoms of swine flu.
– Droplets of cough or sneeze on tangible surfaces like door knobs, drinking glasses and the like are the grounds where these germs are predominantly found and the germs are likely to live for a few hours.
– There are anti flue medicines such as Tamiflu and Relenza that help to prevent as well as treat one suffering from swine flu.
– If children are found with symptoms of swine flu, parents should ensure that they are not in touch with other children as they are most susceptible to falling prey to this heinous disease.

Her Impetigo Is Making Her Misarable

Question:

My 19-year-old daughter, who’s at university’ suffers from impetigo on her face, which she finds distressing. She has been prescribed antibiotic ointment, but this only clears the spots for a while. They tend to appear at certain times of the month. Is there an alternative treatment?

Answer:

This common skin infection is caused by bacteria. It  affect the inner (epidermal) layer of the skin. As the infection develops, fluid accumulates forming a pustule. When this bursts, a honey-coloured crust forms around it impetigo attacks normal skin and also sometime occurs when there is another problem such as acne or eczema. Having it on your face is embarrassing and I sympathise with your daughter’s distress.

The usual treatment is to gently ‘remove the crusts with Savlon or saltwater, and use both topical antibiotics and systemic  oral ones to fight the bacteria. This is usually effective. However, since your daughter is suffering reacurrent infections and the skin lesions appear at certain times of the month, we have to look at the problem a little differently. The fact that she is attracting the infection shows: that her immune system is not strong enough.

The student lifestyle can lead m problems. Their meals are more likely to be fast, cheap, processed, oily and over-sugary rather than fresh and wholesome. They often don’t eat enough vegetables or fruit, and girls may be on a diet. So, all in all, they are likely to be deficient in vitamins and minerals. Teenagers can get away with a lot of dietary irregularities because they are naturally robust, with high energy levels fuelled by puberty and hormones.

They tend to sleep less, sit up the working at their computer: and party at the weekend. But when they get ill, they can be really low because the system that keeps them so active crashes and their bodies just can’t cope. Teenagers with ME or chronic infections such as colds, tonsillitis, bronchitis or glandular fever are quite difficult to treat because once their bodies are down, they take much longer to return to normal.

Since your daughter’s skin seems the erupt at particular times of the month, there is a chance she could have some hormonal imbalances (though my experience does not suggest a fink). I would advise her to consult a qualified homoeopath or acupuncturist.

However, the main aim b to build up her immune system and improve hen energy levels and general health.

This is what I suggest

* Treat the sores daily with Skin Oil (Biotique,), which contains neem oil, a natural antibacterial treatments and kolonji oil to help inflammation.

Dietary guidelines

* Eat fresh, wholesome food (organic where possible); avoid processed and ready-prepared foods.

* Eat regularly-three meals daily, with non-citrus fruits nuts and seeds as snacks in between; never miss breakfast.

* Try to have freshly squeezed juices, such as carrot, celery and ginger (which reduces skin inflammation), at least every other day.

* Sit down for meals, eat slowly and chew food well.

* Aim for at least five portions of vegetables and fruit daily.

* Avoid citrus and acid-tasting fruits and foods {such as oranges, grapefruit, lemons, pineapples, kiwis, mangos, curries, pickles, tinned product). These cause the skin to be hypersensitive.

* Avoid fried foods, which also affect the skin.

* Avoid all yeast and fungal products (bread, pizza, Marmite, cheese, mushrooms, vinegar, ready-made sauces, beer, wine and alcohol in general), which can cause fatigue by fermenting in the gut.

Take the following supplements for two months

* Multivitamin and mineral one a day formulation tablets: daily with breakfast.

* Zinc citrate (tablets): one every other day. This will help boost immunity and fight infection.

* Bioprash : one tablespoonful with a little honey and water after breakfast. This Ayurvedic supplement is a greet immune system booster.

General health

* Try to walk daily in the fresh air and also do yoga or some other enjoyable excercise.

* Get plenty of sleep. Avoid caffeinated drinks after midday and aim to be in bed by l0pm at least two nights a week. For more sleep tips, visit my website www.drmali.com and, under YOU articles, key in ‘sleep’ and ‘insomnia’.

Moving Beyond the Playground: A Healthy Approach to Female Conflicts

For many women, their female friendships have been a source of comfort, support, laughter, and joy.

For others, they have been mired in betrayal, mean-spiritedness, and competition.

But for most of us, they’ve been a combination of these two extremes, and typically, even before we reach the age of twelve!

But, by the time we reach 30 years of age, most of us carry a number of scars from battling – and often losing to – the tactics (or ‘rules of engagement’) that we learned while still making mud cakes in the sandbox.

By adulthood, many women hold advanced degrees in knowing how to masterfully undercut and destroy their ‘competition’, often smiling all the while.

Why are so many friendships between women so complex? So fraught with drama, conflict, and with pain?

Well, the answer is rooted in social conditioning (i.e., ‘women are the competition’), as well as within the experience of the woman herself in terms of learning from her own mother how safe relationships with women can be (i.e., a mother who seriously betrays her daughter can teach her to never fully trust women).

In short, the answer is as usually as complex as the women themselves.

During my years of being a psychotherapist, I’ve sat in front of a large number of female friends who’ve experienced serious fractures in their relationship with one another. I’ve listened to the sadness, the anger, the broken trust, and kind of emotional devastation that results from the way women manage or, rather, don’t manage, the issues that inevitably rise between them over the course of time.

Much of what I’ve heard from these clients in this regard, I can recall from my own personal experiences ‘out there’, and so I can empathize with the suffering these women describe in my office, either in the presence or absence of the friend in question.

My goal in these circumstances is to find the root of the humanness and compassion within each woman that often lies deep underneath the anger and hurt feelings.

It already says something that they’re in an office like mine in the first place; despite the pain that exists between them, there still lies the hope and commitment that their friendship was originally based upon, and that makes my job all the easier because I usually have willing participants in the process of healing their fracture.

But these women are rare; most never get to a place where healing can happen, and more often than not, friendships in crisis between women usually die in painful silence, or after an angry meltdown, with either one or both women turning away from the chance to sort through what went wrong or to take responsibility for the behavior that led to that particular outcome.

Why? Because they were never taught the skills to deal with conflict. Why? Because women were taught early in their lives that they shouldn’t have conflict!

Unlike boys or men, who are far more direct about the conflicts they experience with their own gender, and their ways of dealing with them – not always appropriately… hitting your friend in the face isn’t exactly the best way to deal with your anger… but you get the point: boys and men are considerably more direct when it comes to solving the conflicts they have with their friends.

Girls, however, were taught from a very early age to ‘be nice’, and thus, weren’t ever supposed to find themselves in places of conflict because, well, being nice would, for the most part, eliminate that possibility. Or so ‘they’ thought.

But what ends up happening is that girls, and later women, go ‘underground’ with their methods of conflict management, and engage in behaviors that usually just fuel the flames, thus creating mini-wars that become almost impossible to resolve.

Thus, the birth of passive-aggression, where the person can be filthy angry and can undermine or seriously damage their target but in the absence of any real evidence that they did anything untoward.

Gossip (aka, character assassination), getting others ‘on one’s side’ of the argument with an attempt to alienate the other person from any possible support, being outwardly kind toward the person but in no way betraying the hate or anger that lives below the surface (aka, not being honest), are just a few ways that girls learn how to deal with conflict in ‘nice’ ways.

And young girls often continue these nasty behaviors beyond their high school years and, thus, grow into the same ineffective managers of their friendships later in life as they once were in childhood and adolescence.

I’m of course in no way promoting hitting your girlfriends in the face, but hey, there has to be a faster, and far less damaging way through female conflict to resolution, but how?

Well, here’s a 5-step process:

1) be honest;

2) be willing to listen;

3) be undefended;

4) be empathetic; and,

5) be willing to see the part you played in the conflict that arose.

If you can manage to do these 5 things, there’s likely no conflict that you can’t resolve with your girlfriend(s).

This process works with both genders in their own friendships, and is not just for women; it works equally well in intimate relationships.

It’s a system that, in the absence of which, will in time render any friendship or relationship dead, but it requires those involved to become willing to have what I call the ‘hard conversations’.

If the individuals in conflict are willing to be honest about how they feel, and are doing this directly with the other person (no more gossiping or ‘back-biting’) in person, and not through emails or texts, then at least there’s a good chance that they’ll sort through the existing conflict.

Resolution may not always result in a decision to remain friends, but it’ll certainly allow both of you the dignity to move forward in peace and respect – both for yourselves, as well as for the other person.

So, women, take a moment to inventory your own friendships.

Are there any that you feel might benefit from my ‘5-step’ prescription?

If so, kick aside the ineffective strategies that you learned on the playground, and instead, roll up your sleeves and step into a process that might save the relationship you have with your very best friend.

Triathlon Coaches Have the Keys to Success

Triathlon has seen exponential growth in the past 10 years. Ironman triathlon (swim 2.4 miles, ride 112 miles and run 26.2 miles) is described as the world's most grueling single day endurance event. Incredibly, most Ironman triathlons in the United States sell out in only minutes. To some the idea of ​​swimming, biking and running all at once looks crazy. But to the triathlete it looks like a great way to complete body fitness, a continuous source of intriguing stimulation and great personal satisfaction. If you want to get the most out of triathlon (and your ability) you will need a coach.

TRIATHLON IS COMPLICATED

When first starting there is a lot to learn. Often someone who takes up triathlon is accomplished at one sport and thinks it would be fun to add the others. Even if you are a great runner, you still have to master the complicated aspects of cycling and swimming. Cycling performance is highly dependent upon technique. Even if you have powerful legs, you still need to pedal efficiently to make the most of the bike course. Perhaps even more importantly, you need to be capable of riding so efficiently that you have enough energy in your legs to run after you get off the bike. Coaches know how to help you pick the best cycling gear to match your cycling ability and form.

Swimming is also about technique. It's just about impossible to make an analysis of your own swim stroke. But this is easy for a coach to do as she walks along the edge of the pool watching you swim. Minor adjustments in body alignment, hip position or hand entry into the water could translate into big gains. Your coach will help you make the changes that produce faster swim times.

ORGANIZATION

In order to succeed in triathlon you must organize both your life and your gear. Let's face it, most of us must earn a living, maintain a sane family social life and somehow find time to exercise. You'll have to juggle swim sets, bike rides and run workouts to get stronger and finish your triathlon faster. This is hard to do without the help of a coach. On race day you have to set up your equipment and organize your gear. Listen to your coach's experience and you may save enough time in transition to cover a full mile on the run.

MOTIVATION

Life has it ups and downs and so does training. At some point your job, marriage or other life experiences may sap your energy and detract your focus. An experienced coach will sense when desire is longing. This is part of the game. Your coach not only knows this, he expects it. Triathlon coaches understand and can often predict the peaks and valleys you'll go through in training. He'll help you stay on course in spite of them. The ability to keep training in spite of adversity is critical to success.

RESTRAINT

To excel in triathlon you have to put in lots of hard work. Very few people who undertake the sport lack motivation. Many are hard charging folks interested in new challenges. Others see it as a way to personal transformation. But all have a tendency to push on when the going gets rough. The unfortunate reality is that many triathletes suffer from the "no pain, no gain" mentality. It is beneficial to push on when exhaustion is pounding on the door. Ignoring the minor pains that signal an emerging injury can put you out of the game. Your coach is someone to filter those aches and pains through. You need the voice of reason and experience telling you when to back off.

Injury is your nemesis. A stress fracture in the foot will equal huge fitness losses while the bone heals. If you tear your Achilles tendon, you may never run the same again. If you feel an odd pain, talk to your coach about it. She will then make adjustments to avert disaster while keeping your training on schedule.

INJURY PREVENTION

Overuse injuries are common and preventable in triathletes. Preventing them requires 1) personal experience in the sport 2) solid understanding of biomechanics, and 3) the ability to craft a plan that will build strength without inviting injury. Triathlon coaches have all three. Your coach will help prevent running injuries by analyzing your gait and helping you choose the best running shoes. Your coach will also suggest cleat position and saddle adjustments that minimize stress to your knees while cycling.

Injury prevention is not just about holding back when tendonitis flares up. It begins with a sound analysis of your abilities. It includes a personalized training plan that will work relentlessly on your weaknesses while building on your strengths. The fastest way from start to finish is to swim, bike and run as fast as you are capable without stopping. The only way to do this is to train as hard as possible without stopping to heal an injury or recover from burnout.

Hire a coach who will take the time to understand your triathlon goals and build a training plan around your career and family life. Follow that plan and talk to your coach whenever you hit a bump in the road. With the right coach you'll reach a level that will be unthinkable on your own.

Have You Called Your Mother Lately?

When I worked in the old Bell System, Mother's Day was our largest day of toll revenue (long distance calls). We decided to try to enhance it even more and hired Alabama's legendary coach, Paul "Bear" Bryant to do a commercial for Mother's Day.

He was imprisoned in his office in his crimson sweater to film a commercial that would become legendary. He was supposedly to end in that old gravely voice of his, "Have you called yo mama lately?" He did, but then he paused and went a bit off script. He looked far away as if to Heaven, and wistfully thought out loud, "I sure wish I could."

The old Bell System network could barely handle all the calls home to "mama" after the commercial aired. We had never seen anything like it. Lewis Grizzard wrote about it, and men made speches about it.

Memories of that commercial made me think of my departed mother and a special Mother's Day, how I wish I could call her, and what I would say if she asked, "Son, I if you say Arrested you for being a Christian, would there be enough evidence to convict you? "

Many years ago, my mother rode the bus from her home near Tupelo, Miss. To visit me in Georgia. My 5-foot-3-inch, gray-haired little tornado had a layover in Atlanta. The neighborhood near the bus station had fallen on hard times, and a few unsavory characters lurked nearby. Mother's eyes fell upon a young girl of about 12 or 13 sitting across the station alone. Her eyes drawn to and fro. She looked scared, and she had runaway written in the strain of her young face.

A stereotypical pimp suddenly appeared and began to circle the girl like a vulture. They trolled such places for runaways who were desperate and vulnerable, fresh recruits for the mean streets of the inner city. The 6-foot-4 predator began to talk to the girl. "Are you hungry baby? I'll feed you. Do you need a place to stay tonight? I'll put you up at my place." And, of course, the rest of the story is all too familiar. The girl would be out on the streets and likely dead by her 20s from street violence, drug overdose or AIDS.

My petite Mom looked around and everyone's eyes were averted, looking at the floor. No one wanted to get involved, the curse of our times. Mother stand up, marched defiantly to the girl, forced herself between the towering pimp and the scared little rabbit, and said, "C'mon honey, you are going to sit with me!" Then she gave the pimp "The Look." It was the look my brother and I avoided like the plague growing up. It was like looking down Dirty Harry's. 44 magnum and hearing him say, "Go ahead, make my day!" He withered under her glare, and Mother robbed him of his prey. She took the young girl with her, and they talked. Mother bought her a bus ticket home to Louisiana.

That little girl will never know who that angel was who came into her life and saved her. There were no crowds applauding, no plaques to be given out. Mother was alone with her conscience and her God and displayed what real character is all about: doing the right thing when no one is watching.

On Mother's Day in 2003 as I came home, I thought of that day in Atlanta and many others like it where Mother modeled the code she lived by. Mother had fallen on Christmas Eve while going to work at age 84. She remained a personal care giver for the elderly and the terminally ill and would still today had her own body not finally betrayed her unbreakable spirit and will. She suffered a cerebral hemorrhage, and we sent Christmas and New Year's in the hospital trying to treat the damage to her precious hard head we credited with her survival.

She began to recover from her fall and was determined to show her mettle, the stuff that strong women of her generation seemed to have in abundance. She called just before Mother's Day and said something was wrong, and we were soon to find out why she really fell and what they had missed at Christmas.

Mother and I went to the doctors prepared. We arrived with a detailed list of symptoms and pertinent data to enable him to see this patient, not as an old lady to be dismissed with the usual prescription for painkillers, but a person suffering from a serious ailment.

The young doctor was not jaded and was very aggressive and after some x-rays, he told us that he thought Mother's cancer had returned. It had been 16 years since her mastectomy, but he felt that was it was cancer based on the pictures. Something about that word, cancer, that implies something evil and invasive, not like a failing heart or liver, but something dark and sinister.

The test confirmed the worst: stage 4, inoperable. We made the rounds of the specialists, drawing fluid from her chest, listening to the pros and cons, and finally enough was enough, and we opted for the hospice program. I agreed to stay with Mother as her primary care-giver, and it was the most difficult, trying thing I have ever done. The time with her was also a gift from God.

I would like to say that Mother conveyed great wisdom and insights to me, but she had already done that through her many examples of courage and character like the time in Atlanta. The 11 weeks I spent with her did yield precious memories of days gone by, people gone but not forgotten, a sense of who the people I came from really were and priceless moments saying nothing more than "that peach tasted delicious," or "that Back rub was wonderful, "and" I love you, son. "

Just before the end, it appeared the animals of the forests began to gather round her house on the edge of her ancient forest. The birds she fed came in an abundance of colors, songbirds sang at our windows and peered in at the woman who cared for them. Rabbits munched on her daylilies at our front door and refused to run away when approached. Even a pair of elusive fox came up at dusk as the Whippoorwill's call echoed through the hollows of Temple Grove.

Mother looked at me, and said, "Son, do you hear the birds singing?" "Yes, I do," I answered. "No," she said, as she clutched her Bible, "I mean the one who answered me during my prayers?" Not long
After that, Mother was gone, her pain relieved, and with a look on her face that suggested she knew something that we did not, but one day would.

Have you called your Mama lately?

7 Top Tips for Safe and Effective Squatting

The Squat has earned the title, 'King of Exercises' and rightly so. No other exercise hits the muscle as hard as a good solid set of squats. No other single exercise can get the lungs and heart racing like the squat. No other single exercise can stimulate growth like the squat.

If you're not squatting then it's time you started.

The squat movement itself is pretty straightforward but can be performed with several variations to produce slight different results. These squat variations include, front squat, hack squats, dumbbell squats, sumo squats and box squats.

No matter which style you perform, stick with the tips below to ensure your squats are safe and effective.

  1. Ensure sure your feet point either directly ahead of you or slightly outwards. Never point your feet inwards. An inward turn can place disproportional stress on your knees
  2. Whatever foot angle you find most comfortable it's imperative that you maintain the same angle for both feet. Different angles can place uneven load on one knee – not good.
  3. When lowering, your knees should not extend ahead any further than the end of your toes. Over extending can cause extra stress on the knee joints.
  4. Following on from point 3, ensure that your knees remain vertically in line with your feet, not jutting out to the left or right. Having your knees 'out of line' with your feet can again, can place extra stress on your knee joints.
  5. Rather than trying to lift the bar, focus instead on pushing your legs down into the ground. You'll find this actually makes the lift 'seem' easier. Plus, this approach also helps you maintain proper form with a straight back by thinking about your legs pushing rather than your body lifting.
  6. Ensure your back remains at a constant angle to your body during the squat. You want the power to come from your quads (and hip flexors) not your back. Plus altering the angle places extra load on the lower back.
  7. Squat depth – there's been endless discussions on just how deep you should squat with no common agreement ad probably never be. My advice ?, do not stick to just one depth, vary the depth of your squats regularly.

The squat is the # 1 exercise not just for legs but for complete body conditioning. I highly recommend you include squats in your routine, once per week is optimal.

I'm sure you'll be pleasantly surprised at the progress you make not just with your legs but with all aspects of your training.

The Beauty of Aging

The Japanese have a word for it. Shibui. The beauty of aging.

In Western culture, aging is seen as physical dementia, a loss of beauty and relevance. We're compared to people half our age and, because the contrast is glaring, we're seen as damaged. There's an interaction during conversation that occurs when contemporaries speak; It includes a give-and-take that confirms we're being heard. As we age, that interaction shifts and we sense we're being tolerated. We see our wrinkles and other body changes as unacceptable and spend thousands trying to eliminate the evidence of aging. There's another, more serious side-effect to aging in Western culture: chronic depression. Being unable to shake the feeling that we're no longer wanted or needed, that our lives have no value to the next generation, that we're interlopers in our families' lives, and that the longing we have to be included, loved, And valued will never be satisfied.

The beauty of aging. It's only because of our culture that those words seem to remain a nice thought without truth. In old European cultures, families maintain independence while nurturing inter-dependence among generations. The aging parents live on the ground floor, the adult children live above with their own new family. Both adult children work and the grandparents raise the grandchildren. All three generations share meals and daily activities with a fluid, natural interaction that gives everyone a deeper understanding of what each can contribute. Compare this to how we deal with aging in the West. Here, younger people are often resentful when they have to deal with their aging parents. They hope their parents are financially independent so they will not have to provide care. And, when care is necessary, they consider it a burden and place the parent in facilities that diminish any possibility that their parent's life will continue to have relevance. Much of the stress felt by families can be directly connected to these decisions; How much simpler life would be if we could adopt the European model and cherish the life experiences of our aging families.

Perhaps because the cultures are so ancient, it's in the Asian countries that one finds the highest respect for age. There, people are seen as having continuity; The teachings given while young have to be nurtured and practiced through life. It's only when a person attains an advanced age that he's actually wise and capable of advising with any degree of certainty. Younger people bow to the elder. The hardships and lessons learned in a difficult life are seen as valuable; They provide the basis for words of wisdom that may keep the youngger person from needing to suffer. The Chinese call this shih: an elegant, insightful kind of knowledge.

My lover and I are both over fifty. We've discussed the cultural changes that have created a wide division in life perceptions among generations. It's unusual to find people in our phase of life who carry an I-Pod or Blackberry; We prefer to have conversations one-at-a-time instead of engaging in three conversations at once by using all the various means of communication available today. We're painfully aware of the way in which we've accepted now compared to how it was ten or fifteen years ago; We're rarely considered for opportunities that used to be handed to us. Since we're both vital, intelligent, and energetic, we want to contribute significantly to our world and find that we have to generate our own capabilities now rather than seeking out those already exist. What we sense and what we're experiencing are extremely common; Because opening a discussion about aging is not sexy or part of pop-culture, it remains in the shadows. I believe that the deep problems of our society can be minimized significantly by encouraging a shift in the perception of age. We need to begin seeing older people as part of the natural continuity, as having wisdom that will be lost if not captured, as being great receptacles of history with observations that can serve the future. Aging does not have to be discouraging or depressing; It can be a lovely phase of life that provides a calmness and emotional security not possible when we're younger.

The Japanese have another phrase that gives insight to what aging can provide: ygen: an awareness of the universe that triggers feelings too deep and mysterious for words. It is this that I aspire to feel as I continue the life process.

Delayed Ejaculation – A Problem Waiting to Be Solved?

Male orgasm usually has two components – an extremely pleasurable sensation, due in part to muscle contractions, as orgasm takes place, and the ejaculation of semen.

Ejaculation takes place when semen enters the end of the urethra and creates a build up of pressure, which triggers a series of co-ordinated contractions of the pelvic muscles, which forces the semen out of the body.

But, strangely, some men have trouble reaching orgasm and ejaculating during sexual activity, a condition which is known as male orgasmic disorder, retarded ejaculation, or delayed ejaculation.

Delayed ejaculation, the term I prefer to use, is defined by the American Psychiatric Association (APA) as “persistent or recurrent difficulty or delay attaining in orgasm, or the absence of orgasm, following sufficient sexual stimulation.”

So how common is delayed ejaculation? Estimates vary widely. In 2003 a study of men attending doctors’ surgeries in London reported a rate of 11%. A representative sample of American men aged between 18 and 59 years revealed that 7.8% of men had experienced delayed ejaculation for at least one month over the previous year. And a study of UK men aged between 16 and 44 found that 5.3% had been unable to reach orgasm for at least one month in the previous year. A lower proportion of 2.9% had the problem for at least six months in the previous year.

What causes such a strange condition? No-one really knows, but it has been suggested men with delayed ejaculation may have slower sexual reflexes, lower penile sensitivity, or reduced spinal nerve stimulation…but the fact is, no-one really knows.

Some authors have suggested that insufficient physical stimulation during sexual activity may be the problem. This is because men who prefer autosexual stimulation – that is, stimulation by their own hand – to any kind of partnered sex may have a physically hard way of manipulating their penis as they pleasure themselves, to which they have become habituated. This hard, even aggressive, stimulation lowers their ability to ejaculate during intercourse just because they don’t receive enough stimulation during the gentler act of lovemaking.

And some evidence suggests that intensity and ease of orgasm declines with age. The sexual organs atrophy, testosterone levels decrease, and erections are harder to achieve, all of which points to an age-related decline in the functioning of the sexual system.

Sometimes there are congenital abnormalities of the sexual glands and ducts which could lead to the inability to ejaculate. We also know that pelvic surgery may affect a man’s ability to ejaculate; in particular, radical prostatectomy often results in loss of erectile function and ejaculation. And trans-urethral resection of the prostate, an operation often carried out to resolve problems caused by the enlarged prostate gland, can cause delayed ejaculation.

Other factors associated with delayed ejaculation include vascular disease, smoking, alcohol, physical inactivity, and many drugs approved for the treatment of obsessive-compulsive disorder and depression, together with antiadrenergic, anticholinergic, psychoactive and antihypertensive drugs.

In addition, researchers have observed that almost every psychological problem known to man has been associated with delayed ejaculation! For example, a man who is ambivalent about his sexual relationship may “hold back”: not only from full emotional presence in a sexual relationship but also from sexual intimacy – this can be seen as a type of overcontrol, a way of assuming power in a difficult relationship. This assumes that men with this problem are overcontrolled and resist “letting themselves go” – in every way: psychologically, emotionally, and sexually – including the release of ejaculation.

But there again, sometimes things are not so complex, for as another author has observed, a creaking bed, thin walls, and children wandering about, may inhibit orgasm and ejaculation very effectively. So can penile pain: a phimotic foreskin, painfully stretched over an erection, or a recurrent painful torn frenulum.

In getting to the bottom of what’s going on in cases of delayed ejaculation, a doctor needs to consider whether the problem is physical or emotional. An assessment of the penis and nervous system can exclude peripheral neuropathy, autonomic dysfunction, and spinal cord pathology, as well as other physical causes.

Treatment of delayed ejaculation has often involved vigorous hand stimulation of the penis, using a lubricant, in an attempt to overcome the “block”, and “decondition” the non-ejaculatory response.

Other suggestions have included the use of masturbatory exercises, missionary position sex (which is more physically arousing to men than some other sexual positions), and the use of vibrators to increase sexual arousal. In reality, these are crude approaches which do not take account of the fear or anxiety which may be inhibiting ejaculation: fear of pregnancy and fear of sexually transmitted infections are high on this list. These all need the attention of an understanding therapist or counselor. Hypnosis may be helpful for relaxing a man and encouraging him to “let go” during sex.

In summary, retarded ejaculation treatment must address both physical, emotional and relationship factors, and therapy must be tailored to the individual’s needs.