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Peripatetic Column
Dick – Doc
P Madhok*
It is strange that the reproductive system are the days of submission and sublimation.
It is a day of the aggressor and the sexual conquerer. Men want to be like Zorba, the Greek and women secretly desire the skills Andrologist. And this is not talking about the of Cleopatra. Sexual jokes and conquests are openly discussed in cocktail parties and social Embryologist, etc. Andrology has recently have always apportioned the right attention caught the eye of people because of increasing number of patients with erectile failure. The Ellora and Konark caves bear testimony to testis is not only an organ that produces sexual attitudes of yonder years. Vatsyayan’s, sperms but also has hormonal functions, e.g.
the Leydig cells produce testosterone, which sexology. That makes the Andrologist a very important person specially to the middle aged secondary sexual characters. The Andrologist gentry. Man has constantly looked for a good largely deals with male infertility, low sperm count and cases of inadequate erection.
was rampant, the greater the king the larger Erectile failure has long been ascribed to the harem. So obviously aphrodisiacs were nervousness and psychological causes. Only now it is believed that the majority of cases are because of inadequate blood flow into the penis. Enormous amount of research is going unicorns were hunted for the phallic-friendly properties of their single horn. Even recently highlighted this as a speciality hence the specialist is nick named Dick–Doc.
favours from Tribal chiefs by gifting them longer spoken in hush hush tones. It is now considered an important part of ones life.
The science of Andrology has kept up with Magazines are full of tips to men and women as to how they can perform better in bed.
mechanical stimulators, Vacuum pumps were Seduction is now considered an art. There is a clamour for sex education in schools. Gone erection was achieved a small rubber bandwas used at the base of the penis as atourniquet to prevent back flow. Later on Inj.
*Ex. Hon. Paediatric Surgeon, Bai Jerabi WadiaHospital for Children, Parel; Hon. Surgeon, of Papaverine in the penis became popular Arogyanidhi Hospital, Juhu and BARC Hospital, as it could be used by the patients himself.
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Implantation of semi stiff plastics rods in the even unani systems about their own brands corpora cavernosa were popular, and still of sex stimulators. Clearly the last word is have their supporters. Inflatable implants are devices and the pharmaceutical industries.
The Andrologist still has lot of work to do.
pharmalogical advances. After Viagra, which Man is considered old, only when he stops diverts more blood to the penis (also the copulating. That is where the Dick-Doc comes ALBUMINURIA IN HEART FAILURE : A CHARMING NEW RISK FACTOR?
GFR is now considered to be one of the most important factors of an unfavourable cardiovascularrisk profile in patients with heart failure. However, the National Kidney Foundation Kidney DiseaseOutcomes Quality Initiative not only characterizes renal dysfunction on the basis of a reduction inGFR but also on the basis of renal damage, which is assessed by the presence of increased levels ofurinary albumin excretion, the so-called albuminurias.
These studies showed that almost one-third of patients with chronic systolic heart failure mighthave either microalbuminuria or macroalbuminuria.
Reduced GFR and albuminuria are physiologically two different entities. Although in most casesthey coexist, reduced GFR might be present without albuminuria and vice versa. In the CHARMtrials, almost half of patients with macroalbuminuria actually had a GFR above 60 mL/min per 1.73m2. These patients would not have been considered and classified as having renal impairment on thebasis of GFR. Furthermore, mortality risk associated with albuminuria was independent of serumcreatinine or estimated GFR, which suggests that both entities reflect different pathophysiologicalmechanism.
The CHARM trials did not formally test the effect of candesartan on albuminuria and did not testalbuminuria-targeted therapy. However, even with the substantial proportion of missing simplesand the fact that candesartan had no effect on albuminuria in the small subset of patients with serialmeasurements, this observation is interesting.
Until a properly designed, adequately powered study is done, this question is open to debate.
Kevin Damman, Hans L Hillege, Dirk J van Veldhuisen, The Lancet, 2009; 374 : 506-7.
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Source: http://www.bhj.org.in/journal/2009_5104_oct/download/pg552-553.pdf