What is this Condition?

Premature ejaculation refers to a man’s inability to control his ejaculatory reflex during sexual intercourse, resulting in persistently early ejaculation. This common sexual disorder affects men in all age­groups.

What Causes it?

Premature ejaculation may result from anxiety and is often linked to previous sexual experiences. Other psychological factors may include ambivalence toward or unconscious hatred of women, a negative sexual relationship in which the man unconsciously denies his partner sexual fulfillment, and guilty feelings about sex.

Premature ejaculation can also occur in emotionally healthy men with stable, positive relationships. Rarely, it may be linked to an underlying neurologic disorder, such as multiple sclerosis, or to an inflammatory process such as prostatitis.

What are its Symptoms?

The man with this disorder may be unable to prolong foreplay, or he may be able to prolong foreplay but ejaculates as soon as penetration occurs. Some men may exhibit signs of severe inadequacy or self­doubt in addition to general anxiety and guilt. With other men, the complaint lies solely with the sexual partner, who may believe that the male is indifferent to her sexual needs.

How is it Diagnosed?

The physical exam and lab test results are usually normal because most men with this complaint are quite healthy. However, a detailed sexual history can be valuable in making a diagnosis. A history of adequate ejaculatory control without evidence of psychological problems suggests an organic cause.

How is it Treated?

Masters and Johnson have developed a highly successful, intensive program that combines insight therapy, behavioral techniques, and experiential sessions involving both sexual partners. The program designed to help the man focus on the sensations of an impending orgasm, continues for 2 weeks or longer and typically includes:

• mutual physical exam, which increases the couple’s awareness of anatomy and physiology while reducing shameful feelings about sexual parts of the body

• sensate focus exercises, which allow each partner to caress the other’s body, without intercourse, and to focus on the pleasurable sensations of touch

• Semans squeeze technique, which helps the man gain control of ejaculatory tension by having the woman squeeze his penis every few minutes during a touching exercise that is designed to delay ejaculation.

Another method, called the stop-and-start technique, involves intercourse with pelvic thrusting by the woman, who is in the superior position. She continues thrusting until orgasmic sensations start, then stops and restarts to help her partner control ejaculation. Eventually, the couple is allowed to achieve orgasm.

What can a Man with Premature Ejaculation do?

• Be aware that this is a common disorder that does not reflect on your masculinity.

• Be aware that the condition is reversible

Senile dementia is primarily a disorder of the elderly. Pre-senile dementia, or Alzheimer’s disease, is either the same or a similar disorder that occurs in someone under 60. It may be due to an underlying disorder such as hypothyroidism or a brain tumor , and in such cases it can sometimes be successfully treated if the cause is discovered in time. If this is not the case, it may be due to a progressive loss of brain cells, the cause of which is not known. Reasoning powers, memory, and other thought processes tend to deteriorate more quickly than they do in senile dementia, and the disease in a comparatively young person can be fatal within about five years.

Infections of the nervous system are less frequent than infections of other systems such as the respiratory system, because the brain and spinal cord have no contact with the outside. Those infections that do occur gain entry through the bloodstream, the air spaces in the ears or sinuses, or through fractures caused by head injuries. Most nervous system infections cause obvious, serious illness. Early diagnosis is important, since prompt treatment can save a life and prevent long-term damage to the brain, the spinal cord or the nerves. You should familiarize yourself with the symptoms of this type of infection so that you can act quickly and decisively if anyone in your family gets one,

This type of anemia frequently complicates other diseases. Disorders that often bring on this type of anemia include rheumatoid arthritis hepatitis and tuberculosis. It can also occur in anyone who has an acute infection such as pneumonia .The symptoms of anemia of chronic disease are the same as those for other forms of anemia, combined with the symptoms of the underlying disease. It cannot be treated, except by transfusions, but it should improve when the disease that produces it improves in response to treatment.

What do Doctors call these Conditions?Hypocalcemia, hypercalcemia

What are these Conditions?

Calcium imbalance results tram too much or too little calcium in the blood. Too little calcium is called hypocalcemia; too much calcium, hypercalcemia. Altered calcium levels may interfere with how the body’s cells do their job as well as the formation of bones and teeth, blood clot­ting, transmission of nerve impulses, and normal muscle contraction.

Nearly all (99%) of the body’s calcium is found in the bones; the remaining 1 % exists in the blood. The body’s nervous system relies on this blood-borne calcium supply to function properly. The parathyroid glands (four small glands located in the neck) regulate blood calcium by controlling how much of it is taken up by bone, absorbed from the digestive system, and excreted in urine and feces.

What Causes Calcium Deficiency?

Causes of low calcium levels include:

• too little parathyroid hormone secretion, caused by injury, disease, or surgery

• poor absorption or loss of calcium from the digestive tract, caused by severe diarrhea or laxative abuse - or, sometimes, from lack of vitamin D or parathyroid hormone, or too little acid in the stomach

• consuming too little calcium and vitamin D

• severe infections or burns

• overcorrection of another imbalance called acidosis

• a poorly functioning pancreas

• kidney failure

• too little magnesium.

What Causes Calcium Excess?

Causes of excessive calcium include the following:

• overactive parathyroid glands

• too much vitamin D

• tumors that put calcium into the blood

• multiple fractures and prolonged inactivity

• bone cancers.

What are the Symptoms of Calcium Deficiency?

Because too little calcium causes irritated nerves and muscle spasms, the person may feel a tingling around the mouth, twitching, wrist spasm, seizures and, possibly, irregular heartbeats.

When examining a person, a doctor or nurse will look for two reliable signs of calcium deficit:

• Chvostek’s sign - a tap on the facial nerve by the earlobe that causes the person’s upper lip to twitch

• Trousseau’s sign - a blood pressure cuff applied around the arm and inflated, causing the person’s thumb and fingers to twitch.

What are the Symptoms of Calcium Excess?

The person may develop weakness, decreased muscle tone, lethargy, loss of appetite, constipation, nausea, vomiting, dehydration, extreme thirst, and frequent urination. A severe condition may lead to irregular heartbeats and, eventually, coma.

How are they Diagnosed?

The doctor will order blood tests and urine tests to measure calcium levels and determine if symptoms are related to a calcium imbalance. The doctor will perform an electrocardiogram to determine the effects of the imbalance on the person’s heart.

How is Calcium Deficiency Treated?

If calcium deficiency is mild, treatment may simply be a change in diet. The doctor may suggest a diet that includes more calcium, vitamin 0 (found in most multivitamins), and protein, possibly with oral calcium supplements.

If calcium deficiency is severe, the doctor may prescribe intravenous administration of calcium gluconate or calcium chloride. A chronic problem also requires vitamin 0 supplements to induce the digestive system to absorb the calcium.

How is Calcium Excess Treated?

Treatment primarily involves getting rid of the excess calcium by giving intravenous fluids, which promote calcium excretion in urine. The doctor may also prescribe diuretics to aid excretion of calcium and other drugs if there are complications, such as excessive vitamin o or certain tumors.

What is this condition?

A shortage of white blood cells may involve granulocytes or lymphocytes.

A low granulocyte count can occur at any age and can lead to infections and sores in the throat, digestive tract, and other mucous membranes and on the skin. A low lymphocyte count, a rare disorder, is a deficiency of white blood cells produced mainly in the lymph nodes.

When the total white blood cell count falls to dangerously levels, the body is left unprotected against infection. The prognosis depends on the underlying cause and whether it can be treated.

What Causes this Condition?

A low granulocyte count may result from:

• radiation therapy or cancer drugs
• hypersensitivity to certain antibiotics and heart drugs
• disorders such as aplastic anemia, bone marrow cancer, some hereditary disorders, infectious mononucleosis, and certain viral and bacterial infections
• trapping of blood cells in the spleen.

A low lymphocyte count may result from:

• a genetic abnormality
• radiation therapy or cancer drugs
• dysfunctional lymphatic vessels in the bowel
• an excess of steroid hormones, caused by use of adrenocorticotropic hormone or steroids, stress, or congestive heart failure
• disorders such as Hodgkin’s disease, leukemia, aplastic anemia, sarcoidosis, myasthenia gravis, lupus, protein-calorie malnutrition, kidney failure, terminal cancer, and tuberculosis.

What are its Symptoms?

A low granulocyte count typically causes slowly progressive fatigue and weakness followed by sudden onset of overwhelming infection (heralded by fever, chills, rapid pulse, anxiety, headache, extreme exhaustion), mouth and throat sores, ulcers in the colon, pneumonia, and blood infection, possibly leading to mild shock. If the low count results from a drug reaction, infection symptoms develop suddenly, without slowly progressive fatigue and weakness.

A low lymphocyte count causes swollen glands, an enlarged spleen, and enlarged tonsils, along with signs of an associated disease.

How is it Diagnosed?

To diagnose a low white cell count, the doctor takes a thorough history and performs a physical exam to look for signs of an underlying disorder, orders appropriate blood cell tests, and, if necessary, obtains biopsy specimens of bone marrow and lymph node tissue for analysis.

How is it Treated?

To treat a low granulocyte count, the doctor must find and eliminate the underlying cause, then control infection until the bone marrow can generate more white blood cells. For many people, this means stopping drug or radiation therapy and starting antibiotics immediately, even while awaiting test results. Treatment may also include antifungal preparations. In a newer treatment, the person receives granulocyte colony-stimulating factor or granulocyte-macrophage colony-stimulating factor to stimulate bone marrow production of neutrophils. Generally, white blood cell production in the bone marrow resumes spontaneously within 1 to 3 weeks.

Treatment of a low lymphocyte count aims to eliminate or manage the underlying cause.