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Category : All ; Cycle : October 2010
Medical Articles
Oct28
PANCREAS PRESERVATION
Preservation of pancreatic tissue is an important goal during surgery for biliary and pancreatic diseases. The Whipple procedure is the standard of care and the procedure of choice for many malignant conditions of the pancreas , duodenum and the bile duct. It is also frequently performed for benign disorders that affects these organs. While in some patients, the extent and the nature of the disease may require a Whipple surgery, in some others, alternate procedure that preserves some of the tissues removed during the standard procedure may be an option. Some of these procedures include:
1) Duodenum preserving pancreatic head resection : This is offered to patients with chronic pancreatitis and non cancerous disorders of the head of the pancreas such as cystic neoplasm or small islet cell tumors which would otherwise require a Whipple operation. As the name suggests, this procedure preserves the duodenum. The head of the pancreas is removed. Postoperatively it is seen that the patients have rapid return of bowel function and less GI complications.
2) Central pancreatectomy- : This procedure is indicated for patients who have low grade malignant or benign tumors in the middle part of the pancreas which is also called the neck. Often this may require an extended Whipple procedure and a large portion of the normal pancreas has to be removed along with the tumor, but with the above mentioned alternative specialized technique, only the tumorous portion of the neck of the pancreas is removed.
3) Enucleation of pancreatic islet cell tumors : Insulinomas and gastrinomas are small functional pancreatic surface tumors. They have a lining around them that seperates them from the pancreas. During enucleation these tumors are shelled out from the pancreas without removing any pancreatic tissue. It is done laparoscopically.
4) Spleen preserving distal pancreatectomy : ThIs procedure is indicated for benign disorders or low grade malignancy of the last part or the tail of the pancreas. The purpose is to spare the spleen. Normally a standard distal pancreatectomy with spleen removal is done when in these cases there is often no indication for a splenectomy.
5) Wide resection of Ampulla of vater : For ampullary polyps or some benign disorders of the ampulla such as villous adenomas, the Whipple operation is offered when it is best to do a local resection of the ampulla . In this procedure the ampulla is widely removed and the cut ends of the bile duct and pancreatic duct is reimplanted into the duodenum.
6) Isolated resection of the third and fourth portion of the duodenum : This is also performed to avoid a Whipple surgery for tumors on the third and fourth portion of the duodenum. In this surgery only the third and fourth portion of the duodenum is removed and the cut ends of the intestine are then sutured together.
Pancreas plays an important role in the digestion of food and in the regulation of blood sugar. Loss of pancreatic tissue after surgery increases the risk of developing diabetes and malabsorption of food. It is therefore, very important that we try and preserve this vital organ as much and as far as possible even when there is a need for surgery.


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Oct10
KORO SYNDROME-A GENITAL RETRACTION DISEASE ! EPIDEMIC IN NORTH BENGAL
"KORO-A GENITAL RETRACTION SYNDROME EPIDEMIC IN NORTH BENGAL"




DEFINITION & NOMENCLATURE:------

"Koro" is a Genital Retraction Syndrome where a person thinks that his/her external genitilia (Penis/Testicles or Vulva / nipple of Breast ) will shrink, retract and disappear with or without fear of Death.

It occurs more in male than female patients.The earliest Chinese refrence is seen in'Yellow Emperor's classic of Internal Medicine' dated 300 BC,Western reference to the term koro is found in B.F. Matthes' Dictionary of Beginese Language (1874) of South Sulawesi ,Indinesia. The word is also used in Makassarese Language,meaning "to shrink"; the full dialect for it is garring koro. In Malaysian Language,keruk is the probable linguistic link of koro which means "to shrink". The term shuk yang or shook yong or suo yang (Chinese),Jinjina bemar (Assamese,India),Rok-joo(Thai) are coined for this diseas all in regional language, means "the shrinkage of penis".Actual word "KORO"originated from Malaysian word Tortoise (which is another name for "Penis" in slander language)as Tortoise has a habit of retracting their head resembling (like a PENIS)in to body,so people probably used that example to express this disease.

PSYCHOSOCIAL CLASSIFICATION

Koro has been described as"Culture Bound Syndrome"(which means it occurs in person with certain cultures where these cultural beliefs or myths generate and spread this classical form of disease,it is seen endemic with outbreaks or epidemics as in China,South East Asia, Malaysia, Indonesia (migrated people from China with classical )and certain part of Africa,Thailand,Singapore,India (non chinese local peoples as both classical and non cultural form ) and Western countries like Britain,America, France, Canada, Jordan (sporadic non cultural or secondary Koro where only shrinkage without any fear of death associatedwith CNS disorder,drug induced or under another psychiatric diorder) in mental disorder book and has been subgrouped as'Specific Culture-imposed nosophobia'or 'The genital retraction Taxon' or 'Cultural related beliefs as causes of occurrence'.

PREDISPOSING FACTORS & CAUSES

Psychosocial cultural belief which predispose "koro" a punishment of personal guilt of sex with other ladies/prostitutes(than Spouse/Wife),masturbation/Impotence or Sexual inadequacy (many such ancient folk stories are rampant in Chinese culture or theory of loss of yang humor (The Yan & Ying theory)or semen which is condsidered as vital energy,excess loss of this by frequent Ejaculation(depicted in Taosim which strongly inflence chinese medical thought) may lead to death.Witch Craft or evildoers or Fox spirit or ghost stories and folklore novels or KALA JADU (Assam & Bengal) are prevalent in China where it has been described that these spirits cause genitilia to retract in abdomen,making them physically and sexually weak and utimately dead.in South China and in south asian and Africa and even in India where this disease is prevalent,people have strong belief in such stories and play. Mass hysteria that Contaminated pork with swine fever cause epidemic of Koro in singapore in 1967.In Africa,Black magic was behind this and in Nigeria and ghana,there was panic that penis has disappeared by touch of a stranger.

But in isolated 03 cases in America, patients suffering from anxiety and worries about Penis suffered it after smoking Cannabis which may increase worries and anxiety as its side effect.In Britian and other western part it was due to depression resulting from psychological disorder,phobia for AIDS,brain tumor,schizophrenia etc.,but never a social or folk beliefs based on prevalent ancient stories and dramas.Ethnographic psychologist (who study different cultures) consider koro to be closely related to panic attacks caused by either social belief based on prevalent stories or myth or rumors of food poisioning or evil doers or as punishment to evil doing in form of self perceived or believed sexual offence resulting in retraction or shrinkage of genitialia with or without fear of death.Attacks of koro are often set off when men are in situations that would normally cause the male genitals to shrink slightly,such as emotional distress or cold temperatures.as Scrotum and penis more responds for shrinkage on exposure to mental stress and cold temperature they affect more than female.But tensed and psychological disturbed or introverted sexually freezed or tense female may suffer too complaining of retraction of Nipples and of vulva or disappearance of vulva under tight thighes under severe stress and strain.

SIGN & SYMPTOMS: Koro exist in two forms.Classical or True or Primary Koro where patients under a social belif or rumor or myth complains of shrinkage of Penis or testicles or both in Male and of Vulva or Nipples of breast / breast or both in female folowed by retraction of them in abdomen with physical and sexual weakness with or without fear of death.Mostly present as acute attack lasting for hours to maximum duration of 02 days.But some may show symptoms for years as chronic cases or recurrent cases ,some instead of shrinkage of genitilia complain genital shortening,alteration of penis size,loss of muscular strength,genital paraesthesia with no complain of retraction or breast mass in female with altered breast size and hidden or distorted nipples.Feature of sexual dissolution,loss of sexual or physical power,weakness,urinary obstruction,sterility may be seen.Psychologically Pateint suffer from anxiety neurosis may include fear of death,non specific physical danger,impending madness,spirit possession and feeling of being bewithched or under cover of black magic with feeling to sex change to eother female or vice versa or turning Enuch.

But in secondary or unclassical form of Koro as seen in western world only retraction of penis or loss of penile strength is coplained where person has got intense anxiety for penis with a strong psychosocial disease or under any organic brain disease or under influence of drug or intoxication.

While there are no substantiated reports of the condition itself resulting in any physical damage to the individual, many sufferers have unfortunately inflicted harm upon themselves or physical damage in frantic attempts to stretch the penis or Breast to prevent further shrinkage. It is not unusual for those with koro themselves or wthrough their family members and social sympathisers to resort to using devices such as clamps or weights or pegs or by aloop of string for retraction of penis as mechanical traction device.female either herself or ladies around her grab breast,pull nipples out or insert iron pins in nipple so that it cannot go inside.

Chanting of local religious songs and puja or religious celebration to please God/Goddess through local preachers and pandits or programmes for their blessing or correct any unknown mistake conducted in their past celebration or work out by local witch hunters by putting wood fire and smoking to remove bad blessing or evils or black witch from society or beating or killing of socalled wrong or evildoers suspected in society or villages is done.In North bengal people are putting lime water over both ears and nose ,keep Kush grass or pure water of a temple or river to keep these bad evils from them .some also cover their genitilia and breast so much under clothe as nothing happens to these organs.

DIAGNOSIS: it is easily done when epidemics occur as strong social belief or myth or rumor based on past prevalent stories and drama of witch hunt or as a punishment of some sexual wrong doing or intake of contaminated food or prsence of some diseases with typical full blown symptoms of penile/Testicle shrinkage or retraction in abdomen in patient of introversion suffering from anxiety or psychological disorder or under religiuos and social belifs and faith in myths or evil doers with or without sexual and physical weakness and fear of death.Injuries are secondary to measures taken by patients or relatives to prevent injuries.

TREATMENT:---

As the disease involves social beliefs and psychological insult so both Medical and Indigenous treatment should be given otherwise complete eradication may not be possible.As no defect is found in genitilia and breast to nothing is done for this if injuries inflicted by patient or relatives as mechanical manipulation to prevent retraction of genitilia or nipples then local injuries are dealt both surgically and medically.

in Cultural bound cases,lectures should be organised through healers of society by educating them with anatomy and physiology of Genitilia with audio visual or practical demonstration either as alone or to whole society utilising local media,radio /Tv/poster/leaflets and picturing small booklets,Individualy affect person psychosocial analysis is done and therapy for underlying disease is started.Inwestern type sexual conflict is identified and patient treated for any psychological or organic disease diagnosed.

indigenous medicines by local healers may be also advised to win the belief of people,praying to Gods and submitting to socalled social healers and witch hunters may be allowed to control epidemic spread but side to side strong counselling and health education should be provided individually ,by NGO or by Government health agency and social reforming departments.In china people hit gongs or bells to drive out witches .They use chinese a yang or yin augmenting medicine including herbs,animal penises (of tiger,deer,and fur seal )pilose anter(stag of deer) or deer tail.Pepper soup ,ginger soup,Louki or cucumber soup or liquor is also drunk to cure the diesease,in north Bengal people are using lime water application over both ears and nose and kush grass and holy water keeping to keep awya bad evils.

Dr.D.R.Nakipuria



09434143550

**Author is a naco trained HIV and sex specialist


Category (Psychology, Stress & Mental Health)  |   Views (8500)  |  User Rating
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Oct10
TV WATCHIN/COMPUTER SURFING MAY HARM HUMAN BEING
TV,Video,Mobile Phones,Laptops, Desktop, Palmtop Computer,or Film curtains on different LCD,Microchips,Plasma Screen which is also utilised by many devices in Medical field as Multi parameter Monitor,Pulse oximeter, cardiac, Ventilators,Dialysis machine,Ultrasound,Ech,CTSCAN or MRI machine moitors or machine used as navigation purpose by Radar or Air traffacking or Navy trafficking or used in different electronic and non electronic devices and machines and instruments are now part of our modern life.we watch these devices with ou open eyes for many hours a day some time very constantly,such a mechanical visualisation of these illuminated devices and their screen cause many ill effects over Eyes.the Rods and cones the Retinal cells through which we see a picture or read a text on these devices screen are under all the round on work so easily get fatigues in long term.The screen of Eye ,THE RETINA,The Optical Nerve fibre wchich carries sensation of vision from Retina to Optic centre of Brain both side of Cerebral hemisphere of our brain get exhausted as every living thing like Human being needs rest (as we need sleep and rest) for rejuvenation when chemicals undergoing biochemical changes for carrying this vision get enough energy buildup for next cycle of working .
Secondly as used for long period without any break lead to so much biochemical changes and some one become irreversible leading to permanant damage or death of Vision cells or retna burning or whole in Retina or macular degeneration or damage to optic Nerve leading to permanant blindness because we have not intervened in time or till the time when damage was in reversible stage. Therfore, it is very important to diagnose the damage ongoing in time and take precautions so that never permanant damage takes place.Beside this,it is a general perception that even we visualise these devices screen with faulty means then such damage may occur even if we watch them for a short time as how we watch them,sitting or sleeping,directly or through angles,sitting closely or at a distance,oe watching in dark or in god illuminated light,watching it sitting in a room or place or a moving train bus,car or in aeroplane with bumps with specks or with normal eye with very strong color backgroud with twinkling flashing light or a normal white or pale background with production of excessive sounds by these devices,in day time or night or in early morning or in which mental status such as when we are under depression,anger.,grief,proud ,tension,fear,apprehension,stress and strian or light momment or a serious enviornment and the content of material on these devices also important as they directly influence our day to day activities,knowldge our mesages, business or office transactions beside recreation by music songs,video films and other cultural and sports activities.
we know that if we watch or observe Sun with or naked eye during sun eclipse our eye may be damaged as some infrared rays or ultrasonic waves are liberated out from sun surface and if they are not being blocked by a special screen of Sun black or brown glass or x-ray used fils ,such rays may damage our retina and even infra red rays emitted by a blast furnace or hot metals or by flshing and twinkling fire crackers may damage our eyes directly in notime,similiary devuces screen of these instrument also eject some rays which are not that strong as Infra red rays but if used long term may harm our eyes,so a Guard by a cellophane paper or plastic material coated with preventing or protecting agent should be used pasted over screen of these devices.
We should watch Tv or computer in sitting position about minimum 1 meter away from these devices if screen is smal but if screen is above 14 inches like 36 or 52 inches then we should watch these devices sitting about 6 meter away from these devices.We should watch these devices in sitiing straight before them not through some angles or corner or side vision as they put our Eyes more on strain.We should never watch these devices in sleeping on back or on our beely or head down or very up position as all these position lead to more strain over our Eyes.
we should watch or read or write on these devices constantly for 45-60 min. only after that we should have a break upfor 1-5 min when we should see either a tdistance or close our eyes or look downwards little in darker area,such brek up will give enough relief to our Eyes and they will get proper rest and less damage will occur to them.The TV/Computer should be placed in a well illuminated lighted room or office towatch them in a dark room causes more harm,Tube lights are inferior to speaking bulbs and if we use flash and twinkling images and images moving very fast as videogames they cause more harm or harm in less time ,eye needs more early breakup in these situations.If news or shows or other prgrammes flashing or cracking with sound or with very rapid moving objectsthen these cause more harm.Beside excessive sound produce over 85 decibles do harm our hearing system and inner ear Labryinth and cochleas as discussed in another topic of "hearing loss by Modern Gadgets".
If TV/Computer are watched or read on rapidly moving Cars/Bus/Trains with bums on road or track our vission gets disrupted every time our cones and rod cannot fix at a vision or under tight strain so Eyes need more rests and if possible should be avoided if we are using specks either glass or contact lens of high power.Similiarly if our Eyes have got infections like conjunctivits or freign body insertions or Allergic reactions then our Eye canot bear such high illuminted screen sitting so closely for a long time so in these cases we should not watch these devices.Similiarly if A catract (Lens removal by phaco or lens implant or extraction) operation or operation on anterior chamber or vitreous or retina or nerve fibres has been done then we should not watch TV or Computer before allowed by treating Eye surgeon.Similiarly the persons using very high power of lens or speck for near or short vision should always use specks before watching them ,even distant vision patients should also watch tv ,video or cinemas on screen or computer with their specks on their eyes,naked vision may dmage eye sight or increase power of vision .
These damage are more common in children as their eyes are in developmental phases so any such visionary loss is mor in these gropups and parents should take more precautions for above precautions when their children watch Tv,Computer,Video screen or mobiles to which many affluent or middle class childrens are alsmost addicted Youngers or adloscents our Eyes also bear excess strain as we sit fore excess time watching these devices and gradually power of lens increases and suddely some color blindness or macular degeneration or retinal ruptur or vitreous haemorrhage may occur.If we suffer from diabetes or hypertension due to atherosclerosis as diabetic,obses or smoker patients then micro retinal vessels also get blocked and our Retina gets damaged early if we bear such strain over our Eyes by watching TV/Mobile Computer etc for a long time.These persons should work on these devices for a limited time taking full rest in between with specks and other assistance as advised.Watching TV or working on computer in a domestic flight is permitted but not much in war planes.
It is advisable for children and youngsters who read or prepare examinations sitting long on computer to use it in morning when good day light present and not by awkening in late night study as our eyes has ben exhausted in long day work and if they donot close during normal sleep in night and are allowed to remain open in deep night cause more strss and strain.Prent should monitor the vision of their children normally both for distance,near or color or field vision by an eye surgeon periodically and any change in power should be taken into account and if power rpidly changes or a child complains that his distance or near vision is getting disturbed with existing or no specs he or she must be taken to a EYE clinic,any reddness,pain,defect in vision,haloes in vision,black spots,headache etc should be immediately noticed by aprent on child complain and a thorough Eye refractions,perimetry,Slit lamp and ophtalmoscopic examination of Fundus ,retina and tonometry test should be done along with reading of Ishara Chart for color blindness.
Therfore modern devices TV/COMPUTER/ MOBILE / VIDEO SCREEN/FILM SCREEN ETC are good and have brough a green revolution in our communication,cultural,educational,transport,busines activities and are essential part of our Life but their wise and timely use is mandatory otherwise our vision may be damaged permannatly or partially and our children may be badly affected by our wrong methods and style of watching them and timely intervention will save our vision and protects us from other hearing or mental damage caused by these devices.
Dr.D.R.Nakipuria

09434143550


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Oct06
SINGLE INCISION LAPAROSCOPIC SURGERY
This less invasive surgical technique has generated excitement, criticism and a great deal of discussion since surgeons first started doing them few years ago. It is a challenging approach and still is performed by relatively few surgeons. Clinically, this surgery has yet to show any advantage over traditional laparoscopy in terms of pain or patient recovery. Even the cosmetic appeal - which leaves one scar neatly hidden in the navel is questioned by some because even the scars left by traditional laparoscopy are hard to detect a year after the surgery. So then , where does it stand and where is it headed to? Is it a fad that will fall by the wayside or will it be a progression to Natural Orifice Translumenal Endoscopic surgery? (NOTES)? Will it be embraced by the patients, surgeons and the health industry to become the standard of care?
Although there is an improved cosmetic result from this surgery ,there are not a whole lot of patients who are asking for it. It is mainly driven in part, by the industry and in part by the desire of doing less invasive operations and the surgeons wanting to keep their skills on the cutting edge. Less invasive surgeries require unique and high skill set and it should be attempted only by surgeons who have tremendous experience. It should be done on educated patient population who can understand that there are almost no proven benefits. The good part of it is , if you cant get it perfect you can always add another port and fall back on the standard technique, so that the surgery is not compromised in anyway.
Limitations of instrumentation like internal retracting system, scopes with flexible tips etc are still not widely available. Visualization is a problem. Since it is parellel with the working instruments, the field of view is limited in relationship to where the instruments are and where the target tissue is. Specialy surgeries on the foregut requires a good liver retracting system and it becomes difficult with a single incision technique. Gall bladder, appendectomies and colectemies are best for this approach. Also sleeve gastrectomies and gastric banding. Technologies such as robotics have the opportunity to take away some of the technical dfficulties of single incision laparoscopic surgery.
The reality is, although time consuming and difficult , Single Small Incision Laparoscopic surgery is here and some motivated surgeons are utilizng this on selected patients and the skills developed may enable them to bridge to the next technique ! With new techniques and surgeons not having to touch their patients during surgery, we hope the healing and anointing will still be there flowing through these instruments !


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Oct05
DEFINITION & NOMENCLATURE:----
"Koro" is a Genital Retraction Syndrome where a person thinks that his/her external genitilia (Penis/Testicles or Vulva / nipple of Breast ) will shrink, retract and disappear with or without fear of Death.It occurs more in male than female patients.The earliest Chinese refrence is seen in'Yellow Emperor's classic of Internal Medicine' dated 300 BC,Western reference to the term koro is found in B.F. Matthes' Dictionary of Beginese Language (1874) of South Sulawesi ,Indinesia. The word is also used in Makassarese Language,meaning "to shrink"; the full dialect for it is garring koro. In Malaysian Language,keruk is the probable linguistic link of koro which means "to shrink". The term shuk yang or shook yong or suo yang (Chinese),Jinjina bemar (Assamese,India),Rok-joo(Thai) are coined for this diseas all in regional language, means "the shrinkage of penis".Actual word "KORO"originated from Malaysian word Tortoise (which is another name for "Penis" in slander language)as Tortoise has a habit of retracting their head resembling (like a PENIS)in to body,so people probably used that example to express this disease.
PSYCHOSOCIAL CLASSIFICATION
Koro has been described as"Culture Bound Syndrome"(which means it occurs in person with certain cultures where these cultural beliefs or myths generate and spread this classical form of disease,it is seen endemic with outbreaks or epidemics as in China,South East Asia, Malaysia, Indonesia (migrated people from China with classical )and certain part of Africa,Thailand,Singapore,India (non chinese local peoples as both classical and non cultural form ) and Western countries like Britain,America, France, Canada, Jordan (sporadic non cultural or secondary Koro where only shrinkage without any fear of death associatedwith CNS disorder,drug induced or under another psychiatric diorder) in mental disorder book and has been subgrouped as'Specific Culture-imposed nosophobia'or 'The genital retraction Taxon' or 'Cultural related beliefs as causes of occurrence'.
PREDISPOSING FACTORS & CAUSES
Psychosocial cultural belief which predispose "koro" a punishment of personal guilt of sex with other ladies/prostitutes(than Spouse/Wife),masturbation/Impotence or Sexual inadequacy (many such ancient folk stories are rampant in Chinese culture or theory of loss of yang humor (The Yan & Ying theory)or semen which is condsidered as vital energy,excess loss of this by frequent Ejaculation(depicted in Taosim which strongly inflence chinese medical thought) may lead to death.Witch Craft or evildoers or Fox spirit or ghost stories and folklore novels or KALA JADU (Assam & Bengal) are prevalent in China where it has been described that these spirits cause genitilia to retract in abdomen,making them physically and sexually weak and utimately dead.in South China and in south asian and Africa and even in India where this disease is prevalent,people have strong belief in such stories and play. Mass hysteria that Contaminated pork with swine fever cause epidemic of Koro in singapore in 1967.In Africa,Black magic was behind this and in Nigeria and ghana,there was panic that penis has disappeared by touch of a stranger.
But in isolated 03 cases in America, patients suffering from anxiety and worries about Penis suffered it after smoking Cannabis which may increase worries and anxiety as its side effect.In Britian and other western part it was due to depression resulting from psychological disorder,phobia for AIDS,brain tumor,schizophrenia etc.,but never a social or folk beliefs based on prevalent ancient stories and dramas.Ethnographic psychologist (who study different cultures) consider koro to be closely related to panic attacks caused by either social belief based on prevalent stories or myth or rumors of food poisioning or evil doers or as punishment to evil doing in form of self perceived or believed sexual offence resulting in retraction or shrinkage of genitialia with or without fear of death.Attacks of koro are often set off when men are in situations that would normally cause the male genitals to shrink slightly,such as emotional distress or cold temperatures.as Scrotum and penis more responds for shrinkage on exposure to mental stress and cold temperature they affect more than female.But tensed and psychological disturbed or introverted sexually freezed or tense female may suffer too complaining of retraction of Nipples and of vulva or disappearance of vulva under tight thighes under severe stress and strain.
SIGN & SYMPTOMS: Koro exist in two forms.Classical or True or Primary Koro where patients under a social belif or rumor or myth complains of shrinkage of Penis or testicles or both in Male and of Vulva or Nipples of breast / breast or both in female folowed by retraction of them in abdomen with physical and sexual weakness with or without fear of death.Mostly present as acute attack lasting for hours to maximum duration of 02 days.But some may show symptoms for years as chronic cases or recurrent cases ,some instead of shrinkage of genitilia complain genital shortening,alteration of penis size,loss of muscular strength,genital paraesthesia with no complain of retraction or breast mass in female with altered breast size and hidden or distorted nipples.Feature of sexual dissolution,loss of sexual or physical power,weakness,urinary obstruction,sterility may be seen.Psychologically Pateint suffer from anxiety neurosis may include fear of death,non specific physical danger,impending madness,spirit possession and feeling of being bewithched or under cover of black magic with feeling to sex change to eother female or vice versa or turning Enuch.
But in secondary or unclassical form of Koro as seen in western world only retraction of penis or loss of penile strength is coplained where person has got intense anxiety for penis with a strong psychosocial disease or under any organic brain disease or under influence of drug or intoxication.
While there are no substantiated reports of the condition itself resulting in any physical damage to the individual, many sufferers have unfortunately inflicted harm upon themselves or physical damage in frantic attempts to stretch the penis or Breast to prevent further shrinkage. It is not unusual for those with koro themselves or wthrough their family members and social sympathisers to resort to using devices such as clamps or weights or pegs or by aloop of string for retraction of penis as mechanical traction device.female either herself or ladies around her grab breast,pull nipples out or insert iron pins in nipple so that it cannot go inside.
Chanting of local religious songs and puja or religious celebration to please God/Goddess through local preachers and pandits or programmes for their blessing or correct any unknown mistake conducted in their past celebration or work out by local witch hunters by putting wood fire and smoking to remove bad blessing or evils or black witch from society or beating or killing of socalled wrong or evildoers suspected in society or villages is done.In North bengal people are putting lime water over both ears and nose ,keep Kush grass or pure water of a temple or river to keep these bad evils from them .some also cover their genitilia and breast so much under clothe as nothing happens to these organs.
DIAGNOSIS: it is easily done when epidemics occur as strong social belief or myth or rumor based on past prevalent stories and drama of witch hunt or as a punishment of some sexual wrong doing or intake of contaminated food or prsence of some diseases with typical full blown symptoms of penile/Testicle shrinkage or retraction in abdomen in patient of introversion suffering from anxiety or psychological disorder or under religiuos and social belifs and faith in myths or evil doers with or without sexual and physical weakness and fear of death.Injuries are secondary to measures taken by patients or relatives to prevent injuries.
TREATMENT:---
As the disease involves social beliefs and psychological insult so both Medical and Indigenous treatment should be given otherwise complete eradication may not be possible.As no defect is found in genitilia and breast to nothing is done for this if injuries inflicted by patient or relatives as mechanical manipulation to prevent retraction of genitilia or nipples then local injuries are dealt both surgically and medically.
in Cultural bound cases,lectures should be organised through healers of society by educating them with anatomy and physiology of Genitilia with audio visual or practical demonstration either as alone or to whole society utilising local media,radio /Tv/poster/leaflets and picturing small booklets,Individualy affect person psychosocial analysis is done and therapy for underlying disease is started.Inwestern type sexual conflict is identified and patient treated for any psychological or organic disease diagnosed.
indigenous medicines by local healers may be also advised to win the belief of people,praying to Gods and submitting to socalled social healers and witch hunters may be allowed to control epidemic spread but side to side strong counselling and health education should be provided individually ,by NGO or by Government health agency and social reforming departments.In china people hit gongs or bells to drive out witches .They use chinese a yang or yin augmenting medicine including herbs,animal penises (of tiger,deer,and fur seal )pilose anter(stag of deer) or deer tail.Pepper soup ,ginger soup,Louki or cucumber soup or liquor is also drunk to cure the diesease,in north Bengal people are using lime water application over both ears and nose and kush grass and holy water keeping to keep awya bad evils.
PROGNOSIS:prognosis is seen in patient having an acute attack with short history having uncomplicated sexual life,low freauency of attack with previous functional personality.
Dr.D.R.Nakipuria

09434143550
**Author is a naco trained HIV and sex specialist


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Oct03
SEX FAILURE IN MALE ! IMPOTENCE ! TYPE & REMEDIES
SEX PERFORMANCE FAILURE IN MALE OR IMPOTENCE-TYPE & REMEDIES
SEX performance failure is a matter of great concern for A male person as he thinks himself as active partner and so wants always to be best strong sustained performer in Sex which is considered as sign or exhibition of his musculanity or his existence in as boss in Male dominant society,if this sexperformance is disturbed or fails he starts thinking that every thing has been lost .This Sex performance is always so much in mind of a common person that many starts assuming as some defect in it although they are normal because there is always a will to achieve perfection and superiority in it and such idea becomes more If they are exposed to sexual stimulation through talk,stories or video shows where Sex is depicted as most form of pleasure and enjoyment.
For this defective Sex performance, a word IMPOTENT has been coined on broad base where a man cannot perform sex with a partner .It simple meaning is a failure, weakness inability lack of interest in Sex performance. A man may start feeling that he is impotent but actually he is normal or may start that he has lost dignity, masculinity, wholeness and every thing of his life submitting himself to extreme psychosocial insult. But broadly Impotence in man means that even after proper stimulation(what to talk of normal self stimulation as self stimulation is common in adult male and male unlike female becomes stimulated or erection of penis occurs on mild exciting exposures as remembering,talking,watching listening of opposite partner or her activities dress,eye contact,voluntary or involuntary touch of normal body part,sexual organs or sexual act of another) stimulated by talking exhibition,touch or sexual excitation by opposite partner or sexual activities through book,videos,internet or mms etc man does not achieve proper erection or straightening,thickening ,hardening and tightening of Penis with or wthout secretion of small seminal fluid .But There are many degrees of erectile difficulties too. 1.Some men may be able to achieve an erection, but are not able to maintain it. 2.others become erect, but not extremely rigid. 3. Many others only have problems when they are with a new partner or with a long-time partner. And in last 4., there are those who cannot achieve an erection at all even after stimulation by an opposite sex partner to the extent of heating and touching G-spots. Although these problems has been categorises as stated above but still in most of them psychosocial disturbance remains the core factor.
Person may be suffering from a physical or emotional problem (or both) for which there are definite solutions. If problem is of an emotional nature, the following tips may help. If erectile problem arises from a medical condition, there are now many new medicines, surgeries and therapies that can help restore sexual health. What ever the nature of problem may be,but rule of its correction lies in the fact that almost every man has difficulties with erection at some time in his life and everybody feels some time in himself at least that he suffers from erectile dysfunction(ED). Therefore affected person is not abnormal only , nor he is alone affected by this non performance of Sex.There is no need to suffer in silence. Don't let once embarrassed in alone or silence and let this embrassment of self realisation of less or non-performance or less or no erection keep one from sexual health and happiness.Following type of disturbances of erectile dysfuctions are seen.
1.Low Performance Anxiety :It's not unusual for a man to have an occasional episode of impotence in form of less performance , after drinking alcohol or after a particularly stressful day. However, if he places too much emphasis on the incident and harbors fear that it may happen again, the anxiety itself may become a cause of erectile difficulties. Some men engage in thinking that distracts them or take away from their sexual performance. One should try to take over such low performance incidence and relieve the anxiety about having to get an erection.For such anxiety if no heed is paid to it or a good stimulation is kept such beliefs goes away and man resume strength again.
2.Stereo type Performance: One problem in people's sex lives is that many perform it through certain ruts and routines and they don't have much novelty. For example they always have sex at 11:30 at night with the lights off, with the same foreplay, and so on. Their sex lives are relatively invariant. Soon,their partner becomes about as exciting to them as a flounder. They can change their sex lives by incorporating some variety- go to another place or a different setting. Vary the routine. Buy wife some new night dresses or change sleeping room ,decorate with flowers,perfumes music or change stye of four play or coitus . one shoul spice up sex life.
3.Stress and Strain: Stress and Strain arising either from performance anxiety or from other life situations, can also be a culprit in erectile problems. Relaxation exercises are helpful. Deep breathe or progressive muscle relaxing, where the person consciously tenses and relaxes each part of the body in sequence. In and of itself, as a treatment for impotence, relaxation is not effective but it may be a good first step for someone trying to improve their own functioning.
4.Tension with partner: Marital or relationship difficulties are notorious contributors to sexual problems. Anger, resentment, and hurt feelings often spill into the couple's sex life, turning the bedroom into a battlefield. This situation is especially likely to develop if partners are non communicative ,communication of personal or familial matters and forgetting them during performance is the key for good sexual performance and isappearance of this Impotence.Familial tension,children problems or any other social disturbances or a bad environment will spoil a good Sex completely labelling it charge on male partner mostly as Impotence.
5.Walk,talk and Eat Sex: During Sex it is a rule that one should walk or prepares one self and partner in the way that Sex is only focus in mind.all narrations should be on this topic to increase libido and bring good orgasm and once achieved than one should enjoy in the way as Sex has been served as food. and only r expression of each other sex difficulties ,demanding sex or informing oneís failure or goodness clearly and methodology to get it corrected by showing action as to cover partnerís fault will bring forth good performance.
6.Be ware of intoxication:Now a days Alcohol intake is rampant in society and many think that after intoxication with Alcohol (both Partners) stimulat sex and performance but it is untrue as Alcohol causes uncoordination and synerigism leading to less performance.Similiary smoking,drugs or medicines neither can arouse or contemplate sex .so always avoid them before sex.Bear bars,dancing girls,nudity,aphrodisiac medicines and alluring music and robust lightening etc may bring orgasm but have got no relation with better performance as man gets easy and early excitement so until very experienced usually not able to sustain erection for long time and a second arousal and action is mandatory to satisfy the partner.Aphordisiac medicines and intake of Hasis or cocaine or Ganza or any opoid is habit forming and durg dendance can destroy life completely so never bring it in Sex which can be conducted normally between two willing partner in a lucid environment,time and place.
7.Positivity is the rule:So many fearful history/story or activity or imprint of past experience may surround a new comer or less performer or person suffering from some diseases or in older age as they cannot perform or make partner irritated,please donot think negative,please fullfil good hope aspiration and confidence with very positivity in mind ,a self determined confident can break any stone.many person think that they are not performer and many partner feel that they are not good looking or physique or age wise difference or married un married status to stimulate another partner or of not that status by education,position or economically to suit the partner but this doesnot have any place in Sex performance.As you meet with partner with zeal and positive energy and once sex is started ,sex itself is so inductive that such feelings goes away once orgasm is aroused by touching G spots or Clitors or by shacking and masturbating penis every thing is forgotten and a good performance comes so be remain positive,Every body some time feels that he is impotent as has either got slight erection with immediate discharge or late erection with no discharge or for female pain ,bleeding and loss of virginity or exposure of bad name and reputation all want to inhibit sex but good and strong determination overtake it immediately.
8.Win partnerís confidence: as stated in my article ďSex in recent perspective and modern definitionĒPartner is very important,now a days both partners are called active in SEX.a lazy partner can damage an active sex and a superactive cooperative partner cam make a sluggish boring sex into a dynamic charming sex.interaction,coordination,co-operation,harmony and synerigm is the backbone of good Sex.so always inuce partner bring eachother by stimulation Gspot of each other and start Sex with full orgasm and then perform all 04 stages of Sex taking and giving pleasure giving time to sex,simple rapid erction,penetration and ejaculation is a dry sex as we take food in hurry without any spice and taste to calm hunger but a good cuisine by a good cook with good presentation and slowly eating taking time provides us really interest pleasure and satisfication of food.
9.Read sex and know Sex: sex is so much important method of mental and physical relaxation in the life of an individual and its important in familial life is very strong as it brig better adhesion,cohesion,understanding,bondage liking and love that it canot be taken as a very light just to perform activities as we have modernised and cultured are food taking habit ,same way good,better and best Sex is very important so to know about Sex is mandatory ,how to bring good arousal or orgasm,increase intimacy and cooperation in performance and then sustaining the act.Now a days many formulas,medicines,mantras and tabeez and therapy are sold by socalled sex specialist to enlarge Penis size(most of the time Penis size is normal as first 2 inch of Vagina is only sensitive sexually for penetration so a normal 4-6 inch of Penis is enough for good Sex and no medicine can enlarge the penis except Sidlefinal(vigra) or tadalafil help some patients really suffering from Erectile Dysfunction(ED) in male patients only or testosterone only in castrated or otherwise Addison or any other hormnone disease) or to bring sex arousal,desire or bring Orgasmor increase sustainability ,to icrease power and duration of strokes and delayed ejaculations etc,But most of them are bogus ,only good practise under guidance of expert counselling bring forth good result,understand that sexual organs are as good parts of Body as other parts any abnormal behaviour with them as sex with children or mentally retarded persons may cause much harm bleeding,tear etc leading to death of child.similiarly to sex with animals or introducing different electrical devices and toy ,stimulation by binding with chains ,rods etc is unwanted and regarded as perversion and abnormal sex.
10.Good advise and expert counselling:Sex is so less discussed and expressed in personal life that a affected person remain under quota of days and years under depression and anxiety leading to irreversible stage of Impotence.if a good advise is sought such fear and apprehension goes immediately and rejuvenate the person.some time person is suffering from infections of genitilia as in Female and it remains cause of pain and bleeding during Sex which makes many female a freezed female or male is suffering from phimosis,hypospadius or epispadius or infection of glans or herpes or other infection of genitilia or tight and short frenulum or hydrocoele,spermatocoele,varicocoele or hernia or systemic disease of metabolic disorder as diabetes or protein loosing enteropathy or any systemic cardiovascular or renal or hepatic or hormonal abnormality that sex will remain low until root cause is treated and corrected,.In our country in middle aged person most of doctors donot ask about sex performance nor patient states it but diabete mellitus do affect sex performance too and actual attention should be paid to it ,same after menopause most female donot like to state any thing about sexual life but here Sex is not important to maintain good bondage and relations by relaxation but also helps us to burn good amount of calorie.
Therefore,IMPOTENCE is not necessarily a sex performance failure but lack of better understanding coordination and cooperation between partners because of their covered and hidden beliefs and lack of knowledge of Sex leading to somany psychological disturbance.
Dr.d.r.nakipuria

** author is a HIV & Sex Specialist
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Oct03
SEXAL DESIRE IN MALE & EMALE,METHODS OF CONTROL & ENHANCEMENT
Gradually as we are more educated by Media,internet,print media,films, social interactions, books,our day to day exposure in family,friends,society to sex from our childhood till Adult period or even we are middle aged or old,Sex either comes spontaneously or otherwise due to above reasons becomes a very need of our life like Anger,fear,Greediness,Love,Hunger,Thirst,Sex is important involuntary demand of our body.
But as becomes more informed on this matter either by family /society or our exposure to different above mentioned information channels,we start asking ourselves as we are competent enough to perform Sex properly and completely qualitively and quantitavely perfect.Mostly A person or his/her are experiencing it ,that is why if partner complains (which is mostly not seen in our Indian society) a person is ofeten left to himself whether he is performing normally or not and he becomes more questening whe he reads or sees videos /stories of betters performing persons who are doing sex for much time ,much frequently and in different postures and styles ,satisfying partner with more satisfications in form of penetrations, cries,return behaviours and demands.But most of such behavioural changes are wrong as Sex performance never means deep or forceful penetrations, excessive strong rigid,fatty and thickened tight Penis or Fatty full Labia with prominent Clitoris or with excessive discharge of Male or Female before or after Coitus or making partner more demanding sex or behaving in abnormal styles,fashions and positions.If these comes in our sexual behaviour these are excess above Normal Sexual behaviour,whether this is pervertion or not is questionable but not a certainly normal behaviour.A normal sex apathy cannot be said at all if these are absent,only need is of a normal sex desire at a proper time,place with a normal partner with or without a fore play and after desire a normal erection with normal penetration,coitus , normal holding,exercise for 1-5minutes and normal discharge inside or outside of few ML of fluid only.Iind arousal may come immediately or may not come for hours it never means less strength or apathy or a partner not interested for second after first in short time.But beside this there are some gray areas where a person in normal condition without under any influence of medicine,addiction or psycho social or organic body diseases never gets sexual desire even after proper stimulation by partner or by books / stories or video and remain apathetic to sex ,these persons whether Male or Female are called Apathetic to Sex or we can say Less desire/Drive/Interst for Sex is seen among them,Mostly it is assumed that Male suffers it most and it is reflected more as Male is Active Partner in Sex but it is not true a freezed Female can damp a normally (not Hyperactive) Male too or a stimulated Female can boost up a borderline or less performing Male too also,so Importance of Both Partners exist and one can supplement and correct other by Physical or Psychosocial stimulation,some time change of partner,time,place,orientation,external stimulation,visualisation and exhibition of Normal Sex and psychosocial support corrects this Low desire so well that in most of cases mere psychosocial correction and support yields very good result needing no medicines .
That is why this article will provide us correct knowledge of Less Desire/ Drive in sex. Mostly we assume that wife is a bit concerned, but it doesn?t bother you too much because she doesn?t speak about it or mentions it. However, deep within, you want to understand how and why you have transitioned from a once energetic young chap who could satisfy his newly-wedded wife in a matter of minutes to a man who no longer yearns to play the game. Deep inside, you also realize that the longer things go on like this, the farther apart you and your wife will drift. However, time and time again, you brush the issue under the carpet.Men often don?t express their personal problems, especially those involved with relationships or sexual in nature, and, therefore, find it difficult to seek help. This eventually leads to breakdown of their relationships and causes stress, which further aggravates the problem.
What is low sex drive?
A man with decreased libido thinks less about sex, loses interest in sexual fantasy and in sexual activity. Even sexual provocation by sights, words, or touches, may fail to induce interest. The man, however, often retains the capacity to have sex. Some men, despite having no desire for sex, continue to engage in sexual activity in order to satisfy their partners. In such cases, women may find the excitement completely lacking and might start feeling that their partners are no longer interested in them.Different men have different levels of libidos. This may range from one extreme, (such as wanting sex everyday) to the other extreme (having sex only once, twice or thrice a month/year). Men also have varying levels of satisfaction with their own sex drives. Therefore, there is no normal range of sexual activity for a coupleProblems may arise when the husband?s libido is persistently low, which causes the wife to remain sexually dissatisfied or unfulfilled or when the man seems to be dissatisfied with his own level of sex drive. Compatibility between spouses, including sexual compatibility and sex drive, is essential to maintain healthy sexual life. While libido may be decreased temporarily by conditions such as fatigue or anxiety, some men experience low levels of sexual desire all their lives.
Medical causes
Low libido may be caused by many different medical conditions. One of the most frequent is low levels of testosterone in the body. Apart from erectile dysfunction and premature ejaculation, which may induce anxiety and as a result, decrease your sexual drive, other unrelated conditions (such as Physical weakness Diabetes,TB,anemia, chronic Disease of Liver,Kidney, Lung,Neurological,spinal Gi Tract,cardiovascular disease, Genitourinary diseases pain due to Bony,Skeletal or Muscular diseases,Hormonal diseases) may also lower your libido.Try to rule out all physical or organic disease possibilities for your reduced sex drive. If you have any condition that might be associated with a low libido, see your doctor. You could have a medical condition that can be easily remedied or controlled. Treating the underlying medical condition may help in improving your sex drive.
Stress
Chronic stress can interfere with the hormones involved in the sexual response. This may result in low libido. Stress may be induced due to a variety of factors such as financial, personal, work?related and so on.if by counselling or psychosocial support or some time by psychiatrist using some medicines to cut depression,fear,mania oranger,anxiety, sleeplessness and once these are corrected a normal drives come,but in most of cases of absent such diseases Less Drive is mostly due to our thinking due to our experience or influence by some incidence or videos or exposures and as these are better explained and cleared Drive comes gradually.In Female,a very orthodox bringing a belief of severe pain,bleeding,tear or shock or loss of virginity or of pregnancy create so much nervousness as she never allows any penetration or sometime even any physical exposure or stimulation,They need support from senior members or friends in Family or Partner or some time psychological counselling or medicines.sometime presence of excessive pain due to infection in Genitourinary system causes them Freezed,a proper control of infection by medicines by a good gynaecologist or Urologist or Family Physician corrects it.In amle,except for presence of infections in genitilia or urinary system mostly corrected by good psychological counselling and support ,medicines have got a little role except to correct infection or psysical diseases. Reduce stress and manage it more effectively. This can range from employing stress-relieving techniques such as prayers, meditation and yoga to delegating more responsibilities to your colleagues and peers, depending upon the cause of stress. Alternatively, have sex to reduce stress! It is a well-known fact that sex is a wonderful stress-buster.
No time for sex
Commonly seen now a days! because of our urge to be more and more busy,to earn more and more and in this race we forget our selves,some basic need of our body as we start less eating,gradually it becomes our diet ,same way no time for sex in early days lead to no sex drive in future leading to complete loss of our social and familial life .Juggling multiple responsibilities of earning and providing to your family, parenting, keeping the household afloat and discharging social responsibilities?whew! You find yourself constantly busy. Having packed schedules daily drains your energy and leaves no time for sex. A busy schedule also means a busy mind ? and having a lot on your mind makes it difficult for you to relax and "get in the mood?. Sex, may, therefore, take a backseat and feel like just one more thing on your extremely-long "to-do list." All of these factors contribute to a lower libido.Remember that sex is an important part of an adult relationship. Just as we need to find time for ourselves, we also need to find time for our partners. Designate a night or two a week to spend quality, romantic time with your wife. You can make it more interesting by bringing something new to the bedroom occasionally.
Emotional causes

Men generally overlook emotional causes of decreased libido such as fear, anxiety and depression. When we are afraid, anxious or depressed, sex is usually the last thing on our minds. Anxiety, fear and depression may stem from a variety of causes, be they work dilemmas, relationship issues, family woes, or money problems, but emotional experiences greatly impact our sex drive. On the contrary, fear and anxiety may occur due to sex itself. This includes the fear of contracting an STD, of making your partner pregnant or of not being able to make her conceive.
All these emotional experiences dampen our sex drive and hamper our chances of having a pleasurable sexual experience. Improving your health and immunity are the primary factors that can ensure that you are able to tackle these emotional experiences. You can manage anxiety, fear and depression by meditating, doing yoga, talking to friends or playing with your kids. When your mind is healthy, there are fewer chances of problems intruding into your bedroom. However, if you feel that these emotional experiences are overwhelming you and you cannot cope with them, seek professional help.
Boredom
After being married for few years, some couples can hardly find any sexual excitement left in their lives. You might also lose interest if your mate doesn?t take care of her looks, body and behavior.
Experiment! Bring back the excitement by trying out stuff that you had been fantasizing about for some time. Gift your wife sexy dresses, which will help bring in some spontaneity to the experience. Talk to your partner about her idea of improving the sexual relationship.

Relationship issues
Having relationship issues with your partner such as unresolved conflicts, resentment or unexpressed anger can dampen your sexual desire. You need to deal with relationship issues with your partner if you want to enjoy sex again.
Communicate. Identify the problem and try to find the solution together before issues explode into huge conflicts. If talking to each other doesn't work, seek help from a therapist.

Body Image
Some people feel unhappy about their bodies and are shy to expose them to their partners. Though, we all love and hate some aspects of our bodies, the key here is to learn to be happy with what you have and feel sexy about it.We can do away with the negative feelings by thinking about the positive aspects that you have. Even if you are overweight, you can try out ways to feel sexy by enhancing your other valuable body aspects. If you are obese, try to shed some weight by seeking professional help.
Aging
With age, men produce less testosterone, which reduces their sex drive. Other concomitant factors that may play a role in reduced libidos are age-associated fear, anxiety, and depression. Testosterone levels may be increased by taking testosterone supplements, but this should be subsequent to consultation with your doctor. Additionally, the dosage of testosterone must be carefully monitored, as high levels of this Hormone can cause depression or other side effects like prostatic or testicular cancers. Long-term safety of testosterone supplements, especially in elderly men, has also not been established. Other temporary alternatives can be the use of Viagra (Sildenafil citrate).But it corrects only erectile dysfunction not libido so it is not very useul here works or work as psycological boosting agent However, prior to initiating any medicine to boost your sex drive, it?s essential to consult your doctor.
Sexual Abuse
If you have been a victim of sexual abuse, you may find it difficult to have normal physical relations. By taking your own time to heal, being patient and getting help of friends and counselors, you can overcome this past issue and resume a normal and healthy sex life. The key here is not to pressurize yourself or get pressured from others to have sex until you are completely healed and ready.
Medication
Some common medicines such as those for high blood pressure, depression, or relieving anxiety can reduce sex drive. Depression can also lower your sex drive and so can the medicines you take to relieve it. Additionally, antidepressants can cause sexual dysfunction, such as delay in orgasm, inability to achieve orgasm or erection or ejaculation. Any of these conditions can have an adverse affect on your level of desire. Before taking any new medicine, talk to your doctor about the possible side effects on sexual activity. Also, make a list of all the medicines that you take and get to know about their side-effects. Talk to your doctor and seek alternatives to the medicines which seem to be the cause of low sex drive or sexual dysfunction. Other options may include taking drug holidays, reducing the dosage or taking antidotes. Some people may benefit from taking supplements such as Gingko biloba or switching to a different medicine. The most important thing to remember here is that you should not stop taking any medicine without first talking to your doctor.
The best approach to this problem is to try and identify the cause of low sex drive .Once we are able to do so, try to eliminate the cause or seek professional help. Remember, putting in the effort and resolving problems now will go a long way in living a sexually-fulfilling and blissful life! But most of time our belief in Less Drive/Desire is not correct as either our mental level has raises or we are under above mentioned physical or psychosocial stress and oce we get corrected it,normal desire comes but it is most true that a normal Sex must be perfomed by partners at regular interval as it increases our cohesiveness and adherance to each other and normally shapes our family and society. Neither we should be overactive or more demanding destroying our social fabrics nor we should be so much busy or shameful of performing Sex inspite of our time, space,place, age,religion,enviornment or any other social factor.
DR.D.R.NAKIPURIA
SILIGURI
09434143550
NACO TRAINED EXPERT ON HIV,SEX & VENERAL DISEASES


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Oct03
AGEING PROCESS REVERSED BY STEM CELL ,CAN MAN BE IMMORTAL?
NEW RESEARCH IN MICE SHOWS AGEING CAN BE REVERSED BY STEM CELLS;-----
Ageing is the process which cannot be reversed as the man or animal who has taken birth has to die one day,maximum age for human being is 100 yrs.Our skin ,nerves,hear lung,intestines,bones ,muscles every part starts showing feature of old age and we becomes older and older these tissue becomes mor older and show signs of decaying and loss in structure,function and minor intracellular biochemical activities and ultimately one has to die.
man has conqured the world by reseach of Dolly by producing a replica of a person 100% by on cells without needing fetilisation from oppisite partner egg by establishing and harvesting stem cells or embroyinc cells of primitive or primodial cells which is the mother cells of every thing.As blood and skin and endothelium of intestines are rapidly replaced every day so here Stem cells does a remarable work ,they remain exist here even in old age and Bone marrow which forms all type of blood cells is the store house of these blood stem cells which produce different type of Blood cells.Bone marrow produce myeloid and lymphoid type of blood cells,Myeloid is concerned for producing immune cells resulting in productions of fighting blood cells which helps us o prevent inflammation by infection and cancer.But some lymphoid cells help our body to repair or rejuvenate old cells or tissue.In young mice Myeloid cells are produced in less number than Lymphoid cells but in old Mice Lymphoid are in less number produced,so repair work in not done properly but after injecting stem cells (or blood )from young Mice is injected in to old Mice it travels to Bone Marrow of old Mice and stimulate it to produce lympoid cells so that repair of old tissue being undertaken very rapidly as old Tissue are repaired Ageing Process is being reversed.
This study has been done in Mice only but not in Human Being but as more research will further clear the picture,Man will be immortal as only limitation OF IMMORTALITY is the fact that all body tissue usually becomes old and self decay and destruction is the cause of death of tissue or human being as Man has conquered over diseases and infections but cannot control self dying process and by such invention the last hurdle of Man Being Immortal will be also removed.
By mixing blood of old people with the blood of young people ,these young bllod cells rejuvenate old blood cells .This has been demonstrated by THE HAVARD STEM CELL INSTITUTE by a recent published study on Mice.When blood from young mice bone marrow injected in old mice,these blood cells after entering into Bone Marow of Old mice revitalise these Blod Stem Cells present in Bone Marrow.Reseacher concluded that usually in old Mice Bone marrow produce that type of Blood stem cells which generate more Myeloid series blood cells which control infection or tumors but less amount of Blood stem cells whch produce Lymphoid series cells that orchestrate or regenerate tissue Repair as seen in young Mice but after the injectionof young blood cells even old Mice started producing stem cells that is doing tissue repair.The study is yet to be done in Human being.
hence such study is most important mile stone in life of Human being as now man can produce own replica by oneself,can kill any infection ,defeat any metabolic,cardivasular,immunological or herditory disese but now by this study old age will be turned into young age and Man will live for years as he wants to live or he will be IMMORTAL.
Dr.D.R.Nakipuria


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Oct03
GARLIC PREVENTS CANCER,ARTHRITIS,ATHEROSCLEROSIS,DIABETIC HARM ON HEART
Garlic (Allium sativum) has been found to exhibit several health benefits, including inhibiting enzymes involved in lipid synthesis, decreasing platelet aggregation, preventing lipid peroxidation, and increasing antioxidant status.From the ancient time eating of Garlic and onion has been demonstrated to reduce bad lipid in our blood leading to prevention of Atherosclerosis of Brain,Kidney Eye and Cardiac microvessels and thus very helpful in these lipid induced hyoertension and related disease of kidney,Brain,Eye and Heart and now a daysit has been shown that Garlic reduced immediate rise of blood sugar in Diabetes after food thus preventing Diabetes bad effect on heart and other organs.

Garlic has got an unique antioxidant property of reducing pain of inflammatory or immunological diorder related pain of Joints,bone and muscles,it is very impotant to heal osteoarthritic changes of Knee ,hip and small joints and rheumatoid arthritis and thus very much helpful to ameliorate Bony joints inflammatory or degenerative pains.

By recent study Ohio state UniversityComprehensive cancer research centre it has been demonstrated that Garlic protects us from cancer induced by some contaminated water or componds which enter in our body by sudden cnsuption or by food adulteration or by mistake these compund by process of nitrosation produce carcinogens,The level of carcinogen found in urine of a patient is less who counsume good garlic as shown in their urine level ,more garlic less carcinogen in urine.thus garlic prevents cancer beside giving us a spicy test to our food stuffs.
Garlic oil can protect against diabetic cardiomyopathy, a form of heart disease in people with diabetes, reveals a novel study.Garlic has an enormous potential to prevent cardiomyopathy, which is a leading cause of death amongst diabetics.
It works by controlling the abnormally high sugar levels that occur during diabetes on a common basis.The study, conducted by researchers from Taiwan, took the help of a few diabetic laboratory rats for the research.The rats were fed either garlic oil or corn oil by the researchers. They were then observed to see which oil led to better prevention of cardiomyopathy.Overall, diabetes related cardiac dysfunctions in the rats were dose-dependently relieved with garlic oil.The changes found in the rats were related to the antioxidant properties of the oil, the researchers found.20 contributing substances found in oil,on analysis, almost 20 substances that may contribute to this protective effect were found in garlic oil.
"Our results show that garlic oil supplementation for diabetic rats leads to several alterations at multiple levels in hearts including cardiac contractile functions and structures, myosin chain gene expressions, oxidative stress, and apoptosis and related signaling activities," wrote the researchers, led by Wei-Wen Kuo from the China Medical University in Taiwan.

"In conclusion, garlic oil possesses significant potential for protecting hearts from diabetes-induced cardiomyopathy," the study authors said in a statement.
Dr.D.r.nakipuria


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Oct02
SEX-HOW TO PERFORM ? MODERN PERSPECTIVE & DEFINITION
-HOW TO PERFORM ? A MODERN PERSPECTIVE & DEFINITION
---DR.D.R.NAKIPURIA
SEX although cannot be discussed or expressed openly in our society as it is a topic of intense personal matter and allowed to discuss by grown up or adults or matured in personal couple group or an advice by seniors to upcoming matured adults to practise it as per their experience.Beside this our society think its discussion may destroy social fabric as may stimulate youngster in early sexuality or indulgence of adults and old in abnormal sexuality beside legal partner.SEX has been broadly defined as meeting of two partners of opposite sex or meeting two external genital organs of opposite sex whether any pleasure or satisfication is achieved by this or not.As man has got Penis and it is penetrated in to vagina through introitus by man so he is called active partner and as female simply receives Penis so is called Passive partner but modern detail analysis of patients achieving full satisfication and pleasure by Sex and persons remaining unsatisfied and psychosocially disturbed after Sex has redefined this definition of SEX.
it is very important for a man being active partner realise very much,any defect in performance of Sex either of arousal or desire or LIBIDO or lack of excitement on stimulation by seeing or reading sexual activities or seeing or touching opposite sex partner or her activity or by stimulation through eyes,talk,exhibition or touch of partner or self induced involuntary erection( under influence of body hormones) i.e.,tightening,straightening,thickening and hardening of penis with slight secretion of seminal fluid over glans region with easy slipping of foreskin over it or called as ERECTION or it may be failure of pushing this erect penis in partnerís vagina through introitus or Ext.Genitilia Vulva or discharge of Seminal fluid into vagina immediately after penetration i.e.,EARLY EJACULATION resulting in loss of satisfication and pleasure as strokes gives more and more pleasure which reaches to peak slowly keeping pace with speed and force applied for stroke.by penis.The force is more applied by a thickened, tightened and straight erected penis ,that is why a good erection is mandatory for a good performance of sex.lack of such erection is called Erectile Dysfunction(ED).This enjoyment becomes more excited as partnerí vagina contracts involuntary or by active contraction of Pelvic muscles by partner is increased.Therefore ,apathy of partner,less excitement or lack of attention in sex by partner or deficiency of active cooperation and actions in Sex also result in getting good satisfication and pleasure.Female although by misnomer called as inactive partner but actually her cooperation from the stage of getting desire,attention,environment of Sex to getting aroused or ORGASM either by self excitement or by stimulation by partner by look,touch or reading books or watching video etc.,or after fourplay by partner which is very important in Female as they are less easily excited or reach peak to Orgasm and without her active cooperation Sex remains less pleasant and unfulfilled in satisfication.Role of Accessory or additional Genital organs like Body contour,Pubic Hairs,Moustache,hairs over chest/limbs(in Male),Face color of Body,color of Iris of eye ,shape,size of Eyes,Placement of Eyebrows,straight beak like nose,mouth opening,lips ,fore head,style of hairs over scalp,and contour,fullness,bogginess tightening,size ,shape resistance,compressibility of breast with coloring of areola and stargtening of nipples with shape of belly being scaphoid and centrally placed elliptical umbilicus ,proturbance of buttocks,broadening of Hips with slender slim straight fingers,toes limbs, soft palm and sole with absent of hairs over any part of body except straight small shiny pubic hairs with thickened puffy Labial folds is very important as they play indirect role to either initiate Sex or Libido or later to maintain Sex or good performance or more sustainable play.Early Ejaculation leads to flaccid ,small ,shrunken Penis which freezes immediately a Male partner as female is either at peak of orgasm or getting arousal for orgasm ,such sudden discharge makes her completely dissatisfied and uncomfortable as shrunken flaccid penis cause no dilatation of strchable compressed thickened roomy vagina or touching of cervix of Uterus or deep pockets of vagina around cervix or fournix .So either expressed by modern educated Female partner voluntarily or involuntarily expressed by face or body activities immediately or on subsequent occasion of Sex initiation by male partner who realises this as his biggest failure and suffer from self realised Gilty consciousness leading to Psychosocial disbalance leading to further damage in getting arousal or erection or performance of sex and vice versa.
Therefore,we have realised that sex is no more confined to one partner ,one partner may be less active but other partner can make him co active similiarly an uninterested or freezed partner can freeze or dissatisfy another partner.Previously if one partner is not performing particularly a male doesnot get erection or arousal to perform sex we called it IMPOTENCE and similiary a female doesnot get pregnancy after intercourse we called IMPOTENCE but it should be better termed as INFERTILITY but now a days sex has been better defined as stated above in following stages.
StgageI: Self or stimulated Aroursal and arousal of partner with full Orgasm.
Stage II:Erection of penis with penetration and reception of such erected penis by an active partner.
Stage III;-Mantenance of coital activites by cooperation of both partner ( both are as active no active or passive nomenclature).
StageIV;-Discharge or Ejaculation of Seminal fluid in vagina or condom or ouside gradually allowing partner to cool gradually and slowly.
Sex in different positions or in different openings beside vagina as Anal or oral or Arm pit sex is not called perversion but resource to achieve more pleasure and satisfication in which any of these four stage is fortified depending on which separate methodology we adopt like kissing or messaging of Breast increase stage I and III ,oral ,armpit and anal sex improves stage II,III and IV.Sex with children or old people or desibilated or mentally retarded people or against will of partner forcefully or under intoxification with alcohol ,drugs or sleeping pills is a crime and this needs no discussion as it is always painful .SEX IS A RESOURCE TO BRING JOY, HAPPINESS , SATISFICATION,LIKENESS,ADHERANCHE AND MORE HUMAN BONDAGE WITH LOVE IN LIFE IF IT PAINS EITHER PARTNER DURING OR AFTER PERFORMANCE IT SHOULD NOT BE CALLED SEX.Sex ,how much discarded for discussion openly in society is need of human being to mantain its progeny in universe but Sex is the only simple natural method of producing future generation but every act of Sex is not necessarily mean production as Human has reached highest growth in Animal Kingdom,he has to restrict the number of his progeny,that is why he has learned to enjoy Sex without production by developing so many methods of contraception like Condom,spermicidal jelly tablets,foams ,vaginal condom,pessary jellies,IUCDs ,oral contraceptive pills/injections/patches for female and male,sex during safe period,external ejaculation etc.,
Lack of availability of partner in war time battalions leads to sex with same sex partner and gradually a class of people called as GAY or LESBIANS has evolved in society in good number across the globe,they are perfect Humanbeings with good mental and social judgement but they got enjoyment with same sex or HOMOSEXUAL.They are no more defined as perverted or sexually abnormal persons ,many countries provide their activity as normal as Sex among HETROSEXUAL exist.even in India,their such act is now not under any screeing of unlawful activity.gradual wecome and accept of these Homosexual have added further definition of SEX where in Stage II erection of penis or penetration of Penis may or may not present and partner may utilise aroused finger /hand /toe or any soft compressible toy/instrument after excitement for penetration or simply with external genitilia or with accessory Genital organs as mentioned above completes further stages of SEX where Ejaculation may or may not come avoiding need of any contraception to avoid pregnancy but needed to arrest spread of sexual transmitted disease like HIV,Syphlis,Gonorrhoea,Herpes,Hepatitis B & C ,etc.But in this Homosexual activity which is regarded as abnormal activity by many as it turned very purpose of SEX and human existence of Love for man and woman keeping our social fabrics intact also involves very intimate cooperation of both partners,here both partners are highly active members as lethargy or apathy of one partner cannot initiate this at all and this strong love,affection,intimacy,bondage and physical contact has lead to more increase in their numbers in society .
In modern time if SEX is not performed keeping intact all 04 stages of SEX with strong bondage affinity and adherence of both partners leads to breaking in relations or crimes where SEX is performed by male as simple formality of penetration after slight or full erection knowing nothing about arousal of opposite partner and ejaculation ,satisfication,pleasure,enjoyment is left behind or never asked or taken care of where female is always acts as passive receiver and Male as dominant partner serve as active partner without any question or liking of opposite partner or self realisation of failure covered under social dominance of male over female or a female even unsatisfied either gets satisfication by illegal means or remain unsatisfied but never asks or challenge male partner under social obligation of male dominance and even pay price of Infertility (being discarded by family or divorced ) even having her no fault.Sex can be performed in many style and ways with use of fragrance,sweet smelling scents,powders,lotions,jeelies,perfumes wearing alluring clothes or creating inductive environment like rose petal bathing,swimming or candle light meetings under flower shade ,exorbiant seducing music and video shows,dance with slight intake of stimulants and usual duration of 10-20 minutes(which may be increased in some one who practise its regularly) for stage II-IV performance is regarded as normal Sex ,regarding frequency 1-5 times a day to once a week or month is regarded as normal sex but if its frequency reached more or filthy means of using electric vibrators,binding partner with rods,chains or belts or stimulation by smoking ,alcohol or drugs or burning partners body parts or genitilia or Accessory Genitilia by cigratte butts or by pin pricks or electric or thermal currents is perversion and abnormal sex which comes as obesity hypertension,heart disease comes after over eating.Sex under intoxication of excessive cigarette,alcohol or drug is always perfomed of low category as performance is mostly un coordinated and incomplete,so it is better to avoid it.Enviornment personal privacy and isolation is important for good Sex performance as Sex is always a private personal matter in our society,no body wants its open and frank exhibition and show.and we have been matured in this way through our culture and social rules that sex has been always a private matter of a couple through which person and society both grow,sharing and swaping of partners or multiple partners or prostitutions or Jigglos cannot be termed as normal lawful practice of society and has been regarded as offence in Sex.In no way Sex promotes separations,loneliness ,breaking and divorces and it is not limited to simple enjoyment and satisfication burning and destroying our social fabrics involving two willingful compatible and legal partners .simple meeting and performance of these IV stages where social fabrics is destroyed canot be termed as normal sex.hence sex with animals like horse,dogs,cattles canot be termed as normal Sex,these should be avoided as damage to our external genitilia or body parts may occur as animals are not trained to perform sex with human beings and many sexual transmitted disease can spread through it.As in our many acivities like eating ,reading,sleeping,playing etc we do some time nothing ,some time excess and these are termed abnormal activities ,same way in Sex if we either do apathy or doesnot involve our partner or do which should not be done or praticed or do excess then it is called abnormal sex or perversion which brings many diseases as obesity after excessive eating and Anxiety nervosa after no eating.Sex with children,mentally retarded persons or under pressure against will of even a partner is termed rape and regarded as unabailable offence in our system.

Hence sex requires two active willing legal partners for its true performance,if partners are either excited by oneself or by simple stimulation of each other and a private suitable place and time is selected,Sex can be performed excellently without need of any counselling, advice ,medicine or artificial allurement environmental things as mentioned above.In society so many quack doctors or self styled sex specialist doctors or therapy are advertised in print,electronic and internet media claiming better and best Sex.Nothing like this actually exist,if both partners are really happy and pleasant a good sex has been performed irrespective of its total duration and duration of any stage mentioned above or overlapping of stages,it is a continous live processnot a machnary computer which will always move through stages by giving every stage a good time ,these stages has ben enumerated to uderstnd Sex in better way .if intimacy,adherence and closeness achieved in partners with Conception(reproduction) then Sex has fulfilled its target(reproduction is not necessary as mentioned above) and there is no role of any thing ,instrument,medicine,doctor,counselling or therapy .A rumor is spread regarding penis size,so many instruments,medicines or message oil or sold to increase its size but for a better performance of sex only 2-4 inch penis is enough as only outer 2inch of vagina is sensitive to penetration so such size odf penis will give pleasure to both man and woman and till today no convincing scientific medicines has been discovered which can increase penis size,thickness or tightening.No medicine or therapy has come which increase arousal or libido in male or female (Testosterone helps only those male who have got less its amount in Blood not in normal male where if it used may cause prostatic cancer or toother virilising effect)but so amny are sold in market for increasing desireness or lure for sex .Sex is a totally personal psychological matter which can be easily controlled and maintained by psychological counselling removing childhood fear,apprehension or any doubt about Sex as sex is painful,sex is crime,sex is abnormality,sex always result in pregnancy,sex is discarded things and sex is a formality to be performed after marriage in first night only and after that on demand by husband (wife has go no right to ask sex or question sex),limited sex after child births,no sex after menopause,no sex during menstruation ,no sexual discussion among family or with children or in school ,our external genitilia are dirty parts of waste disposable only so should be never cleaned or cared for.A good development has taken place in some patients of actual Erectile Dysfunction (ED) where Sildefinal or tadalfil gives good result but it has got no effect on many patients of ED too and in normal persons it never increases size or erection of penis but sold like anything and even female takes it where it has got no role ,same way for delayed ejaculation so many medicines and creams and injections are marketed which is better controlled by psychological counselling and gradual practise and learning style of performing sex under guidance of an expert.After unprotected sex to avoid pregnancy I-pill or unwanted 72 are sold openly in market which are nothing but high doses of oestrogen and progesterone which completely disturb a womanís menstrual cycle and in many woman as suffering from migraine,thrombosis,hypertension,jaundice etc., they are contraindicated so government should ban selling of these drugs with harmful side effects by advertising in TV and printed media as youngsters are now developing live in relations and sexual activities openly with removal of fear of getting pregnancy but risk of developing sexual transmitted diseases like HIV,Gonorrhoea,herpes ,septic abortions and infertility.
DR.D.R.NAKIPURIA

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***Author is an expert Sex and HIV practitioner


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