What Is Erectile Dysfunction?


Erectile Dysfunction is a male sexual dysfunction that makes men incapable of triggering off erections or sustaining the erections long enough to have a satisfactory sexual intercourse. Male sexual health is often placed at risk on account of a whole range of sexual disorders and among all the sexual problems suffered by men; erectile dysfunction is a prominent one. The other sexual disorders that constantly afflict men are ejaculatory problems like premature or early ejaculation, delayed or retarded ejaculation, dry orgasm, peyronie`s disease, priapism, male infertility et al.

Erectile Dysfunction: Another Name For Male Impotence

In 1993, the NIH Consensus Development Panel on Impotence called impotence "an important public health problem." The panel proposed that the term "impotence" be replaced by the less pejorative and more precise "erectile dysfunction" (ED) to signify "the inability to attain and/or maintain penile erection sufficient for satisfactory sexual performance."

How Erectile Dysfunction Sterilizes The Sex Life Of Men?

All the sexual dysfunctions affect men one way or the other but when it comes to male impotence or erectile dysfunction, the impact is very strong for the reason that once a person falls in the grip of erectile dysfunction, adequate amount of blood fail to reach his penile section. When proper blood flow to the penis is restricted, the person fails to trigger off erections necessary for satisfactory sexual intercourse. Erectile dysfunction not only sterilizes a man's sex life but also becomes a cause for other diseases such as depression.

Other Consequences Of Erectile Dysfunction

After erectile dysfunction or male impotence makes a man incapable of achieving sexual fulfillment with his partner, a whole array of unwanted circumstances evolve as the ultimate end result:

* Erectile Dysfunction means more than just the sexual incapability of a man. The emotions and uncertainties that coincide with this condition often have a significant effect on a man's self-esteem, as well as, his relationship with his partner.
* In case of erectile dysfunction afflicted married men, relationship breakdown is an inevitable outcome.
* There are significant consequences of erectile dysfunction like looking down upon by friends and peers and most particularly the rejection from girls can be very painful for a man.
* Guys are increasingly at the risk of losing their girlfriends as soon as their erectile dysfunction secret is out.
* Erectile dysfunction, the premier male sexual disorder is generally accompanied by tension, stress and other mental setbacks. These mental disorders further accelerate disaster in a man's personal as well as social life.

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The Side-Effects of Viagra



Every drug is accompanied with some of its side effects too apart from its benefits and Viagra is also no exception to it. But the side effects of Viagra are very mild and do not last for a long time. Some of the side effects of Viagra occur only if you take large dosages so if you are taking Viagra for the first time then it is best to start with the lowest pill dosages.

The most common are

* Headache
* Flushing of the face
* Upset stomach.
* Stuffiness of the nose

Less common medicine effects that may occur are

* Temporary changes in color vision (such as trouble telling the difference between blue and green objects or having a blue color tinge to them)
* Eyes becoming more sensitive to light or blurred vision
* Cloudy or bloody urine
* Increased frequency of urination
* Pain on urination
* Diarrhea

Some of the rarest side effects which have been noticed are as follows, though you must remember that these are some of the rarest side effects and does not necessarily mean to be experienced by everyone taking Viagra.

* Painful genital erection that lasts many hours.
* Convulsions or seizures
* Bleeding of the eye
* Decreased or double vision
* Prolonged and inappropriate erection of the penis.
* Anxiety

You should call a medical doctor immediately if you ever have an erection that lasts more than four hours.

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The causes of Erectile Dysfunction

The causes of erectile dysfunction can be broadly classified into two principal categories, physiological and psychological causes. From these two, physiological factors are found to be the primary cause of erectile dysfunction. However physicians state that approximately eighty-five percent of erectile dysfunction is attributed to physiological/organic conditions while only fifteen percent is due to psychological or mixed origin (both psychological and organic). Moreover, there are some lifestyle factors which are also found to cause erectile dysfunction to a substantial degree.

Physiological Causes Of Erectile Dysfunction

Some of the prominent physiological causes responsible for erectile dysfunction in men are detailed below:

* Vascular diseases like arteriosclerosis, hypertension, hypercholestremia,
* Diabetes
* PrescriptionMedications

(i)Antihypertensives such as beta-blockers, diuretic medications and calcium channel blockers.

(ii)Antidepressant/antipsychoticmedications

(iii)Antiandrogen medications used in the treatment of prostate cancer

(iv) Chemotherapy/radiation therapy used in the treatment of cancer
* Substance abuse like the chronic intake of marijuana, cocaine, alcohol e.t.c.
* Radical Pelvic Surgery
* Neurological Diseases
* Deficiencies in the Endocrine System
* Psychological Erectile Dysfunction
* Anatomical deviation of the penis

Psychological Causes Of Erectile Dysfunction

Even though physiological reasons account for most of the cases of erectile dysfunction, the role played by psychological causes in triggering off erectile dysfunction in men cannot be ruled out altogether. The effective functioning of a man's sexual life depends a lot on his mental well being and only when a man is mentally steady and fine, he is able to extract the maximum sexual satisfaction by physically uniting with his partner. There are a lot of factors that cause mental disturbance in a man and make him a victim of erectile dysfunction thereby ruining his sex life. The psychological causes that lead to erectile dysfunction are namely,

* anxiety with regard to one's sexual performance
* Indifference towards the existing sexual relationship between partners
* Stress caused by hectic lifestyle and other factors
* Serious depression on account of relationship failure, business loss and similar other setbacks
* low self esteem resulting from earlier episodes of unfulfilled sex

Lifestyle Causes of Erectile Dysfunction

A healthy lifestyle prevents the occurrence of erectile dysfunction or male impotence to a considerable extent but if men continue to indulge in harmful vices like smoking, drinking, drug usage et al, then sooner or later they are likely to become erectile dysfunction patients. Important facts concerning lifestyle causes and erectile dysfunction are placed below:

* Excessive alcohol intake may increase high blood pressure levels and induce erectile dysfunction.
* High levels of nicotine released in the blood on account of cigarette smoking and the smoking of other tobacco containing substances reduce blood flow to the penis and lead to erectile dysfunction.
* Apart from alcohol and tobacco containing products, the intake of marijuana, cocaine, ecstasy is also a primary cause of male impotence.
* Overweight men as well as people leading sedentary lifestyle are highly at risk of erectile dysfunction.

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Viagra and Depression Induced Erectile Dysfunction


The term 'Impotence' has been replaced with 'Erectile Dysfunction' by the National Institute Health, USA . The erectile dysfunction is one of the most common sexual problems regarding male sexual health.

Erectile dysfunction has a range of physiological and psychological causes behind its occurrence. The psychological causes take the maximum share amongst the percentage of the reasons responsible for erectile dysfunction. According to a survey for both men and women approximately 78% cases of erectile dysfunction or inhibited sexual desire are of mental or emotional origin. This shows that erectile dysfunction is often the consequence of either sexual guilt or disturbed and cold relationships between the spouses or the partners. It is very important for us to clearly understand the causes which are responsible for erectile dysfunction like fear of intimacy, sexual guilt or may be some recreational drugs.

Coming to an altogether different area of discussion, let us throw some light on depression too which is often found closely related to many cases of erectile dysfunction. Impotence and Depression are highly coexisting condition. Depression is one of the most common and the most serious mental health problems that men are facing today. According to a study published in American Journal of Psychiatry successful treatment of erectile dysfunction or impotence in depressed men can lead to marked improvement in depression. 60% of all men over the age of 40 showed some degree of impotency and 30% of Americans have a depressive disorder every year. Study found a correlation between change in Impotence and change in depressive symptoms - but it was not cleared whether the depression caused impotence erectile dysfunction (ED), or impotence erectile dysfunction (ED) caused the depression.

For millions who suffer from depression the sexual side effects of the medication can be a big turn off for them to continue their treatment with the anti depressants like the selective serotonin inhibitor drugs used for treating depression. In a study it has been proved that Viagra, the oral pill to treat erectile dysfunction, can ease a man in his condition of depression by having a positive impact. When a person knows that he can lead a normal sexual life with Viagra, in spite of the sexual side effects caused by the anti depressants, he will surely not hesitate to shy away from his treatment for depression. This way, a man suffering from anxiety no more has to worry about his sexual problem of erectile dysfunction which is an undesired side effect of taking anti depressants. Viagra increases the body's ability to achieve and maintain an erection during sexual stimulation. A Survey indicates that Viagra showed great improvement in Men in their Impotency as well as in their depression.

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What is Benign Prostatic Hyperplasia a.k.a Enlarged Prostate?

Benign prostatic hyperplasia (BPH), known as an enlarged prostate, is a non-cancerous growth of the prostate that commonly occurs in men over 50. The prostate, which is located below the bladder and surrounds the first inch of the urethra (the duct through which urine and sperm are discharged), is a walnut-sized gland that secretes fluid for semen. As a man ages and the prostate gland grows, it compresses the urethra and bladder, resulting in restricted urine flow.
Symptoms of an Enlarged Prostate

While most symptoms of BPH start gradually, the most common ones involve changes or problems with urination.

* Difficulty starting to urinate
* Hesitant, weak urination stream
* Blood in the urine
* Interruption of urination stream

However, the size of the prostate does not determine the severity of a man's symptoms. While some men with extremely swollen glands have little obstruction and few symptoms, others with less enlarged glands experience more blockage and greater problems.

As the urethra narrows and the bladder wall becomes thicker, the bladder itself becomes smaller causing the following symptoms:

* Bladder irritability
* Urge to urinate frequently, especially at night
* Incontinence (the inability to control urination)

Over time BPH can lead to other urinary problems, such as urinary tract infections, bladder or kidney damage and bladder stones. In some cases these symptoms could be a warning of a more serious disease and should be treated by a doctor.
Risk Factors and Preventative Measures

While age is the most common risk factor, ethnicity and genetics also play a role in the development of BPH.

* Age: BPH is rare before the age of 40, but more than half of men in their 60s and as many as 90% in their 70s and 80s have some symptoms of BPH.
* Ethnicity: While BPH is common in Europeans and Americans of European descent, it is rare in Asian men.
* Heredity: Having a family history of BPH greatly increases a man's chances of developing the condition.

Lifestyle changes can also help reduce the occurrence of BPH symptoms:

* Reduce the intake of coffee, tea and soda
* Eat an early dinner to eliminate drinking fluids later in the evening
* Cut down on fluids after 7pm
* Drink 8 glasses of water per day to help prevent accumulation of bacteria
* Avoid over-the-counter (OTC) cold remedies that contain pseudoephedrine and antihistamines
* Avoid spicy and salty foods
* Stay regular (constipation may aggravate the urinary tract)
* Ejaculate regularly
* Take hot baths
* Avoid prolonged sitting
* Drink cranberry juice to increase the acidity of the urinary tract

Treatment Methods

Treatment options vary from case to case depending on the severity of the symptoms. If a patient's symptoms are mild, the usual procedure is "watchful waiting" and no pharmaceutical or surgical treatment is recommended. For moderate symptoms doctors may prescribe alpha-receptor blockers to relax the prostatic-urethral muscle or 5-alpha-reductase inhibitors to help shrink the size of the prostate. In extreme cases surgery is considered the most effective treatment option after other methods have been exhausted. There are different types of surgical treatments used to improve urine flow, including transurethral resection of the prostate (TURP) and transurethral incision of the prostate (TUIP), as well as several newer minimally invasive procedures.

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Could Your Child Be Suffering From Attention Deficit Hyperactivity Disorder (ADHD)

Attention-deficit/hyperactivity disorder (ADHD), previously known as attention deficit disorder (ADD), is a common mental condition characterized by poor concentration, distractibility, hyperactivity and impulsiveness that are inappropriate for the child's age. It affects between 3 and 5% of American children and is usually diagnosed in childhood, although roughly 60% of the cases continue into the adult years.Justify Full
Symptoms Of ADHD
The symptoms of ADHD can be broken down into 3 different subtypes: a predominantly inattentive subtype, a predominantly hyperactive-impulsive subtype and a combined subtype.
Symptoms of the inattentive subtype of ADHD include the following:
* difficulty keeping the mind on any one thing
* skipping over details
* getting bored with a task before it’s completed
* making careless mistakes
* being easily distracted from a task, lesson, or conversation
* difficulty listening when directly addressed
* disorganization and forgetfulness
* difficulty following instructions or finishing tasks

Children experiencing the hyperactive/impulsive
form of ADHD may:

* have difficulty with quiet, sedentary activities
* fidget or have trouble staying in their seat
* talk excessively
* blurt out answers before questions are completed
* speak tactlessly or inappropriately
* exhibit difficulty waiting
* move around constantly, often running or climbing inappropriately
* interrupt or intrude on others

The combined subtype applies when a child shows symptoms of both the inattentive and hyperactivity/impulsivity type of ADHD. Children diagnosed with ADHD will exhibit persistent symptom in a variety of settings, including at home, in school and during extracurricular activities.

Causes of ADHD
While the cause of ADHD remains unknown, studies show that the brains of children with ADHD may function differently than those of other children, suggesting an imbalance of chemicals that help regulate behavior. Research also indicates that genetics play a significant role in the development of ADHD, contributing to about three quarters of the total ADHD population. However, roughly 1/5 of all ADHD cases are thought to be acquired after conception due to brain injury caused by substance abuse or physical trauma prenatally or postnatally.
Will my child outgrow ADHD?

While ADHD is considered a chronic disorder, symptoms often get better as children grow older and learn to adjust. Hyperactivity usually stops in the late teenage years, but about half the children diagnosed with ADHD will continue to be easily distracted, have mood swings, hot tempers and are unable to complete tasks. However, parenting plays an important role in helping a child with ADHD. Children with loving, supportive parents who work together with school staff, mental health workers and their doctor have the best chance of becoming well-adjusted adults.

Treatment of ADHD
Although there is no cure for ADHD, a child’s symptoms can be controlled with a combination of behavioral management, counseling and medication.

Behavioral management can help you and your child identify unwanted behaviors and replace them with more positive ones.

Counseling may include psychotherapy, social skills training or parental training, and it can often help a child deal with low self-esteem, anxiety, depression and stubborn behaviors.

Medication is most effective when it is combined with behavioral management or counseling. While there are many different types of ADHD medication, stimulants are the most common. By affecting the brain’s chemistry, it can help reduce overactivity and increase a child’s attention span.

If you think your child may have ADHA, talk to your doctor to learn what you can do to help.

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Breastfeeding Does NOT sag New Mother's Breast



Breastfeeding won’t make a new mom’s breasts sag, but having more babies might, a new study indicates.
“A lot of times, if a woman comes in for a breast lift or a breast augmentation, she’ll say ‘I want to fix what breastfeeding did to my breasts’,” University of Kentucky plastic surgeon Brian Rinker told Livescience. So he decided to study any possible connection. Rinker and his colleagues interviewed 132 women who came in for breast lifts or augmentation between 1998 and 2006. On average, the women were 39 years old, and 93% had experienced at least one pregnancy. Among the mothers, 58% had breastfed at least one of their children. The average duration of breastfeeding was nine months.
The researchers evaluated the study particpants’ medical history, body mass index, pre-pregnancy bra cup size and smoking status.
The results of the study, presented this week at a conference of the American Society of Plastic Surgeons, showed no difference in the degree of breast ptosis (or sagging) between women who breastfed and those who didn’t. The main factors that did affect sagging were age, smoking status and the number of pregnancies.
Rinker noted that the smoking connection made sense because “smoking breaks down a protein in the skin called elastin, which gives youthful skin its elastic appearance and supports the breast”.
Pregnancy also “has a very strong contribution to breast ptosis (sagging)”, Rinker said. “In fact, our study showed that those negative effects increase with each pregnancy.”
Rinker says this finding should alleviate the fears of new mothers over what nursing their child might do to their breasts in the long run and will encourage them to breastfeed because of the health benefits to their infant. “Women may be reluctant to breastfeed because of this unfounded myth that doing so means the end of youthful breasts,” Rinker said. “Now, expectant mothers can relax knowing breastfeeding does not sacrifice the appearance of their breasts.”

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Safe Handling Tips for Preventing Foodborne Illness From Pet Food and Pet Treats

Consumers can take steps to help prevent foodborne illness, including Salmonella -related illness, when handling pet foods and treats. These products, like many other types of foods, can be susceptible to harmful bacterial contamination.

Salmonella in pet foods and treats can cause serious infections in dogs and cats, and in people too, especially children, older people, and those with compromised immune systems. Salmonella in pet foods and treats potentially can be transferred to people ingesting or handling the contaminated products.

FDA has stepped up its efforts to minimize the incidence of foodborne illness associated with pet foods and treats. Pet owners and consumers can also help reduce the likelihood of infection from contaminated pet foods and treats by following safe handling instructions:
Buying

* Purchase products in good condition, without signs of damage to the packaging such as dents or tears.

Preparation

* Wash your hands for 20 seconds with hot water and soap before and after handling pet foods and treats.
* Wash pet food bowls, dishes, and scooping utensils with soap and hot water after each use.
* Do not use the pet's feeding bowl as a scooping utensil—use a clean, dedicated scoop or spoon.
* Dispose of old or spoiled pet food products in a safe manner, such as in a securely tied plastic bag in a covered trash receptacle.

Storage

* Refrigerate promptly or discard any unused, leftover wet pet food. Refrigerators should be set at 40º F.
* Dry products should be stored in a cool, dry place—under 80º F.
* If possible, store dry pet food in its original bag inside a clean, dedicated plastic container with a lid, keeping the top of the bag folded closed.
* Keep pets away from food storage and preparation areas.
* Keep pets away from garbage and household trash.

Raw Food Diets

FDA does not advocate a raw meat, poultry, or seafood diet for pets, but is stepping up its efforts to minimize the risk such foods pose to animal and human health. The agency understands that some people prefer to feed these types of diets to their pets. For the protection of both you and your pet, the FDA recommends you follow these instructions when handling or using raw meat, poultry or seafood, for use in a pet’s diet:

* Keep raw meat and poultry products frozen until ready to use.
* Thaw in refrigerator or microwave.
* Keep raw food diets separate from other foods. Wash working surfaces, utensils (including cutting boards, preparation and feeding bowls), hands, and any other items that touch or contact raw meat, poultry or seafood with hot soapy water.
* Cover and refrigerate leftovers immediately or discard safely.

In addition:

* For added protection, kitchen sanitizers should be used on cutting boards and counter tops periodically. A sanitizing solution can be made by mixing one teaspoon of chlorine bleach to one quart of water.
* If you use plastic or other non-porous cutting boards, run them through the dishwasher after each use.

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Why You must take the Flu Shot this Flu Season?

Each winter, millions of people suffer from the flu. Flu—the short name for influenza—is caused by viruses. Viruses are very small germs. Some viruses can spread easily from one person to another. They cause illnesses or infections like the flu.

For some people, flu is a mild illness. For older people, especially those who have health problems like diabetes or heart disease, the flu can be very serious.

How Serious Is Flu?

Most people who get the flu feel much better in a week or two. But, some people can get very sick. For example, because your body is busy fighting off the flu, you might pick up a second infection. Older people are at great risk of these secondary infections, such as pneumonia.

How Does Flu Spread?

It was mid-November, and Ellen had not gotten a flu shot. One day she was out having lunch with a friend and noticed people sneezing and coughing at the next table. Two days later, Ellen woke up feeling achy and had a fever. She had the flu. Her husband Jack took care of her and was careful to wash his hands after touching Ellen’s dishes. But, a few days later he too was sick. Maybe he used the phone just after Ellen finished talking with their son. Or, maybe he touched a doorknob Ellen used after sneezing. Flu spreads easily from one person to another.

The flu is contagious—that means it spreads from person to person, often through the air. You can pass on the infection before you feel sick. You are contagious for several days after you get sick. You can catch the flu when someone near you coughs or sneezes. Or, if you touch something the virus is on, like Ellen and Jack’s phone or doorknob, and then touch your nose or mouth, you could catch the flu. The flu virus can live on a surface like a book or doorknob for a number of hours. Remember to wash your hands often when you are around someone who is sick. Make a point of washing them before eating and touching your eyes, nose, or mouth. If you can, stay away from sick people. That will help stop the flu from spreading.

Is It the Flu or a Cold?

It’s easy to confuse a common cold with the flu. A cold is milder than the flu, but since the flu can make older people very sick, you should know the difference. That way you will know when to call the doctor who might want to give you a prescription for medicines that can help you get over the flu.

People with the flu can have fever, chills, dry cough, general aches and pains, and a headache. They feel very tired. Sore throat, sneezing, stuffy nose, or stomach problems are less common. What some people call “stomach flu” is not influenza.

Why Do You Need A Flu Shot Every Year?

Flu viruses change often. Each year’s virus is just a little different than the year before. So every year the vaccine in the flu shot is changed. That’s one reason why you need a flu shot every fall.

Are There Side Effects?

Most people have no problem with a flu shot. In fact, for most people, the flu is more dangerous than the flu shot. When you get the flu shot, your arm might be sore, red, or swell a bit. These side effects may start shortly after getting the shot and can last up to 2 days. They should not get in the way of your daily activities. A few people do have a headache or a low-grade fever for about a day after they get the shot. The flu shot cannot cause you to get the flu. If you are allergic to eggs, you should not get the flu shot. Because eggs are used to make the flu vaccine, people who are allergic to eggs could have a serious reaction to the shot.

What Can I Do if I’m Sick?

If you get the flu, there are things you can do to feel better. First, call your doctor to see if there are medicines that can help. Remind him or her if you are taking drugs to fight cancer or other medicines that make it hard for your body to fight illness. There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after the flu begins, these drugs can make you feel better more quickly. Antibiotics do not help you get over the flu. They are sometimes prescribed to help you get over a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.

Antivirals can also be used to prevent flu. If you hear that there is a flu outbreak in your area, check with your doctor. He or she could prescribe an antiviral that might protect you. Prevention is key. The first choice for preventing the flu is a flu shot.

If you are sick, try to rest in bed and drink plenty of fluids, like juice and water but not alcohol. Medicine such as aspirin or acetaminophen can bring down your fever, which might help with the aches and pains. It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs, as well as your nasal passages. These same areas are also bothered by smoking. Take it easy as much as you can until you are well.

Can Flu Be Prevented?

Getting a flu shot every year can help you stay healthy. A flu shot contains the flu vaccine, which could keep you from getting the flu. Medicare will pay for the shot, and so will many private health insurance plans. You can get a flu shot at your doctor’s office or from your local health department. Sometimes grocery or drug stores offer flu shots.

A flu shot won’t keep everyone healthy. But, getting the flu shot every year can mean that if you do get the flu, you might have only a mild case.

Who Should Get a Flu Shot?

The Centers for Disease Control and Prevention, part of the Federal Government, says that people age 50 and older should get a flu shot every year. Anyone who lives with or takes care of people age 50 or older should also have a flu shot every year.

When Should I Get My Flu Shot?

Most people get the flu between November and April. That’s why that time is called the flu season. It takes at least 2 weeks for your shot to start working, so try to get your flu shot in October or early November. Don’t worry if you can’t get your flu shot before the flu season starts. The shot can help keep you healthy no matter when you get it.

What Can I Do if I’m Sick?

If you get the flu, there are things you can do to feel better. First, call your doctor to see if there are medicines that can help. Remind him or her if you are taking drugs to fight cancer or other medicines that make it hard for your body to fight illness. There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after the flu begins, these drugs can make you feel better more quickly. Antibiotics do not help you get over the flu. They are sometimes prescribed to help you get over a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.

Antivirals can also be used to prevent flu. If you hear that there is a flu outbreak in your area, check with your doctor. He or she could prescribe an antiviral that might protect you. Prevention is key. The first choice for preventing the flu is a flu shot.

If you are sick, try to rest in bed and drink plenty of fluids, like juice and water but not alcohol. Medicine such as aspirin or acetaminophen can bring down your fever, which might help with the aches and pains. It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs, as well as your nasal passages. These same areas are also bothered by smoking. Take it easy as much as you can until you are well.

It is important to check with your doctor when you first get the flu. Also, call your doctor if:

* your fever goes away and then comes back; you may have a more dangerous infection.
* you start having breathing or heart problems or other serious health problems.
* you feel sick and don’t seem to be getting better.
* you have a cough that begins to make thick mucus.

What About the “Bird” Flu?

Sometimes a new, different kind of flu virus appears. You may have heard about the avian or bird flu. This flu is an example of how changes in a flu virus might lead to serious illness. However, there is some good news about bird flu. It is rare in people. In most cases, the bird flu has not passed from one person to another, and so, it might not become widespread in humans. But this could change over time. Scientists are working on new vaccines that can help protect people from bird flu. Right now, the flu does not protect you against bird flu.

Things to Remember About the Flu

* The flu can be dangerous for older people.
* The flu can be prevented.
* Older people need a flu shot every year.
* Medicare pays for the flu shot.
* The flu shot is safe.

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"Sunshine" Vitamin D Reduces Breast Cancer Risk

Nidhi Sharma
Women who get an adequate amount of vitamin D through daily exposure to the Sun are less likely to develop breast cancer as compared to women who do not, new studies suggests.

The "sunshine vitamin," when taken in high doses may cut the risk of breast cancer by 70%. Vitamin D is synthesized naturally in human body after the skin is exposed to the ultraviolet (UV) rays and lack of UV exposure is linked to higher risk of breast cancer.

A new study led by Garland FC and colleagues from the University of California San Diego showed there is an association between low ultraviolet irradiance and higher breast cancer risk. The study, which is published in the March 17, 2008 issue of Breast Journal also found high levels of vitamin D translated to a 50% lower risk of breast cancer.

The researchers concluded that "there was a protective effect of UVB irradiance on risk of breast cancer that was independent of fertility rate, proportion of the population overweight, alcohol intake, animal energy intake, and other covariates."

A second study by Canadian researchers, found that women who spent time outdoors or got a lot of vitamin D from their diets or supplements. This holds true especially for teens who were 25% to 45% less likely to develop breast cancer than women with less vitamin D.

Approximately 1,150,000 cases and 410,000 deaths from breast cancer occur annually worldwide, including 215,000 new cases and 41,000 deaths in the United States.

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The Safety and Risks of Acupuncture Treatment

Most modern acupuncturists use disposable stainless steel needles of fine diameter (0.007" to 0.020", 0.18 mm to 0.51 mm), sterilized with ethylene oxide or by autoclave. These needles are far smaller in diameter (and therefore less painful) than the needles used to give shots, since they do not have to be hollow for purposes of injection. The upper third of these needles is wound with a thicker wire (typically bronze), or covered in plastic, to stiffen the needle and provide a handle for the acupuncturist to grasp while inserting. The size and type of needle used, and the depth of insertion, depend on the acupuncture style being practised.

Warming an acupuncture point, typically by moxibustion (the burning of a combination of herbs, primarily mugwort), is a different treatment than acupuncture itself and is often, but not exclusively, used as a supplemental treatment. The Chinese term zhen jiu (??), commonly used to refer to acupuncture, comes from zhen meaning "needle", and jiu meaning "moxibustion". Moxibustion is still used in the 21st century to varying degrees among the schools of oriental medicine. For example, one well known technique is to insert the needle at the desired acupuncture point, attach dried moxa to the external end of an acupuncture needle, and then ignite it. The moxa will then smolder for several minutes (depending on the amount adhered to the needle) and conduct heat through the needle to the tissue surrounding the needle in the patient's body. Another common technique is to hold a large glowing stick of moxa over the needles. Moxa is also sometimes burned at the skin surface, usually by applying an ointment to the skin to protect from burns, though burning of the skin is general practice in China.

An example of acupuncture treatment

In western medicine, vascular headaches (the kind that are accompanied by throbbing veins in the temples) are typically treated with analgesics such as aspirin and/or by the use of agents such as niacin that dilate the affected blood vessels in the scalp, but in acupuncture a common treatment for such headaches is to stimulate the sensitive points that are located roughly in the center of the webs between the thumbs and the palms of the patient, the hé gu points. These points are described by acupuncture theory as "targeting the face and head" and are considered to be the most important point when treating disorders affecting the face and head. The patient reclines, and the points on each hand are first sterilized with alcohol, and then thin, disposable needles are inserted to a depth of approximately 3-5 mm until a characteristic "twinge" is felt by the patient, often accompanied by a slight twitching of the area between the thumb and hand. Most patients report a pleasurable "tingling" sensation and feeling of relaxation while the needles are in place. The needles are retained for 15-20 minutes while the patient rests, and then are removed.

In the clinical practice of acupuncturists, patients frequently report one or more of certain kinds of sensation that are associated with this treatment, sensations that are stronger than those that would be felt by a patient not suffering from a vascular headache:

* Extreme sensitivity to pain at the points in the webs of the thumbs.
* In bad headaches, a feeling of nausea that persists for roughly the same period as the stimulation being administered to the webs of the thumbs.
* Simultaneous relief of the headache.

Indications according to acupuncturists in the West

According to the American Academy of Medical Acupuncture (2004), acupuncture may be considered as a complementary therapy for the conditions in the list below. The conditions labeled with are also included in the World Health Organization list of acupuncture indications. These cases, however, are based on clinical experience, and not necessarily on controlled clinical research: furthermore, the inclusion of specific diseases are not meant to indicate the extent of acupuncture's efficacy in treating them.

* Abdominal distention/flatulence
* Acute and chronic pain control
* Allergic sinusitis
* Anesthesia for high-risk patients or patients with previous adverse responses to anesthetics
* Anorexia
* Anxiety, fright, panic
* Arthritis/arthrosis
* Atypical chest pain (negative workup)
* Bursitis, tendinitis, carpal tunnel syndrome
* Certain functional gastrointestinal disorders (nausea and vomiting, esophageal spasm, hyperacidity, irritable bowel)
* Cervical and lumbar spine syndromes
* Constipation, diarrhea
* Cough with contraindications for narcotics
* Drug detoxification
* Dysmenorrhea, pelvic pain
* Frozen shoulder
* Headache (migraine and tension-type), vertigo (Meniere disease), tinnitus
* Idiopathic palpitations, sinus tachycardia
* In fractures, assisting in pain control, edema, and enhancing healing process
* Muscle spasms, tremors, tics, contractures
* Neuralgias (trigeminal, herpes zoster, postherpetic pain, other)
* Paresthesias
* Persistent hiccups
* Phantom pain
* Plantar fasciitis
* Post-traumatic and post-operative ileus
* Premenstrual syndrome
* Selected dermatoses (urticaria, pruritus, eczema, psoriasis)
* Sequelae of stroke syndrome (aphasia, hemiplegia)
* Seventh nerve palsy
* Severe hyperthermia
* Sprains and contusions
* Temporo-mandibular joint derangement, bruxism
* Urinary incontinence, retention (neurogenic, spastic, adverse drug effect)

Safety and risks

Because acupuncture needles penetrate the skin, many forms of acupuncture are invasive procedures, and therefore not without risk. Injuries are rare among patients treated by trained practitioners.

Certain forms of acupuncture such as the Japanese Toyohari and Shonishin often use non-invasive techniques, in which specially-designed needles are rubbed or pressed against the skin. These methods are common in Japanese pediatric use.

Common, minor adverse events

A survey by Ernst et al. of over 400 patients receiving over 3500 acupuncture treatments found that the most common adverse effects from acupuncture were:

* Minor bleeding after removal of the needles, seen in roughly 3% of patients. (Holding a cotton ball for about one minute over the site of puncture is usually sufficient to stop the bleeding.)
* Hematoma, seen in about 2% of patients, which manifests as bruises. These usually go away after a few days.
* Dizziness, seen in about 1% of patients. Some patients have a conscious or unconscious fear of needles which can produce dizziness and other symptoms of anxiety. Patients are usually treated lying down in order to reduce likelihood of fainting.

The survey concluded: "Acupuncture has adverse effects, like any therapeutic approach. If it is used according to established safety rules and carefully at appropriate anatomic regions, it is a safe treatment method."

Other injury

* Other risks of injury from the insertion of acupuncture needles include:
* Nerve injury, resulting from the accidental puncture of any nerve.
* Brain damage or stroke, which is possible with very deep needling at the base of the skull.
* Pneumothorax from deep needling into the lung.
* Kidney damage from deep needling in the low back.
* Haemopericardium, or puncture of the protective membrane surrounding the heart, which may occur with needling over a sternal foramen (an undetectable hole in the breastbone which can occur in up to 10% of people [citation needed]).
* Risk of terminating pregnancy with the use of certain acupuncture points that have been shown to stimulate the production of adrenocorticotropic hormone (ACTH) and oxytocin.

These risks are slight and can all be avoided through proper training of acupuncturists. For correct perspective, their risk should be compared to the level of side effects of common drugs and biomedical treatment - see below. Graduates of medical schools and (in the US) accreditated acupuncture schools receive thorough instruction in proper technique so as to avoid these events.

Risks from omitting orthodox medical care

Some doctors believe that receiving any form of alternative medical care without also receiving orthodox western medical care is inherently risky, since undiagnosed disease may go untreated and could worsen. For this reason many acupuncturists and doctors prefer to consider acupuncture a complementary therapy rather than an alternative therapy.

Critics also express concern that unethical or naive practitioners may induce patients to exhaust financial resources by pursuing ineffective treatment. However, many recent public health departments in modern countries have acknowledged the benefits of acupuncture by instituting regulations, ultimately raising the level of medicine practiced in these jurisdictions.

Safety compared to other treatments

Commenting on the relative safety of acupuncture compared to other treatments, the NIH consensus panel stated that "(a)dverse side effects of acupuncture are extremely low and often lower than conventional treatments." They also stated:

"the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same condition. For example, musculoskeletal conditions, such as fibromyalgia, myofascial pain, and tennis elbow... are conditions for which acupuncture may be beneficial. These painful conditions are often treated with, among other things, anti-inflammatory medications (aspirin, ibuprofen, etc.) or with steroid injections. Both medical interventions have a potential for deleterious side effects but are still widely used and are considered acceptable treatments."

In a Japanese survey of 55,291 acupuncture treatments given over five years by 73 acupuncturists, 99.8% of them were performed with no significant minor adverse effects and zero major adverse incidents (Hitoshi Yamashita, Bac, Hiroshi Tsukayama, BA, Yasuo Tanno, MD, PhD. Kazushi Nishijo, PhD, JAMA). Two combined studies in the UK of 66,229 acupuncture treatments yielded only 134 minor adverse events. (British Medical Journal 2001 Sep 1). The total of 121,520 treatments with acupuncture therapy were given with no major adverse incidents (for comparison, a single such event would have indicated a 0.0008% incidence).

This is in comparison to 2,216,000 serious adverse drug reactions that occurred in hospitals 1994. (Lazarou J, Pomeranz BH, Corey PN., JAMA. 1998 Apr 15;279(15):1200-5.) So to compare indirectly, Acupuncture has a 0.2% chance of causing a minor adverse effect compared to prescription medications having a 6.7% chance of causing a serious adverse event in a hospital setting.

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Gastroenteritis outbreak claims 120 lives in Northern Nigeria


The Nigerian Ministry of Health is trying to determine what caused a gastroenteritis outbreak that has claimed 120 lives in northern Nigeria’s Sokoto state and dozens more in the northwest, according to national health statistics.

“Unfortunately, it is the environment,” said the Ministry of Health’s deputy director, Abdul Nasidi. “The environment is so dirty. We are trying to work with the Ministry of Environment to inculcate in Nigerians how to live in a better environment. We want to get to the bottom of these outbreaks.”

Not cholera

“It is a serious outbreak,” Sokoto state health commissioner, Jabbi Kilgori, said at the height of the outbreak on 10 October. “We have 23 local government areas and at least 10 are affected. We have between 2,000 and 3,000 people affected and 120 deaths.”

He said authorities had initially thought the illness was cholera.

“We have received reports from four, five states in the northwest in particular,” said the Ministry of Health’s Nasidi on 11 October. “From some of the samples taken, we tested for cholera and they were all negative.”

Similar to cholera, gastroenteritis causes diarrhoea, but beyond that, stomach and intestinal inflammation can also cause pain, nausea and vomiting. Parasite-laden faecal-contaminated drinking or cooking water cause both illnesses. If left untreated, both can quickly kill.

Response

Kilgori told IRIN officials are acting as quickly as possible, contrary to what some locals said was a sluggish start to control the spread: “We [local health officials] are taking measures, including the use of oral dehydration [and] antibiotics, disinfecting the affected areas and ensuring that sanitation is improved – especially where people defecate,” he said, adding that the source of drinking water must be protected.

Kilgori said Sokoto state is distributing gastroenteritis treatments worth US$200,000 in the north.

Rivers, ponds and open wells in northern Nigeria, which serve as the main sources of drinking water in the typically arid communities, have been contaminated by unusually heavy rains in recent months, the doctor told IRIN.

“We have to provide proper latrines to these communities,” said Kilgori. “We are also working to protect the source of drinking water and encourage people to avoid drinking water from open water sources.”

Underreporting

Northern residents said the death toll may be higher as most of the deaths were never reported and the victims were buried the same day, in line with Islamic custom.

“I can confirm 90 deaths in Dange Shunni [in the northern region] alone,” declared Sokoto-based primary health worker, Aminu Abdullahi, who visited the area in early October. “Most of [the people] died at home and were buried without the health authorities being informed.”

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Irish Law Reform Commisssion To Consider Advance Medical Directive



There is a need for legislation to cater for people who want to make advance care directives – in other words, who want to make their wishes known about what should happen to them in the event of an incapacitating accident or illness, the Law Reform Commission (LRC) has said.

An advance care directive sets out a person’s wishes about what should happen to them in the event of an incapacitating accident, such as a serious car crash, or illness, such as a stroke or Alzheimer’s disease, that makes it impossible for them to communicate their wishes directly.

Such a directive can be written or verbal and quite often, the person will also nominate another person to carry out their wishes. This other person is sometimes called a health care proxy.

At its annual conference today, the LRC is launching its Consultation Paper on Bioethics: Advance Care Directives, which forms part of its Third Programme of Law Reform 2008-2014.

The paper provisionally recommends that there is a need for legislation in this area and it makes 25 specific recommendations on the topic. Some of the main recommendations it makes are:

-The proposed legislation would not involve euthanasia or assisted suicide and it would not allow a person to refuse basic care.
-It would only deal with advance care directives involving refusal of treatment, e.g. ‘I do not wish to be resuscitated’. It would not deal with requests for treatment, e.g. ‘I want a liver transplant’.
-An advance care directive could be written or verbal, however one that refuses life sustaining treatment would have to be in writing.
-The proposed legislation could, in general, allow a person to refuse treatment on religious grounds.
-A person should be encouraged to seek medical advice when making an advance care directive, but this should only be mandatory in the case of directives involving the refusal of life sustaining treatment.
-A healthcare professional would not have any legal liability where they follow an advance care directive that they believe to be valid and applicable to the condition being treated.

The Law Reform Commission is an independent statutory body whose main role is to keep the law under review and to make proposals for reform. Today’s conference is taking place at Dublin Castle.

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the effectiveness of computer-aided detection (CAD) for screening mammography

When it comes to reading mammogram results, two heads aren’t always better than one.

A new study found that so-called computer-aided detection (CAD) for screening mammography has rates of cancer detection similar to mammograms read by two different radiologists.

“Reading mammograms by a single reader (radiologist) using CAD has been shown to be as clinically effective as having films read by two expert readers,” said the study’s lead author, Dr. Fiona Gilbert, a professor of radiology at the University of Aberdeen in the United Kingdom.

“Women should be reassured that the final decision on recall is made by the human reader using their knowledge and experience to decide if any areas of the mammogram marked by CAD merit further investigations,” she said.

In the United Kingdom and many European countries, the recommendation is that every mammogram be read by two independent radiologists. This practice isn’t common in the United States, according to Dr. Thomas Hall, director of breast imaging for Providence Hospital in Southfield, Mich. “Most mammograms are single-read in America, though most places now, when they get digital mammography, also get CAD,” he said.

Gilbert said, “We know that two readers will detect approximately 10 percent more cancers than a single reader.” But two readers aren’t always available. Sometimes, there might be seasonal shortages, as might occur during the holidays. Or, it may be that there aren’t enough resources to have multiple radiologists available to read mammography results, she said.

So, Gilbert and her colleagues wanted to know if the computer plus one reader would be similarly effective to two readers.

To assess this question, the researchers randomly assigned more than 31,000 women undergoing routine screening mammography to have their films read by two radiologists, by CAD and one radiologist, or using both measures.

Double reading found 87.7 percent of the cancers, while CAD plus a single reading was able to detect 87.2 percent. Recall rates, that is the number of women called back for further testing due to suspicious findings, were 3.4 percent for double reading and 3.9 percent for single reading with CAD.

The study findings were expected to be published in the Oct. 16 issue of the New England Journal of Medicine, but were posted online Oct. 1.

“CAD could increase the cancer detection rate of a single reader in breast screening centers currently using single reading alone,” said Gilbert, who added that, “in countries where double reading is standard practice, CAD could be used if there is a shortage of readers without compromising cancer detection rates.”

Hall said it’s likely that, if this study had been done with a digital mammography system, the results would have been even better. He said for this study, the researchers took mammography films and scanned them into the computer before the computer reading. That means the computer was essentially checking a copy, and when you copy something, information may be lost, he said.

“There are definite advantages to digital mammography with CAD. Digital helps you visualize the anatomy better, and the CAD helps keep you on your toes,” Hall said.

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What You Need to Know About Seasonal Flu Vaccine

The single best way to protect against the flu is to get vaccinated each year.

There are two types of vaccines:

* The "flu shot"— an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.

* The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “live attenuated influenza vaccine” or FluMist®). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant.

Each vaccine contains three influenza viruses-one A (H3N2) virus, one A (H1N1) virus, and one B virus. The viruses in the vaccine change each year based on international surveillance and scientists' estimations about which types and strains of viruses will circulate in a given year.

About 2 weeks after vaccination, antibodies that provide protection against influenza virus infection develop in the body.
When to Get Vaccinated

Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later.

Who Should Get Vaccinated

In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, it is recommended by ACIP that certain people should get vaccinated each year. They are either people who are at high risk of having serious flu complications or people who live with or care for those at high risk for serious complications. During flu seasons when vaccine supplies are limited or delayed, ACIP makes recommendations regarding priority groups for vaccination.

People who should get vaccinated each year are:

1. Children aged 6 months up to their 19th birthday
2. Pregnant women
3. People 50 years of age and older
4. People of any age with certain chronic medical conditions
5. People who live in nursing homes and other long-term care facilities
6. People who live with or care for those at high risk for complications from flu, including:
a. Health care workers
b. Household contacts of persons at high risk for complications from the flu
c. Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Use of the Nasal Spray Flu Vaccine

It should be noted that vaccination with the nasal-spray flu vaccine is always an option for healthy* people 2-49 years of age who are not pregnant.
Who Should Not Be Vaccinated

There are some people who should not be vaccinated without first consulting a physician. These include

* People who have a severe allergy to chicken eggs.
* People who have had a severe reaction to an influenza vaccination.
* People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine.
* Children less than 6 months of age (influenza vaccine is not approved for this age group), and
* People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated.)

Vaccine Effectiveness

The ability of flu vaccine to protect a person depends on the age and health status of the person getting the vaccine, and the similarity or "match" between the virus strains in the vaccine and those in circulation. Testing has shown that both the flu shot and the nasal-spray vaccine are effective at preventing the flu.
Vaccine Side Effects (What to Expect)

Different side effects can be associated with the flu shot and LAIV.

The flu shot: The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. Some minor side effects that could occur are

* Soreness, redness, or swelling where the shot was given
* Fever (low grade)
* Aches

If these problems occur, they begin soon after the shot and usually last 1 to 2 days. Almost all people who receive influenza vaccine have no serious problems from it. However, on rare occasions, flu vaccination can cause serious problems, such as severe allergic reactions. As of July 1, 2005, people who think that they have been injured by the flu shot can file a claim for compensation from the National Vaccine Injury Compensation Program (VICP).

LAIV (FluMist®): The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. (In clinical studies, transmission of vaccine viruses to close contacts has occurred only rarely.)

In children, side effects from LAIV (FluMist®) can include

* runny nose
* wheezing
* headache
* vomiting
* muscle aches
* fever

In adults, side effects from LAIV (FluMist®) can include

* runny nose
* headache
* sore throat
* cough


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What You Need to Know About Pinhole Glasses

Sandy Williams

The technology of pinholes is not new. Neither was it invented by man. Use of principle of pinholes by nature can be seen in the eyes of the mollusk Nautilus found in the Indian and Pacific oceans. It uses its pinhole eyes effectively to scavenge for food.

The science behind pinholes has been known to man since 5th Century BC. Since then he has tried variously to use this knowledge to his benefit. The Ancient Chinese seem to be the first to observe the pinhole effect. They observed that rays from an object would cast an inverted image when passed through a pinhole. Using it, they cast pinhole images of a model 'Pagoda' (a type of tower in Oriental temples) on a screen inside the temple premises.

Later, in the 4th Century BC, Aristotle makes a mention in his book 'Problems', of the curious behavior of sunlight when viewed through a pinhole. It took 2000 years to find solutions for the questions concerning light raised by the philosopher in that book.

Arab mathematician and physicist, Ibn al-Haytham too experimented with the effect of pinholes on candle-light. His observations led to the discovery of linear behavior of light rays.

Ever since then, the principle of pinholes has been used for varied purposes like telling time(Cathedral of Florence, Paolo Toscanelli, 1475), by artists as an aid for drawing (Camera Obscura, Renaissance artists) and for making the Pinhole Camera.

Pinholes as an aid to vision

Eskimos seem to be the first in using the principle of pinholes for helping eyesight. They struggled from the glare of sunlight as it reflected from ice as they went about their daily life. Ingenuously, they used wooden spectacles with very narrow slits to overcome this problem.

Today, Ophthalmologists use instruments based on this principle in diagnosing vision related problems. They use these instruments typically on their patients to measure the sharpness of their vision.

They also use this principle in a piece of equipment called a Pinhole Occluder to check whether vision related problems in their patients are due to refractory errors or not. Patients with refractory errors are seen to have better vision when using this tool than when not using it.

Use of Pinhole Glasses

Even though nature attests the veracity of its effectiveness and modern medicine makes use of its principles, use of pinhole glasses is not as popular as it ought to be.

However, because of a wider spread of word about this tool and resolution of irrelevant problems associated with its use, more and more people are taking interest and availing of its benefits.

Most persistent amongst these problems is what is known as the “Honeycomb Effect”. It arises from a notion that viewing through pinhole glasses would be like viewing through a honeycomb; that you would not be able to see any images at all; that all you would get to see is a lot of plastic.

This has been seen to be untrue and is really a matter of adjustment. For instance, people new to wearing spectacles would testify to the fact that initially a large part of their field of vision is taken up by the frame of their glasses. But after some time, when the brain gets adjusted to the glasses, one no longer perceives the frame.

Similarly, when using pinhole glasses initially the glasses might be more prominent in your vision. But after your eyes get adjusted, you will enjoy nothing but clearer vision.

Diffraction

Another problem that deters people from buying pinhole glasses is reports by some users of occurrence of double images when using them. To understand this problem, it is necessary to know the science behind it.

It is a common phenomenon, and one that can easily be attested to, in daily life that light bends around the corner of objects. Closely observe a shadow formed from a single light source. You will observe a fringe on the edges of the image. This is an example of diffraction or the phenomenon of bending of light rays.

Diffraction happens when light rays pass through the edges of small holes like those in pinhole glasses. Since in these glasses light rays will be entering from multiple holes, you will see fringes bordering the image.

For people with low refractory errors i.e. with lens requirements of less than 6 diopters, this would be hardly noticeable and would pose no problems. But for higher ratings, the diffraction would be significant enough to prevent the user from seeing a clear image. This is the reason why pinhole glasses are not advised for people who have refractive errors greater than 6 diopters.

In fact, at such high ratings, the 'honeycomb effect' explained earlier too will prevent users from experiencing the benefits of wearing pinhole glasses.

READ MORE


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When Blood Transfusion Translates To An Early Death

Kat Piper

Mounting evidence that routinely giving blood transfusions to patients could actually increase their risk of death or other complications has prompted calls for medical staff to be more cautious about who they administer transfusions to.

Jehovah's Witnesses refuse blood transfusions based on a passage from the Bible, which forbids them to "eat blood," but many still successfully undergo operations including open-heart surgery. This, say some surgeons and anaesthetists, should be the way most operations are performed.

Higher death rates
The danger is not from infections such as HIV but from something to do with the blood itself. Many studies over the past ten years have shown that transfusions, particularly of those involving red blood cells, are linked to higher death rates in patients who have had a heart attack, heart surgery, or who are in critical care.

Although the exact nature of the link is not yet known, it seems likely that chemical changes in ageing blood, their impact on the immune system, and the blood's ability to deliver oxygen are key. "Probably 40 to 60 percent of blood transfusions are not good for the patients," said Bruce Spiess, a cardiac anaesthesiologist at Virginia Commonwealth University in Richmond, to New Scientist.

Transfusions first became part of medical procedure during World War One when they were used as a last resort to treat soldiers who had lost a lot of blood. Its usage is now no longer confined to cases of catastrophic bleeding, but is often employed as a routine treatment for patients undergoing surgery or intensive care.

Background
The rationale behind giving transfusions is that by giving patients red blood cells, oxygen is better transported around the body thereby increasing the chances of survival. A healthy person has 120 to 170 grams per liter of haemoglobin—the oxygen-carrying protein in red cells—in their blood, usually with 35 to 50 percent of their blood volume being composed of red cells. Doctors commonly decide to give patients a transfusion if the haemoglobin levels fall to between 70 and 100 grams per litre.

Less effective blood
A 1999 Canadian study of 838 critical care patients found that significantly fewer patients (22 versus 28 percent) died in hospital when treatment with transfusion was limited to patients with haemoglobin levels of less than 70 grams per litre. In 2004, a study published in the Journal of the American Medical Association showed that heart attack patients with red blood cell levels of over 25 percent were three times more likely to die or have another heart attack within 30 days of having a transfusion.

A U.K. study of almost 9,000 heart surgery patients between 1996 and 2003 supports this finding, and indicates a six-fold increase in the risk of death after 30 days with a three-fold increase in the risk within one year following surgery. Transfusions were also associated with more infections and higher incidences of stroke, heart attack, and kidney failure. These complications were usually linked to a lack of oxygen to body tissues.

Little benefit
"There is virtually no high-quality study in surgery, or in intensive or acute care—outside of when you are bleeding to death—that shows that blood transfusion is beneficial and many that show it is bad for you," said Gavin Murphy, a cardiac surgeon at the Bristol Heart Institute and leader of the U.K. study.

Recommendations ignored
Many experts are now worried that guidelines are being ignored. They suggest that transfusions should only be given as a last resort and that preventing blood loss in the first place whilst ensuring patients are not anaemic before they undergo surgery should be prioritised.

"Usually when there is any clinical uncertainty about a treatment you don't give it, but with transfusions we do," said James Isbister of the Royal North Shore Hospital in Sydney, Australia, who is an adviser to the Australian Red Cross Blood Service. But Mr. Isbister still encourages people to donate blood as it is used to treat other conditions as well as extreme blood loss.

The specific reasons why blood transfusions appear to be harmful to some patients are not yet fully understood and further research is being strongly encouraged by health authorities, including the U.S. National Institutes of Health.

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6 Key Ways to Manage Social Anxiety

Matthew Shulman

It is normal to feel nervous and awkward in some social situations. Going on a first date or giving a presentation may give you that uncomfortable feeling of having butterflies in your stomach, for instance.

For some people, though, common, everyday social situations cause extreme anxiety, fear and self-consciousness, and they may become impossible to engage in. You may go to great lengths and come up with many excuses to avoid dating or giving presentations. You may not even be able to eat with acquaintances or write a check at the grocery store, let alone go to a party with lots of strangers.

With anxiety this extreme, you may have social anxiety disorder. Social anxiety disorder is a chronic mental health condition that causes an irrational anxiety or fear of activities or situations in which you believe that others are watching you or judging you. You also fear that you'll embarrass or humiliate yourself.

If you or a loved one has social anxiety disorder, take heart. Effective treatment — often with cognitive behavior therapy, medication and positive coping skills — can improve your quality of life and open up new opportunities.

Social anxiety disorder can be far more crippling than normal shyness, even on the mild end of the disorder's spectrum. Experts offer these tips on how to overcome the symptoms.

1. Pay attention to your breathing. Hyperventilation can bring about a panic attack, so try to take deep, slow breaths.

2. If you're worried about embarrassing yourself at a party or on a date, prepare beforehand by reading the news, catching a broadcast, or seeing a movie. You'll have things to talk about with others.

3. Consider joining an organization like Toastmasters, where speaking to groups is encouraged in a friendly and constructive environment.

4. A lot of anxiety in public situations is normal, but when it becomes pervasive and debilitating, seek the help of a professional. Cognitive-behavior therapy, a form of talk therapy, can help identify unwanted thoughts and develop ways to modify irrational or unrealistic behavior.

5. Psychiatrists sometimes prescribe a combination of cognitive-behavior therapy and medication, which may include selective serotonin-reuptake inhibitors, or SSRIs, other antidepressants, beta blockers, or short-acting benzodiazepines that can help calm you down.

6. After several preparatory sessions, a psychotherapist may bring you into uncomfortable situations in order to engage your feelings head-on and challenge your negative thoughts and associations with those experiences.

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Rheumatoid Arthritis, What Is It?

What is rheumatoid Arthritis?

Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. It is a disabling and painful inflammatory condition, which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles.

Signs & Symptoms
Daily joint pain is one of the most common symptoms for rheumatoid arthritis. Most patients also experience some degree of depression, anxiety, and feelings of helplessness. Some of the more common symptoms for rheumatoid arthritis include: morning stiffness in and around the joints, at least three joint areas with simultaneous soft tissue swelling or fluid, and at least one swollen joint area, in the wrist, knuckle, or middle joint of the finger. The disease often affects the wrist and finger joints closest to the hand.

Do you feel pain in at least one of your joints daily?
Yes No

Is your body stiff in the morning around your joints?
Yes No

If you answer yes to any of these questions, see your doctor please

Who gets RA?
More than two million people in the United States have rheumatoid arthritis. Generally, it affects more women than men. RA typically develops between the ages of 25 and 50. While RA itself is not inherited, what can be inherited are the genes that may make someone more likely to develop the disease. Although scientists believe it is unlikely that genes alone bring about RA, research continues to discover what role genes may play in the development of the condition.

How do you know if you have RA?
Only a qualified physician can determine whether or not you have RA. While your general practitioner may be able to diagnose your symptoms, it's a good idea to see a rheumatologist if you suspect you have RA or any other type of arthritis.

Rheumatologists specialize in treating arthritis and are trained to manage conditions involving joints, muscles and bones. They can work with, or as a consultant to, your physician.

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The Neuromuscular Disease, Restless Leg Syndrome or RLS

Restless Leg Syndrome (RLS), also known as Ekbom's Syndrome, is a neurological disorder that affects up to ten per cent of the population at some point in their life.

RLS affects about 15% of Americans, and incidence increases with age. Women have a higher incidence of RLS than men, especially during the last months of pregnancy. The syndrome also appears to run in families.

Although the symptoms are distinctive, many people dismiss the feelings as muscle aches or restlessness, and do not suspect that they have RLS. Thus, RLS is frequently misdiagnosed and often left untreated, resulting in restlessness, insomnia, and daytime sleepiness.

Those Who Have It

For some, RLS is a mild disorder with occasional symptoms. For others, it is much more serious, causing chronic insomnia resulting in daytime fatigue that interferes significantly with everyday life. Said one victim: “I feel as if worms are creeping and crawling in my legs. I need to wiggle my legs to make the feelings go away.”

RLS affects both sexes and is most common and more severe in older people. Most often it is diagnosed in people in their 50’s, though often the symptoms appear decades earlier. Sometimes symptoms can be traced back to childhood. Often, though, RLS goes unrecognized in children. Because they can’t sit still or are constantly fidgeting, young people with RLS are frequently labeled as “hyperactive.”

Though experts recognize RLS to be a neurological disorder, its cause is difficult to pinpoint. In most of those who have it, the cause is unknown. RLS has, however, been linked to certain factors. For example, RLS runs in families, passing genetically from parents to their children. Some pregnant women experience RLS symptoms, especially during the last months of pregnancy. After delivery, the disorder usually disappears. Sometimes medical disorders, such as low iron levels or a lack of certain vitamins, trigger RLS discomfort. Chronic disease may also cause RLS symptoms—particularly kidney failure, diabetes, rheumatoid arthritis, and peripheral neuropathy, damage to the nerves in the hands and the feet.

The Search for Relief

Sadly, there is no cure for RLS, and the symptoms often worsen over the years. However, the good news is that RLS can be treated effectively, often without drugs. There is no one solution; what works for one person may not work for another. Those who have it need to find what habits, activities, or medications either worsen the symptoms or improve them.

A first step in treatment is to decide if there is some correctable medical condition that is causing RLS symptoms. For those who have an iron or vitamin deficiency, supplementing the diet with iron or vitamin B12 may be all that is needed to relieve RLS symptoms. However, taking too many vitamins and minerals can endanger one’s health. Thus, a health-care provider should be involved in deciding whether a person should have iron or vitamin supplements.

In some people caffeine aggravates RLS symptoms. Coffee, tea, chocolate, and many soft drinks contain caffeine. Cutting back on caffeine or cutting it out may help to improve or eliminate RLS symptoms. Alcohol consumption too usually increases the span or intensity of symptoms. By reducing alcohol in the diet or eliminating it, some find relief.

Living With RLS

If you have RLS, life-style changes may help you. Since fatigue and drowsiness often make symptoms worse, a consistent sleep routine can be a real help. If possible, it’s best to have a sleeping environment that is quiet, cool, and comfortable. Going to bed at the same time every evening and waking up at the same time every morning also help.

A regular exercise program will help you get a good night’s sleep. However, vigorous exercise within the six hours before you go to bed may have the opposite effect. Some with RLS find that moderate exercise immediately before bedtime helps them sleep. Experiment with various exercises to discover what is best for you.

Don’t fight the urge to move. If you try to suppress movement, the symptoms usually worsen. Often the best solution is to get out of bed and move about. Some find a measure of relief in walking, stretching, bathing in hot or cold water, or massaging their legs. If you have to sit for a long time, such as when traveling, it may help if you keep your mind actively engaged in reading.

What about medication? The Restless Legs Syndrome Foundation, located in Raleigh, North Carolina, U.S.A., says that “the institution of pharmacologic [drug] therapy may become necessary.” Since there is no one medication that is effective for all who suffer from RLS, your health-care provider may need to find the one that works best for you. Some find that a combination of medications is most effective. Sometimes a medication that works for a while loses its effectiveness. Since taking drugs and especially combinations of drugs carries health risks, it is important to work closely with your health-care provider to determine what works best for you.

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More Than Four Hours Daily On Cell Phone Lowers Sperm Count

In a study of 361 men seen at their infertility clinic, researchers at the Cleveland Clinic found an association between the patients’ cell phone use and their sperm quality.

On average, the more hours the men spent on their cell phones each day, the lower their sperm count and the greater their percentage of abnormal sperm.

The findings, published in the journal Fertility and Sterility, add to questions about the potential health effects of cell phones and other wireless devices. Some studies, for example, have linked long-term cell phone use to a higher risk of brain tumors, though many other studies have found no such connection.

The concern is that, over time, the electromagnetic energy emitted from mobile phones could theoretically harm body tissue — by damaging DNA, for example.

However, the new findings do not prove that cell phones somehow damage sperm, according to the researchers.

“Our results show a strong association of cell phone use with decreased semen quality. However, they do not prove a cause-and- effect relationship,” lead researcher Dr. Ashok Agarwal told Reuters Health.

He and his colleagues based their findings on semen samples from 361 men who came to their infertility clinic over one year. All of the men were questioned about their cell phone habits.

In general, the researchers found, sperm count and sperm quality tended to decline as daily cell phone hours increased. Men who said they used their phones for more than four hours each day had the lowest average sperm count and the fewest normal, viable sperm.

“We infer from our results that heavy cell phone use ... is associated with a lower semen quality,” Agarwal said. But whether cell phones somehow directly affect men’s fertility is not clear.

Agarwal said he and his colleagues have two studies underway aiming to shed light on the issue. In one, they are exposing semen samples to electromagnetic radiation from cell phones to see what, if any, effects occur.

The second is a follow-up to the current study that is assessing a larger group of men. Agarwal said this study is more rigorously designed and will account for certain other factors like lifestyle habits and occupational exposures that might affect sperm quality.

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Bloodless Surgery Tops Agenda Among Non-Jehovah's Witnesses

JOSIE HUANG

Over the last five years, surgeons have replaced Iris Carr's knees, repaired a hip, removed a gall bladder. They have opened her chest to slice away a tumor from her heart.

Not one of those times was she given any blood.

A Jehovah's Witness, Carr is forbidden from getting blood transfusions. So she built up her blood level ahead of time by taking bioengineered drugs and intravenous iron supplements. During open-heart surgery, when blood loss is particularly heavy, Carr's doctors at Maine Medical Center in Portland suctioned off blood that had pooled around the incisions so it could be washed in a machine and returned to her body.

Carr returned home to Cape Elizabeth slightly anemic, but within a couple weeks her blood count was back to normal. And she did not develop any of the infections that can result from receiving someone else's blood: "I'm glad I went through with it," Carr, 89, said.

Bloodless medicine used to be geared toward people with concerns about transfusions. But studies showing that skipping transfusions results in faster recoveries -- and therefore lower hospital costs -- has more medical leaders saying the practice should be for everybody. Maine's largest hospitals are the latest to join a movement among medical facilities to turn no-transfusion medicine from an offering by some of its doctors into a standard of care.

Eastern Maine Medical Center in Bangor started a blood management program with a medical director more than a year ago, while Maine Med this year hired a medical director to lead theirs. A committee of doctors from different departments at Central Maine Medical Center in Lewiston has been meeting on the issue since last spring.

All three hospitals have spent the last several years on reducing transfusions in cardiac surgery, which historically has higher rates of transfusion. Today, both EMMC and Maine Med transfuse roughly a quarter of their patients. CMMC did not provide figures.

"Patients always ask, 'What are the chances of me getting a blood transfusion?'" said Dr. Robert Kramer, a cardiac surgeon who works on quality improvement projects at Maine Med. "We used to say 50/50. Now it's less, and we're hoping to get it even lower and lower."

There still is a need for transfusion in certain situations: the victim of a car crash, or a woman who keeps bleeding after giving birth, may have lost so much blood that a transfusion is the only option.

But even in emergencies, blood conservation techniques can be used so that transfusions can be kept to a minimum, according to the Society for the Advancement of Blood Management, which represents more than 120 blood management programs around the country.

Not only is bloodless medicine safer, it removes the need to buy blood, an increasingly expensive commodity, the group said.

Ten years ago, a unit of blood cost $75 but now it is about $300, said Dr. Jonathan Waters, society president and Chief of Anesthesia Services at Magee-Womens Hospital of the University of Pittsburgh Medical Center. "Those costs have gone through the roof," Waters said. Most of the cost is coming from rigorous testing to make sure blood doesn't contain pathogens and viruses such as HIV or hepatitis. As a result the blood supply is the safest it has ever been, Waters said.

COMPLICATIONS STILL OCCUR

But blood recipients still risk developing transfusion-related problems such as renal or respiratory failure or an infection because the donor's blood is suppressing the patient's immune system. There is also the chance the patient will receive the wrong blood type and develop a bad reaction. For much of the last half-century, the medical community saw the benefits of transfusions as outweighing the risks. The value of donated blood gained wide recognition during the world wars, when advancements in blood storage and distribution helped to save soldiers on the front lines.

After World War II, American Red Cross blood centers and independent blood banks began to crop up across the country.

Interest in finding alternatives to transfusions began to surface with the rise of AIDS during the 1980s. There was also a growth in the number of Jehovah's Witnesses, who believe the Bible prohibits transfusions. An oft-cited verse comes from Genesis: "Only flesh with its soul -- its blood -- you must not eat."

Doctors, on an individual basis, have offered bloodless medicine for decades. In Maine, there are 90 of these doctors, up from just one in the 1970s, according to the Jehovah's Witnesses.

It took longer for hospitals to recognize transfusion-free medicine. The first hospital programs debuted in the 1990s, and began to use multiple blood conservation methods on a large scale.

In the weeks leading up to surgery, a patient could take synthetic erythropoietin or EPO, which stimulates production of red blood cells in the bone marrow.

On the day of the surgery, doctors could remove blood from the patient -- so fewer red blood cells will be shed -- to be returned to the body later. To make up for the lost volume, patient are injected with donated plasma -- the yellowish liquid that blood cells float in -- and saline solution.

OTHER STRATEGIES

Another strategy is to use a "cell-salvage" machine that collects blood pooling during the surgery and filters out the impurities for reinfusion into the body. After the surgery, doctors would make sure to draw smaller amounts of blood for testing than was taken in the past.

At Englewood Hospital, which has one of the oldest and busiest bloodless medicine programs in the country, the transfusion rate among patients receiving coronary artery bypass grafting -- one of the most common surgeries -- is down to 8 percent, said the program's medical director Dr. Aryeh Shander.

Maine hospitals are hoping for similar outcomes by formalizing blood management programs. Dr. Irwin Gross, who runs the EMMC program, said his challenge is to work with a medical establishment -- including doctors, nurses and technicians -- who have been hard-wired to see transfusions only as a life-saving tool.

"There's a lot of work to do in terms of education, changing physician practices and changing hospitals systems so the care is uniform," Gross said. The American Red Cross said the rise of bloodless medicine has taken some of the pressure off the donor blood supply.

"If somebody uses a blood conservation method -- and not a unit of blood -- that makes the unit available to another patient who may need it," said Dr. Patricia Pisciotto, chief medical officer of the Northeast Division of the Red Cross.

But Pisciotto added that bloodless medicine is not commonplace enough to reduce the need for volunteer donors. The Red Cross in Maine said it typically has only several days' worth of blood at any given time.

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Snorers More Likely To Develop Chronic Bronchitis

People who snore regularly are more likely to develop chronic bronchitis, according to a study published today.

Researchers at Korea University Ansan Hospital studied 4270 people (52 per cent men and 48 per cent women) starting in 2001.

Why snoring might lead to bronchitis was not clear, said the team led by Inkyung Baik.

Participants provided information on demographics, health conditions, family disease history and lifestyle, as well as details about how often they snored. They were interviewed again every two years through 2006.

During the four years of follow-up, 314 people developed chronic bronchitis.

Those who snored six to seven times a week were 68 per cent more likely to develop bronchitis than those who never snored.

Those who snored five times a week or less were 25 per cent more likely to develop bronchitis.

The association was strongest in individuals who had never smoked, who worked in the home or who were overweight.

"It has been suggested that structural or functional changes in the airway due to inflammation may cause snoring and obstructive sleep apnea syndrome," the authors wrote.

"Conversely, repeated snoring vibrations may act as mechanical stresses, leading to increased inflammatory response in the upper airway."

Further study is needed to confirm the association as the "mechanisms underlying the association between snoring and chronic bronchitis are largely unknown," the authors concluded.

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Finding And Feeling The G-Spot Made Easy

For many women, the G-Spot is a highly sensitive, highly erotic area that provides hours of pleasure. For others it's a knobbly bit that, when touched too much, creates an overwhelming sensation of needing a wee.
Yet for some others they wonder What the G-Spot is? Where it is? What to do with it and how to feel it during intercourse? Playing this video might help.



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Bloodless Surgery: Safer And Cost Saving For Patients

ANI
The pioneer of transfusion-free bloodless surgery has revealed just why the technique is so beneficial, especially for patients wary of transfusions or those whose religion does not allow for it.

People such as Jehovah's Witness patients believe that accepting blood from a source other then themselves defies the scriptural teachings that their religion holds steadfast.

"Jehovah's Witness patients no longer have to die for want of blood," says Patricia Ford, MD, a hematologist/oncologist and Medical Director of the Center for Bloodless Medicine and Surgery at Pennsylvania Hospital, part of the PENN Medicine hospital network.

Dr. Ford is one of the pioneers of bloodless surgery and has been teaching its technique to doctor's around the world.

One technique a bloodless surgery can employ is called "cell salvage" in which blood lost during surgery is siphoned from the body, passed through a filter for cleaning and returned to the body.

The physician can also use it during surgery to limit blood loss and to avoid the need for transfusion of blood from sources other than the patient.

Originally developed to meet the needs of the Jehovah's Witness community, bloodless surgery is transfusion-free and is acceptable to Jehovah Witness followers because they are being reinfused with their own blood.

Bloodless surgery and medicine is a viable and life-saving option for these patients and those wary of the safety of the blood supply, and it is safe for a growing number of surgical and medical conditions, except for acute leukaemia and traumatic injury.

"Bloodless procedures have proven to be safer than blood transfusion because they help eliminate complications resulting from transfusions such as immunosuppression, infection, diseases from emerging pathogens for which our blood supply is not yet tested," said Dr. Ford.

"The hospital stay is also shorter for our bloodless patients, a cost savings for the patient and the institution," she continues.

Pennsylvania Hospital in Philadelphia is one of the pioneering centres for bloodless medicine and surgery.

Dr. Ford likens the weeks-old blood often used for transfusions to "water from a dirty fish tank." Depleted of most of its oxygen-carrying capacity, the stored blood is not maximally beneficial to any patient.

Prior to surgery, Dr. Ford prepares patients carefully - using medicines to build red blood cells, and managing their haemoglobin count. A higher haemoglobin level lowers the risk of transfusion.

Dr. Ford has performed the largest number of successful stem cell transplants without blood transfusion of anyone in the world. Among the procedures for which Dr. Ford has prepared patients for bloodless medicine and surgery are cardiothoracic surgery; radical hysterectomies, prostatectomies, cystectomies, and repair of aneurysms, chemotherapy management, and total hip and knee surgery.

The bloodless team at Pennsylvania Hospital has saved the lives of many Jehovah's Witness patients who otherwise would not have received care.

"We see patients from all over the country who come to us for our expertise in bloodless medicine. The needs of the Jehovah's Witness community have helped us develop practices that can not only save their lives, but can also benefit the entire patient community," concluded Dr. Ford.

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