Sex Drive: The Healthy Way

Sex Drive: The Healthy Way

Sex is good for you! (Tell that to your spouse tonight.)

Plenty of studies show it: Regular sex increases immunity from viruses, relieves stress, and even helps protect the health of a man's prostate gland by emptying fluids held there.

It also triggers the release of chemicals that improve mood and ease pain.

If your sex drive has stalled out, you have good reasons to rev it back up again.

You don't need jumper cables or even little blue pills.

Just try a couple of these tips and we guarantee your engine will be turning over again in no time.

Most people can and should have sex well into old age! While menopause in women affects sexual drive and function somewhat, there is no reason why healthy men or women can't experience sexual pleasure at any stage in life. Sure, the nature and intensity of the sex may change, but the love and pleasure don't!

Some Healthy Ways

Having intercourse regularly helps to keep your sex drive in high gear by increasing the production of testosterone, which is the hormone mainly responsible for libido in both men and women.

Stop smoking.

Smoking can clog the blood vessels in the penis in the same way it clogs the arteries in your heart. Ever heard a better reason to quit?

More than 200 medications can cause erection problems and diminished sex drive, including drugs used to treat high blood pressure, heart disease, depression, and stomach problems.

Make a list of all drugs that you use and seek help from your doctor or pharmacist if any of the drugs on your list could be culprits and what to do.

Women! Do Kegels.

They are the squeezing exercises your doctor told you to do after pregnancy or because you were having a bit of a problem with leaking urine.

They're also great for strengthening the pubococcygeus muscle, essential for orgasm.

To do Kegels, take note of the muscle you use to stop urinary flow, then practice contracting that muscle, gradually releasing it.

Work up to 20 contractions three times a day.

Men! Take supplements of gingko biloba and Arginine daily.

They promote better blood flow, getting more blood to the brain and... other organs.

It doesn't take much imagination to figure out how that might help you! Follow the instructions on the bottle, but check with your doctor first.

POM, OTC, UTC, BTC and all that

POM, OTC, UTC, BTC and all that Up until now, drugs are officially categorised either as prescription-only medicines (POM) or over-the-counter (OTC) medicines.

Well, unofficially and widely unacknowledged, there are the under-the-counter (UTC) medicines as well as the behind-the-counter (BTC) medicines.

The UTCs are associated with developing countries like China, Brazil, Nigeria, India, etc.

In these countries, prescription-only medicines not prescribed can be easily obtained largely illegally.

The BTCs are associated with the developed, western countries like Italy, Germany, France, UK, Netherland, etc.

The Food and Drug Administration (FDA) of the United States of America recently hinted that it may create a new category of drugs that may be obtained from pharmacies without prescriptions.

These drugs will however be obtained only after consultation with a pharmacist.

This only means that the US is about to join its European allies in the unacknowledged categorisation of drugs into BTCs.

The FDA held a public meeting on November 14 2007 to hear feedback about the "behind-the-counter" concept, which could make some drugs now available by prescription more widely accessible to patients.

As expected, the effort met resistance from heavyweights who market over-the-counter drugs.

The Consumer Healthcare Products Association, which represents a wide range of companies from Kimberly-Clark Corp to Johnson & Johnson, opposes a three-tier system.

"We believe the current two-class system is the best system for consumers," said Elizabeth Funderburk, a spokeswoman for the group.

Only a few behind-the-counter drugs, such as Barr Pharmaceuticals Inc's Plan B birth control drug, are now sold in the United States.

They are more common in Britain, several European nations, Australia, Canada and New Zealand.

The efforts to make drugs more accessible is actually the driving force behind the BTC concept, but the fear is genuine; all the drugs in POM, UTC and BTC categories are referred to as “poisons” by the pharmacists and should be handled by professionals and well controlled.

On the other hand, we have the problem of workload shedding. Leaving prescription of certain drugs to pharmacists and in some cases even to nurses, affords the physician more qualitative time with the patient.

Your reaction please!

WHAT MUMMY EATS DETERMINE THE SEX OF CHILD

WHAT MUMMY EATS DETERMINE THE SEX OF CHILD

Earlier researches and observations have clearly shown that male embryos thrive best in nutrient-rich lab cultures.

In other words, it takes more nutrients to build boys than girls.

A new research, the first ever, has now shown a link between a woman’s diet and whether she has a boy or a girl.

Regularly eating breakfast, having an excellent appetite and eating potassium-rich foods laced with sugar seem to increase the chance of having a boy.

According to the lead author of the research carried out at the (British) University of Exeter, Fiona Mathews, the findings also fit the early fertility research showing male embryos poorly survive in lab cultures with low sugar levels.

When this is translated from test tube to humans, this means skipping meals can result in low blood sugar levels.

The research involved about 700 first-time pregnant women in the United Kingdom who didn't know the sex of their fetuses.

They were asked about their eating habits in the year before getting pregnant.

Among women with the highest calorie intake before pregnancy (but still within a normal, healthy range), 56 percent had boys, versus 45 percent of the women with the lowest calorie intake.

Women who ate at least one bowl of breakfast cereal daily were 87 percent more likely to have boys than those who ate no more than one bowlful per week.

Cereal is a typical breakfast in Britain and in the study, eating very little cereal was considered a possible sign of skipping breakfast, Mathews said.

Kids and Cough Syrups

Kids and Cough Syrups

In a country where enforcement of the laws regulating distribution, handling and control of access to medications is ineffective, where patients are their own physicians and pharmacists, where medicines are bought and sold like other items of merchandise, it should not be surprising that children’s mortality rate are among the world’s highest there.

There is no doubt that faulty self-medication without professional input contributes immensely to the mortality rate.

Nigeria is one of those countries where just any medicine may be obtained without prescription, with stark illiterates hawking all types of medicines on their heads in the hot, blazing sun with patronage from supposedly educated people, bargaining for cheaper prices.

Non-recommended medicines are bought for and used on children.

Sometimes, adults’ medications are used “in reduced doses” by the “wise” parent who “knows what he/she is doing”.

Contents of capsules (including tetracycline) are emptied unto spoons and administered on children while any cough syrup for adults is used “at reduced dose” on the children.

Without any exception, ALL medicines (prescription-only medicines (POMs) and over-the-counter (OTC) medicines) should be carefully evaluated before prescription, dispensing and administration on children.

Medicines for common cold and cough are very diverse in components and combinations of components.

However, many of the components are unsuitable for children and should not be administered on them.

In June 2006 the Foods and Drugs Administration (FDA) of the US ordered removal of 120 carbinoxamine-containing cough and cold medicines from store shelves.

According to the agency, the action was taken because of a lack of evidence that carbinoxamine is safe for children younger than two.

In January of 2007, the CDC announced that three other ingredients common to POM and OTC cough and cold remedies had been linked to three infant deaths.

All three of the infants had elevated blood levels of pseudoephedrine and two had detectable levels of the cough suppressant dextromethorphan and the analgesic paracetamol.

An American advisory panel recommended in October 2007 that OTC cough and cold medicines that have been widely used for decades should not be given to children under 6 years of age.

Questions have been raised about the safety of these products and whether the benefits justify any potential risks from the use of these products in children, especially in children under two years of age.

"The studies that are available do not demonstrate efficacy," said panel member Dr. Robert Daum, a paediatric infectious diseases expert at the University of Chicago Children's Hospital.

A group of pediatricians and public health officials have petitioned the FDA to restrict sales for children younger than 6 years old.

They are alarmed by reports of deaths, seizures, hallucinations and other problems in some children who took the medicines.

Wayne R. Snodgrass, M.D., Ph.D., of the University of Texas Medical Branch at Galveston, who chairs the American Academy of Paediatrics' committee on drugs, said widespread use of the non-prescription medications has persisted despite lack of evidence that the products are effective or safe for young children.

"This is not some life-threatening illness that we're talking about," said Dr. Snodgrass, a co-author of the petition.

"We have to keep in mind that we're talking about the common cold."

Makers said the products are safe and effective, when given as directed, to children aged 2 and older.

In October 2007, major manufacturers voluntarily pulled 14 cough and cold products for children up to age 2.

The FDA advisory committee, after two days of testimony and deliberations, voted 21-1 that use for kids under 2 should not be recommended for over-the-counter cough and cold products that contain antihistamines, decongestants or antitussives.

The panel voted 13-9 against using the products for children aged 2 and 6.

However, in a 15-7 vote, the panel declined to recommend against the medicines for ages 6 to 12.

Although the drugs have been sold for decades, the FDA generally has not required companies to prove they work for children. Instead, data was extrapolated from adults.

DRUGS AND DRIVING

DRUGS AND DRIVING

It is a known fact that illicit drugs and alcohol are predominant in drugs’ associated with road traffic accidents, but a number of prescribed drugs also contribute to injuries and deaths.

Although if taken as prescribed and instructed, there may be no injuries or fatalities, due to the use of drugs, still, a number of prescribed drugs (used correctly or not) impair the ability to drive.

Creating awareness among prescribers, dispensers and patients is therefore paramount.

REQUIREMENTS IN DRIVING Both cognitive and psychomotor skills are the two main requirements of the body to drive safely and competently after learning the skill.

While the ability to make appropriate decisions relates to cognitive skills, psychomotor skills include reaction times and hand-eye coordination.

In other words, the most important skills required for safe driving are vigilance, ability to interpret traffic situations and to divide attention between tasks.

The driver's behaviour and attitude also contribute to the risk of having an accident, just as attentiveness and concentration, vigilance, divided attention skills (performing two or more functions simultaneously), visual fields and acuity, limb-eye (hand-eye and foot-eye) coordination, reaction time as well as ability to maintain lane control (tracking).

Drugs can also affect a number of brain functions that adversely influence the ability to drive safely.

BRAIN ACTIVITIES AND DRUGS A large range of substances are known to impair the cognitive or psychomotor skills required for safe driving.

Any drug acting on the central nervous system has the potential to adversely affect driving skills.

Central nervous system depressants reduce vigilance, increase reaction times and increase errors associated with decision making and speed control in a very similar manner to alcohol.

Drugs that affect behaviour may exaggerate adverse behavioural traits and risk-taking behaviour.

Special mention must be made of alcohol and illicit drugs.

Alcohol continues to be the most prevalent drug causing road trauma.

The average blood alcohol concentration in fatal accidents is over 0.15%.

Cannabis (marijuana), amphetamine-type stimulants and opioids are the others.

Taking drugs with alcohol increases impairment of driving skills.

During the acute phase of activity, central nervous system stimulants such as the amphetamines and cocaine tend to reduce performance on divided attention tasks, cause tunnel vision and increase risk taking.

They can also cause rebound fatigue, inattention and hyper-somnolence when the stimulatory effects wear off.

Prescribed drugs also impair cognitive and psychomotor skills.

However, with the exception of benzodiazepines, the evidence for the role of prescribed drugs in road trauma is uncertain.

In general, most drugs tend not to be significant risk factors on the road when the drugs are used as prescribed.

Some drugs can cause impairment due to their central nervous system depressant properties, particularly early in treatment before the patient becomes accustomed to the drug, or when the drug is misused.

The most common examples seen in road trauma are the anticonvulsants and the antidepressants, but their presence does not necessarily mean that they had a contribution to the crash.

In many cases two or more impairing drugs including alcohol are detected.

Combinations of drugs increase the opportunity for impairment and the risk of a serious crash.

Antidepressants Antidepressants are double-edged.

While they can reduce the psychomotor and cognitive impairment caused by depression and return mood towards normal, thus improving driving performance, some of them are sedating (tricyclic antidepressants, typified by amitriptyline and dothiepin).

The ability to impair is greater with sedating, than with the less sedating serotonin reuptake inhibitors.

Antipsychotics This diverse class of drugs can improve performance if substantial psychotic-related cognitive deficits are present.

However, most antipsychotics are sedating and have the potential to adversely affect driving skills through blockade of central dopaminergic and other receptors.

Older drugs such as chlorpromazine are very sedating due to their additional actions on the cholinergic and histamine receptors.

Some newer drugs are also sedating, such as clozapine, olanzapine and quetiapine, while others such as aripiprazole, risperidone and ziprasidone are less sedating.

Sedation may be a particular problem early in treatment and at higher doses.

Benzodiazepines Obviously for hypnotic / sedative properties, benzodiazepines are well known to increase the risk of a crash.

They are found in about 4% of fatalities and 16% of injured drivers taken to hospitals.

In many of these cases, benzodiazepines were either abused or used in combination with other impairing substances.

The illicit trade in these drugs is significant and they are often obtained by “under-the-counter” (UTC), “behind-the-counter” (BTC) or “doctor shopping”.

Prescribers do need to be aware of this possibility when prescribing benzodiazepines and the related hypnotics zolpidem and zopiclone.

If a hypnotic is needed, a shorter-acting drug is preferred.

Tolerance to the sedative effects of the longer-acting benzodiazepines used in the treatment of anxiety gradually reduces their adverse impact on driving skills.

Opioids There is little direct evidence that opioid analgesics such as hydromorphone, morphine or oxycodone have direct effects on driving behaviour.

Cognitive performance is reduced early in treatment, largely due to their sedative effects, but neuro-adaptation rapidly sets in.

This means that patients on a stable dose of an opioid may have a less risk of an accident.

This includes patients on buprenorphine and methadone for their opioid dependency, providing the dose has been stabilised after some weeks and they are not abusing other impairing drugs.

Driving at night may be a problem due to the persistent miotic effects of these drugs reducing peripheral vision.

Drugs for diabetes Hypoglycaemia , which translates into less glucose reaching the brain, can be a significant problem.

The drugs themselves have no major effect on skills, but how well they control blood glucose will affect driving performance.

MEDICINES THAT MAY IMPAIR DRIVING SKILLS Anticonvulsants (carbamazepine, gabapentin, phenobarbitone, phenytoin, valproate, vigabatrin, etc.)

Antihistamines - sedating (azatadine, chlorpheniramine, cyproheptadine, diphenhydramine, promethazine, doxylamine, trimeprazine, etc.) - less sedating (cetirizine, desloratidine, fexofenadine, loratidine, etc.) Antipsychotics (amisulpride, chlorpromazine, haloperidol, pericyazine, clozapine, olanzapine, etc.)

Benzodiazepines and related compounds (temazepam, lorazepam, nitrazepam, oxazepam, alprazolam, clonazepam, diazepam, zolpidem, zopiclone, etc.)

Drugs for diabetes Muscle relaxants (baclofen, dantrolene, orphenadrine, etc.) Opioid analgesics (codeine, buprenorphine, methadone, morphine, oxycodone, pethidine, tramadol, etc.) Serotonin reuptake inhibitors and reversible monoamine oxidase inhibitor antidepressants (fluoxetine, sertraline, paroxetine, citalopram, venlafaxine, moclobemide, etc.) Tricyclic and tetracyclic antidepressants (amitriptyline, clomipramine, dothiepin, doxepin, imipramine, trimipramine, mianserin, mirtazapine, etc.) Sympathomimetics (pseudoephedrine, phenylephedrine, etc.)

THE ROLES OF THE PHARMACIST Adequate counselling of patients is very important.

Patients should be warned about the dangers of driving a motor vehicle early in treatment with the drugs that can affect driving.

The pharmacist may additionally label the caution (as auxiliary labels) if the product information of the drug does not contain a precaution about driving.

Patients driving at night or working shifts where normal sleep patterns are altered are also at an increased risk of fatigue-related crashes.

Many drugs can exacerbate the effects of sleep deprivation and increase the risk of a crash.

References 1. Burns M, editor. Medical-legal aspects of drugs. 2nd ed. Tucson (AZ): Lawyers & Judges Publishing Company; 2007.

Drummer OH, Gerostamoulos J, Batziris H, Chu M, Caplehorn JR, Robertson MD, et al.The incidence of drugs in drivers killed in Australian road traffic crashes. Forensic Sci Int 2003;134:154-62.

Ch'ng CW, Fitzgerald M, Gerostamoulos J, Cameron P, Bui D, Drummer OH, et al.

Drug use in motor vehicle drivers presenting to an Australian, adult major trauma centre. Emerg Med Australas 2007;19:359-65.

Bramness JG, Skurtveit S, Morland J. Testing for benzodiazepine inebriation - relationship between benzodiazepine concentration and simple clinical tests for impairment in a sample of drugged drivers. Eur J Clin Pharmacol 2003;59:593-601.

Drummer OH, Gerostamoulos J, Batziris H, Chu M, Caplehorn J, Robertson MD, et al.The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes. Accid Anal Prev 2004;36:239-48.

Ramaekers JG, Berghaus G, van Laar M, Drummer OH. Dose related risk of motor vehicle crashes after cannabis use. Drug Alcohol Depend 2004;73:109-19.

Drummer OH. Benzodiazepines - effects on human performance and behaviour. Forensic Sci Rev 2002;14:1-14.

New Asthma Guidelines

New Asthma Guidelines Places Emphasis on Patient Empowerment and Disease Control

There is no doubt that asthma affects different patients in different ways.

The National Asthma Education and Prevention Program of the US has issued new evidence-based guidelines on the disease.

The Expert Panel Report 3, as the guidelines are known, focus on four key areas of asthma diagnosis and treatment: assessment and monitoring, patient education, control of environmental factors and other modifiable conditions that can affect asthma, and medications.

The chairman of the expert panel that drew up the guidelines, William Busse, M.D., of the University of Wisconsin at Madison, USA said that the guidelines are based on evidence from research and clinical experience over the past decade into the mechanisms underlying airway inflammation and into better methods for control.

Regarding medication, the guidelines continue the established stepwise approach to asthma control, but with revised and expanded management charts based on three age groups: birth to four years, five to 11, and 12 and older.

The addition of the five to 11 group is a recognition of differing drug responses between children and adults, Dr. Busse said.

The guidelines, weighing in at 487 pages, which include a new emphasis on patient involvement and control of environmental triggers of asthma. build on earlier iterations from 1991, 1997 and a 2004 update, but with several key differences, Dr. Busse said.

These differences include: • Further substantiation of the role of inflammation in asthma, with recognition of phenotypic differences resulting in variability in patterns of inflammation • Recognition of genetic and environmental interactions in asthma expression, with allergic reactions identified as an important environmental factor. Emerging evidence also points to the role of viral respiratory infections. • Understanding that "the onset of asthma for most patients begins early in life with the pattern of disease persistence determined by early, recognizable risk factors including atopic disease, recurrent wheezing, and a parental history of asthma."

The report reaffirms that patients with persistent asthma require both long-acting control medications and acute rescue therapies as needed, with inhaled corticosteroids recognized as the most effective agents for chronic control in all age groups.

The guidelines also include new recommendations on the use of leukotriene receptor antagonists and cromolyn sodium for chronic asthma control, long-acting beta agonists as adjunctive therapy with inhaled corticosteroids; omalizumab (Xolair) for severe asthma, and on the use of albuterol, levalbuterol, and corticosteroids for acute exacerbations.

"The new scientific evidence that makes up the guidelines that we're releasing today point to one truth: asthma control is achievable for nearly every patient," said Elizabeth Nabel, M.D., director of the National Heart, Lung, and Blood Institute.

"With appropriate medical care, healthy environments, and well-informed and empowered patients asthma can be controlled and patients can lead full active lives," she said in a media briefing.

The guidelines call for assessing and monitoring asthma with multiple measures of asthma severity, including frequency and intensity of symptoms, lung function, and limitations of daily activities as well as future risk (risk of exacerbations, progressive loss of lung function, or adverse effects from medications).

The guidelines emphasize that some patients with intermittent asthma may still be at high risk for frequent severe exacerbations.

The guidelines also stress the importance of educating patients about self-assessment of symptoms and management of asthma, including use of a written action plan with instructions for daily treatment as well as acute and chronic symptoms.

New recommendations emphasize bringing asthma education into community setting such as schools, pharmacies, and homes.

The report includes recommendations on control of environmental asthma triggers, with an emphasis on multiple approaches to achieving control, and expands information on treatment of co-morbidities such as rhinitis and sinusitis, gastroesophageal reflux, overweight or obesity, obstructive sleep apnea, stress, and depression.

The report also describes promising new avenues for research into improving asthma management, including tailoring treatment to the asthma phenotype and genotype of individual patients.

"Research is beginning to help us identify genes that influence how well certain patients respond to certain asthma medications," said James Kiley, Ph.D., director of the NHLBI Division of Lung Diseases.

"This information is helping us move toward providing personalized treatment for asthma based on a patient's individual characteristics."

The report, titled Expert Panel Report 3:Guidelines for the Diagnosis and Management of Asthma, is available free of charge at the NHLBI web site Additional Asthma Coverage Primary source: National Heart, Lung, and Blood Institute Source reference: Expert Panel Report 3:Guidelines for the Diagnosis and Management of Asthma

Asthma and pylori

We rush for H. pylori eradication so that the risk of gastric ulcer and cancer may decline, but we may be paying back in another coin!

H. pylori negativity predicted a significantly increased risk of early-onset asthma, asthma recurrence, and asthma severity in children, Martin J. Blaser, M.D., of New York University, said at the Infectious Diseases Society of America meeting.

H. pylori also had an inverse association with a history of wheezing, allergic rhinitis, eczema, dermatitis, and rash, he said.

Investigators explored the hypothesis using data from the 1999-2000 National Health and Nutrition Examination Survey, the most recent version of the survey to include test results for H. pylori. The NHANES database included information on 3,327 participants ages three to 19.

Comparison of H. pylori status and asthma history showed that participants who tested positive for the bacterium were 35% less likely to have any history of asthma (OR = 0.65; 95% CI = 0.43-1.01) and 44% less likely to have asthma onset before age five (OR = 0.56; 95% CI - 0.37-0.87).

Among participants ages three to 13, H. pylori seropositivity was associated with a 53% reduction in the relative risk of asthma (OR = 0.56; 95% CI = 00.37-0.87).

"We started out just looking at asthma, but because we had data on all these other conditions, we decided to look at them as well," said Dr. Blaser. "What we found is that H. pylori had an inverse association with all of them, all of these essentially allergic disorders."

"The findings are consistent with the hypothesis that H. pylori protects against all of these conditions, and therefore, the disappearance of H. pylori is fuelling, in part, the rise in these conditions.

The data don't prove that, but they are consistent with the hypothesis that H. pylori protects against asthma, possibly by priming the immune system in some way," said Dr. Blaser. The reduced likelihood of wheezing, allergic rhinitis, eczema, dermatitis, and rash suggests H. pylori has a broader protective role that encompasses a variety of manifestations of atopia, he added.

The findings also support the hypothesis that H. pylori, as the dominant species when present in the stomach, affords natural protection against gastroesophageal reflux disease and, by extension, conditions associated with GERD. Dr. Blaser noted that GERD and asthma have a well-documented association.

The results also are consistent with findings that Dr. Blaser and colleagues reported earlier in 2007 (Arch Intern Med 2007; 167:821-827).

Also based on NHANES data, that study demonstrated a significant inverse association between H. pylori seropositivity and asthma history in adults, particularly childhood-onset asthma. (See: H. pylori May Offer Kids Asthma Protection).

APPENDIX HAS A PURPOSE!

For many people, professionals or not, appendix is “a useless, troublesome, worm-shaped unnecessary addition to the human body”. For generations, the appendix has been dismissed as superfluous. Doctors figured it had no function. Surgeons removed them routinely.

People live fine without them.
Appendicitis is a nasty contributor of morbidity and mortality. When infected, the appendix can turn deadly. It gets inflamed quickly and some people die if

Now, some scientists (surgeons and immunologists at Duke University Medical School) think they have figured out the real job of the troublesome and seemingly useless appendix: It produces and protects good germs for your gut.