compare penis enlarement pills

United Kingdom DVD Region In UK, the DVDs and DVD players that are manufactured and sold are coded for Region 2, since UK falls in the Region 2 code. These local DVD players are able to play only the DVDs that have the region code 2 marked on them. However, regionfree or code free DVD players will be capable of playing back a DVD from anywhere in the world. It is perfectly legitimate to own and use a region free DVD player in the UK; however it should not be misused for illegal activities. United Kingdom's Video and TV Format The video and television format used widely in UK is PAL standard, however, in certain products, NTSC standard is also available. The Pal and NTSC standards are incompatible and are limited to playing only the same format discs. This problem is overcome by using a regionfree DVD player in the UK that has the provision for switching between PAL and NTSC, as per the disc requirement. Electricity Facts for the UK The electricity supply in UK is 220-240 volts and all the local appliances are designed to run at this voltage. However, an American make of DVD player would normally not be able to operate in this voltage, since it is designed for 110 volts. To overcome the differences in voltage supplies for different parts of the world, some of the regionfree DVD players have the dual voltage feature, which enables the customer to use his DVD player anywhere in the world. A Variety of Features for UK Codefree DVD Players Most of the regionfree DVD players in the UK come with some great standard features, some of which include language choice, which makes it possible to select video scenes, menus, audio tracks and subtitle tracks automatically. Special effects for playback can be used for the functions called freeze, slow, step, scan and fast. The parental lock facility can enable parents to restrict the access of their children to play back certain discs. Programmability, random and repeat play, and digital audio output are other great features. They can also recognize DTS Digital Surround audio tracks. Also available are the wall mountable DVD players that can be good space savers around the house, and the portable DVD players that can be taken along in a car. Advanced Features of Code Free DVD Players Some of the more expensive code free DVD players in the UK have certain enhanced features, such as playback for video CDs and super video CDs, MP3 CDs, MP3 DVDs, laser discs, CDVs, and picture and photo CDs. They can also play back video files in unique formats like MPEG-4 and DivX. These DVD players can give a better picture quality through the component video output and progressive scan component output (YUV or RGB). They also have multi lingual on-screen display feature, reverse single-frame stepping and reverse play at normal speed. They can provide a perfect digital picture quality using SDI, DVI, or HDMI digital video outputs. They have a 6-channel analog output using MLP, Dolby digital or DTS. The advanced models also have a Digital Zoom feature that gives a 2 × or 4 × enlargement of part of the picture. There is a wide choice of brands available, and the information about the models and their pricing can be obtained from the Internet easily. Web sites are springing up everywhere that offer a lot of information related to types of codefree DVD players and their features, rates, and availability. The commonly available brands include Toshiba, Samsung, Sony, Panasonic, Pioneer, Philips, Nissan, Yamada, Denon, and several others. The price range of code free DVD players in the United Kingdom varies widely according to the choice of features in each brand. To state broadly, one can buy a DVD player from around $90 to $800 based on one’s choice and requirement. No matter where you live, you're sure to find the regionfree DVD player that's right for you. herbal natural pennis enlargement vigrx enhancement com enlargment penis penis pump free magna rx enlargement manhattan penis surgeon penis enlarement review vimax penis enlargement video best penis enlargment surgery

compare penis enlarement pills

THE RESPIRATORY SYSTEM Intake of oxygen and removal of carbon dioxide are the primary functions of the respiratory system. The respiratory system carries out these life-sustaining acts in close coordination with the circulatory system. Most of the time, we remain blissfully unaware of these automatic functions. The respiratory organs deliver oxygen to the circulatory system. The circulatory system transports the oxygen to all body cells. Oxygen is used by cells to liberate the energy needed for cellular activities. The respiratory system also removes carbon dioxide. Thus, the circulatory system prevents the buildup of this lethal waste byproduct in the body tissues. Irreversible damage to tissues can occur if the respiratory system is halted even for a few minutes. This can cause failure of all the other body systems. The consequence is death! NOSE COMMENCES THE RESPIRATORY PROCESS The respiratory system begins from the nose. It ends in the lungs. The respiratory system is broadly divided into two parts, viz., the upper and the lower respiratory tracts. The upper respirator tract is made up of the nose and the throat (pharynx). The lower respiratory tract includes five organs. They are the voice box (larynx), and the windpipe (trachea), bronchi, bronchioles and the lungs. The trachea splits into the two branches called bronchi. The bronchi further gets divided into further smaller branches called bronchioles. The lungs are a pair of spongy saclike organs. The bronchioles, bronchi, trachea, larynx, pharynx and the nose transport air to and from the lungs. It is the lungs that interact with the circulatory system for delivering oxygen and removing carbon dioxide from the lungs. THE RESPIRATION PROCESS Respiration is a two-pronged process. It involves the respiratory and the circulatory systems. Respiration connotes the coordinated functioning whereby the cells are delivered oxygen and the lethal carbon dioxide is removed. The first phase: The nose begins the first phase of respiration. This is done with inhaling or inhalation (breathing in). The process brings in air along with oxygen from outside the body into the lungs. From the lungs, oxygen goes via the blood vessels to the heart. The heart pumps the oxygen-rich blood to all parts of the body. The first phase of respiration ends with the oxygen moving into the cells from the bloodstream. The second phase: The second phase commences after the oxygen gets into the cells. The cells use the oxygen to produce energy. This independent process is called cellular respiration. It produces the byproduct -- carbon dioxide. The accumulated carbon dioxide now moves from the cells to the bloodstream. Next, the bloodstream transports the carbon dioxide to the heart. Then, the carbon dioxide-laden blood is pumped back to the lungs. The third phase: Again the nose comes into picture during this stage. The lungs push the byproduct to the nose from where it is exhaled or breathed out. This is the final or the third stage when the body gets rid of the carbon dioxide. At the end of the third stage or the entire respiratory cycle another one starts automatically. OTHER FUNCTIONS OF THE RESPIRATORY SYSTEM The respiratory system further regulates the balance of acid and base in tissues. This balancing act is crucial for the normal functioning of cells. It protects the body against disease-causing organisms and toxic substances inhaled with air. The respiratory system also houses the cells that detect smell. Moreover, the respiratory system assists in the production of sounds for speech. THE OLFACTORY NERVE The brownish olfactory nerve is also called olfactory receptors. The olfactory nerve inside the nose is the main nerve of smell. The olfactory region is made up of thick nasal soft mucous membrane. Its brownish color is because of a pigment. The olfactory nerve ends in minute varicose fibers (several small branches). These fibers ultimately conclude in the epithelial cells. Mentionably, the epithelial cells project into the nasal free surface. The olfactory nerve is the first to know of any chemicals that may enter the nasal passages. The receptors immediately trigger off a signal to the brain. This creates the smell perception. THE ESOPHAGUS Esophagus is a muscular tube. The esophagus carries food from the throat to the stomach. The esophagus and the pharynx situated behind the mouth swallow the food and move it to the stomach. The stomach temporarily stores the food, mixes it with digestive juices, and carries out some digestion. The esophagus also holds the stomach contents in place. Actually, this function is carried out by the lower esophageal sphincter. This sphincter is a muscle. It is located at the lower end of the esophagus. THE PHARYNX The pharynx is a passageway for both air and food. The pharynx connects the nose and mouth with the windpipe (trachea) and the food pipe (esophagus). The pharynx is a muscular tube. The pharynx is located within the neck. The pharynx is lined with a mucous membrane. The pharynx is approximately five inches (13 cm) in length. The pharynx lies in the front of the spinal column. The upper portion of the pharynx is known as nasopharynx. The name arises as it begins in the back of the nasal cavity.. The lower part is oropharynx. It points to that area in the back of the mouth. The pharynx ends at the epiglottis. Epiglottis is a flap of cartilage. Epiglottis prevents food from entering the trachea. However, the epiglottis allows the food to enter the esophagus. Two eustachian tubes connect the pharynx to the middle ear. These eustachian equalizes the eardrums air pressure. The pharynx can be infected via the mouth as well as the nose. Sore throat involves pharynx infection (pharyngitis) or throat inflammation. Pharyngitis can be due to infectious mononucleosis, herpes, and viral infections. The viral infections are German measles (rubella), influenza, and common cold. It can also be caused by bacteria like staphylococcal, streptococcal, chlamydial, and diphtherial. These bacteria multiply cause sore throat by multiplying rapidly within the pharynx. Tonsils and Adenoids Among the adults the pharynx contains the tonsils, while among the children the pharynx contains the adenoids. Tonsils: Tonsils are lymphoid tissues at the back of the throat. Tonsils form a tissue ring around the pharynx or the throat. Tonsils are cells. Tonsils are similar to the bloodstream lymphocytes. Tonsils are embedded in fibrous connective tissues. Tonsils are covered by a single epithelium layer. The lymphoid cells are phagocytic. The cells protect the pharynx from bacteria that can cause diseases. Tonsils may become inflamed and chronically or acutely infected. This condition is called tonsillitis. It is generally caused by streptococcus infection. During tonsillitis and streptococcal, the tissues surrounding the tonsils form pus. Then a whitish coat forms over the tonsils which can appear as white specks. This state is called quinsy. When the pharyngeal tonsils become inflamed they become abnormally large. They are called adenoids. Acute cases of tonsillitis are often treated by antibiotics like penicillin. Chronic recurrent tonsillitis may be treated by tonsillectomy (surgical removal of the tonsils). Adenoids: Adenoids are lymphoid tissue at the back of the throat. Adenoids usually shrink and disappear by adolescence. Enlargement of this tissue is common among children. Such a state can interfere with breathing. Symptoms of enlarged adenoids include restless sleep, snoring, breathing via mouth, and a nasal voice. Earlier, these tissues were removed in children. It was thought that inflamed adenoids led to recurrent colds and infections. Nowadays, this condition is recognized as benign. As a result, there are lesser adenoidectomies. THE LARYNX From the pharynx, the inhaled air moves to the larynx. The larynx is about five inches (13 cm) in length. The larynx is located in the central part of the neck. The larynx is made up of several layers of flexible but tough cartilage, a tissue. Mentionably, during puberty the males experience a protrusion of the cartilage. This enlarged prominent extension at the neck is called the Adam’s apple. FUNCTIONS OF THE LARYNX The larynx primarily transports air to the wind pipe (trachea). Besides, the larynx also helps in producing the sounds. The epiglottis -- a leaflike thin tissue portion of the larynx -- further prevents the food from entering the trachea (thus obviating the possibility of choking). Moreover, the cilia cells as well as the mucous membrane of the larynx also filter air. The cilia cells take the airborne substances towards the pharynx where they are swallowed. The epiglottis: The epiglottis stem is attached to the top and the front portions of the larynx. When the epiglottis remains in a vertical position, it acts like a trap door. This happens during the breathing process. But as a person starts swallowing, a reflexive action forces the epiglottis and the larynx to move near each other toward each other. This coming closer of the epiglottis and the larynx forms a protective seal. As a result, the fluids and food are specifically sent towards the food pipe (esophagus). When the reflexive action doesn’t work: What happens when the reflexive action doesn’t function is that the food can enter the larynx. This happens when one eats the meal fats or when one laughs while swallowing. The result is that there will be a recurrent cough impelled choking effect. At times this apparently simple choking effect can even be life-threatening. The cough is the body’s reflexive action to clear the larynx of the impediment. Whenever such choking takes place, someone must thump the back portion between the shoulder blades several times. This will help the person to get over the choking effect. The Heimlich maneuver: The Heimlich maneuver clears the windpipe of obstructions like food or fluid. The first-aid providing person applies thrusts in quick and in upward motion at the patient’s abdomen. The objective is to expel the object stuck at the trachea (windpipe). Standing behind the victim, the person keeps both his arms across the patient’s waist. Then, he places the fist of one hand below the rib cage and a bit above the navel. All the while, he keeps the thumb against the patient’s body. He uses the other hand for holding the fist and for applying pressure. Next, he puts quick pressure on the abdomen. The pressure is put in an inward and an upward motion. This fast recurrent action forces the lung air to get rid of the substance blocking the windpipe. However, in cases where the patient cannot stand still, is overweight, faints following the choking effect, the Heimlich maneuver is done in a different manner. The patient is made to lie face down. The first-aid provider carries on the process with the heel of a hand. Important: Nonetheless, it is important that the person does not put undue pressure on the rib cage. This is especially true when the patient is a child or an elderly person. Too much pressure can break ribs. Pertaining to pregnant woman or overweight people, the first-aid provider must place his hands only on the lower half of the breastbone (sternum) while carrying out the maneuver. In acute choking, tracheotomy (a surgical procedure) is undertaken to carry out bypass of the larynx. This operation brings in air to the trachea. TRACHEA, BRONCHI, AND BRONCHIOLES The trachea is another tube measuring approximately six inches (15 cm). The trachea is located below the larynx. From the larynx the air passes on to the trachea. About 20 sturdy C-shaped cartilage rings constitute the trachea. These rings help to keep the trachea open. In the process, air gets transported unhindered. While the unfastened cartilage is located at the trachea’s back portion, their ends are linked to each other by muscle tissues. Bronchi & bronchioles: The trachea base is situated at the portion where the neck meets the body trunk. At this juncture, the trachea splits into the right and the left bronchi. These bronchi transport air to the right and left lungs respectively. Inside the lungs, these bronchi again break up into smaller tubes -- the bronchioles. In fact, the respiratory system’s cleansing process is carried out by those bronchioles that are situated at the initial part, bronchi, and the trachea. These organs carry out the cleansing process via the mucous membrane linings as well as the ciliated cells. These cilia and the lining push the mucus upward towards the pharynx. Alveoli & capillaries: Alveoli are minute sacs inside the lungs. Most of the alveoli are lung tissues. Alveoli are formed by the bronchioles as they divide several times. The alveoli along with the bronchioles resemble a tree. The alveoli are only 0.02 inches (0.5 mm) in diameter. There are about 150 million alveoli in each lung. The alveoli carry out a dual function. While providing oxygen to the circulatory system, they also remove carbon dioxide from the lungs. The thin elastic alveoli walls expand when air moves into them. The walls collapse to exhale the air. The alveoli remain in clusters like the grapes. Each cluster is surrounded by capillaries. The capillaries are thin-walled and form a dense net of tiny hairs. The alveoli wall air is generally located 0.2 microns away from the blood carried by the capillary. Mentionably, the alveoli have more oxygen concentration then the capillaries. So, oxygen disseminates to capillaries from alveoli. Through the capillaries, oxygen goes to the larger vessels. These vessels then transport the oxygenated blood to the heart. Next, the heart pumps the cleaned blood to the other parts of the body. Macrophages: Among the alveoli are interspersed many macrophages. The macrophages are blood cells. These large white cells act as the last sentinels of the respiratory system among the alveoli. The macrophages segregate the foreign elements which may have passed through the earlier filtration process. This last line of defense ensures that the alveoli are not infected. Carbon dioxide disposal: The cells from across the body dump Carbon dioxide as a waste product. It is dumped in the bloodstream. The blood carries Carbon dioxide into the heart. From the heart, the Carbon dioxide moves to the alveolar capillaries. Notably, the capillaries have more concentration of carbon dioxide than the alveoli. So, carbon dioxide gets diffused into the alveoli from the capillaries. When a person exhales, the Carbon dioxide is forced back via the respiratory routes. The gas is then thrown outside the body. vigrx results natural penis enlargement pill penile enlargement pic online vigrx male pnis enlargement natural penis enhancement exercise free penis enlargement pills free natural pnis enlargement compare penis enlarement pills

The causes of obesity that health experts present are quite a number of factors to consider for the concerned consumer, and more studies are ever made to make the condition even more complicated. Developing awareness of the correlated causes of obesity though may encourage people to be more attentive to their personal wellbeing. Here are some of the major causes of obesity: * eating too much fat giving excess energy stored in the body * too much sugar, starch or other carbohydrates which are also important energy sources convertible into fats * too much of preprocessed products (no-cook or easy-to-cook) that often have more fat or sugar, for preservation (sweet beverages, soda, cakes, ice-cream, fast food and tetra/foil-packed snacks) * eating too much food all together, including proteins that could also be converted to fat if over-consumed * irregular eating habits, like eating much at one time, little at another time, long span in-between some meals, consuming food with high doses of sugar at some times while no sugar at other times – producing an uncontrollable appetite physiology making you deposit more fats in your body * consuming too much high-calorie alcoholic drinks * lack of vitamins and minerals, and a generally unhealthy diet decreasing the body’ capacity to burn extra amounts of fats and sugar * inactive ‘sitting’ lifestyle wherein the body burns little fat and sugar, and * boredom in daily routine life resulting to excessive eating as a way of getting entertainment Some specialized studies on health also reveal unanticipated causes of obesity or excessive body weight: * hypothyroidism decreasing food metabolism, appetite loss and modest weight gain wherein protein deposits in the body cause fat accumulation and fluid retention * essential fatty acid or good fats (flaxseed oil) deficiency needed by the body to maintain the body’s metabolic rate and also causing cravings for fatty foods * food sensitivity occurring many hours later as bloating and swelling caused by fermentation of foods, particularly carbohydrates, in the intestines, inflammation and the release of certain hormones that increase fluid retention and weight gain * cushing’s syndrome producing excess cortisol hormone and resulting to rounded ‘moon face’ and ‘buffalo hump’ * use of certain prescription drugs like steroids, non-steroidal anti-inflammatory drugs (NSAIDs), antidepressants, diabetic medications, hormone replacement therapy and oral contraceptives containing estrogen causing fluid retention and increased appetite * prior kidney, heart or liver disease causing fluid retention and weight gain * organ enlargement, such as from an ovarian cyst, and obstruction of lymph fluid * blood sugar imbalance due to rapid fluctuations in blood sugar levels, then the need for insulin to store sugar away and lower the sugar level, finally triggering cravings for more sweets, and * emotional eating (BED/ binge-eating-disorder) to respond to stress or depression affecting eating habits and causing weight gain These are other causes of obesity that are not easy to control. It is therefore up to us to controllably manage our activities and consumption against storing more than we can burn-off. vigrx hoax vimax penis enlargement surgeon truth about penis enlagement prosolution pennis enlargement pills enlargment manhattan penile surgeon top penis enlargement pill penis enhancement stretcher penis enhancement tip compare penis enlarement pills

The Prostate: Part I – BNP What is situated below a body of water, has four zones and is commonly associated with venial pleasures. No it is not some romantic European city, but rather a walnut sized male organ that serves important procreative functions. It also happens to be an organ that plagues men as we age. This organ or gland is the prostate. This is the first of two articles on the male prostate. This article will focus on a disease process that affects older men, something we refer to as benign prostatic hyperplasia (BPH). BPH is a non-cancerous growth in the size of the prostate gland that impairs the flow of urine out of the bladder. The second article will focus of prostate cancer. But first a little about the small yet important male organ. The gland is located just below the bladder. It usually measures one inch by one-and-a-half inches (approximately the size of a walnut). It surrounds the urethra (the tube that takes urine out of the bladder). It is responsible for producing a fluid important in male sexual function. In the past the prostate was described as having “lobes”, but today we refer to it as having concentric zones. These zones are important both on an anatomical as well as histological level. We can separate pathology along these zones as well. For instance most all cancers occur in the peripheral zone while the benign process of enlargement occurs almost exclusively in the transitional zone (which only occupies about 5% of the total prostate volume). The prostate gland is also made up of different cell types. Cancer cells develop from the epithelial cells, but it is the interaction with stromal cells that is important in the behavior of the cancer. BPH develops from an interaction between these cells as well, but it is complex and poorly understood. Testosterone and other hormones and their interactions with this gland are hot topics of research in understanding prostate disease. The prostate gland produces most of what is found in the male ejaculate. The average volume is about 3 mL. This is less than a teaspoon and only 1% of it is sperm. The majority of the semen volume is made of products of the seminal vesicles and the prostate. The male ejaculate is very rich in potassium, zinc, citric acid and fructose. Along with these substances it also contains prostaglandins. There are many other unusual substances found in the semen. Not all is know about their function or purpose. This important male organ is a complex mix of anatomical structures and cell types that make it possible for human reproduction. However beyond the reproductive years of men, this organ becomes one of burden rather than usefulness. We will discuss the finer points of BPH and how to best avoid it and if plagued with it, treatment options. BPH typically affects men from their fourth to fifth decade of life and beyond. Several hormones come into play that have a drastic effect on the transitional zone (the zone that is most central and surrounding the urethra). Namely a metabolite of the male androgen Testosterone called Dihydrotestosterone (DHT) plays a big part on the enlargement of cells of the prostate and the encroachment on the urethra. There are several signs and symptoms that correlate with BPH and they are: slow urinary flow, the urge to urinate all the time, nighttime urination, enlargement and distension of the bladder with continuous urine leakage (incontinence) and urinary obstruction. Autopsies suggest that more than 90% of men older than 70 years have BPH. The average age for symptomatic development is about 65 years for white Americans and about 60 years for African-American men. Ways to prevent the effects of DHT on the prostate gland and the ensuing enlargement are via medications that block the enzyme 5-alpha-reductase, which converts Testosterone to DHT. Proscar is such a drug commercially available through a pharmaceutical company. Proscar works on blocking the effects of androgens on the epithelial cells and can actually shrink the size of the prostate making some of the symptoms of BPH resolve. Alternatively two FDA approved drugs that aid in symptoms of BPH (but act differently than Proscar) are Hytrin and Cardura. Both Hytrin and Cardura are drugs in the alpha1-blocker class. Originally researched as a centrally acting blood pressure reducer for patient with hypertension, it was discovered that this drug would actually relax the prostate tissue surrounding the urethra making symptoms of BPH resolve. Side effects generally include low blood pressure, dizziness, and nasal stuffiness. While neither of these two drugs will “cure” or reverse the process, they certainly do provide symptom relief for the patient plagued with BPH. Another way to treat this disease and a more natural approach is the use of herbs know for their anti-androgenic effects on the prostate. These include the well-studied Saw Palmetto herbal extract that blocks 5-alpha-reductase in the same manner as the prescription drug. Saw Palmetto taken in a standardized dose of 160mg twice daily has shown increased urine flow, with minimal side effects. Saw Palmetto is an herb indigenous to the Lowcountry of Georgia and South Carolina. Pygeum Africanum is shown to do the same yet it is not as effective and there is a fair degree of stomach symptoms. Pygeum is derived from an African evergreen tree. Stinging Nettles (Radix urticae) is another herb used widely in Europe for prostate health that has been shown to lower the residual urine volume in men with enlarged prostates. These phytotherapeutics (plant derived medicines), used and described by the Egyptians as far back as the 15 Century B.C., have a common compounds called phytosterols. The most effective phytosterol is beta sito sterol for BPH. None of the medications or herbs has been shown to prevent prostate cancer. These prescription medications and herbs are for the treatment, reduction in size or prevention of the benign process of enlargement of the prostate. Prostate cancer prevention and treatment is by other means and the subject of the next article. Besides the herbal and drug therapies there are a few surgical therapies worth mentioning. These include the most common transurethral resection of the prostate or TURP. This is where under the care of an urologist the constricted urethra within the prostate gland is “reamed out” thus mechanically or surgically widened the opening. A variant of this is the transurethral incision of the prostate (TUIP) where an incision rather than resection of the tissue is performed. A suitable procedure for patients with prostates 100 mL in volume. This involves an abdominal operation and removal of the whole prostate. Of course symptoms mentioned above for TURP are of greater frequency with this more radical procedure. There is also thermotherapy (a type of microwave treatment) that alleviates irritative symptoms, but not much is available in long-term results in the medical literature. And finally stent placement is an option. This can be used in selected cases of patients with a poor general condition and in the non-operative candidate. Symptoms of BPH include: Obstructive symptoms: Hesitancy in initiating voiding (trouble getting started) Weak urinary stream, prolonged voiding Post-voiding dribbling (mild incontinence) Sensation of incomplete emptying Nocturia (night time urination) Overflow incontinence Acute urinary retention (very painful condition) Irritative symptoms: Dysuria (discomfort in urination) Frequency Urgency Scoring BPH: The American Urological Association Symptom Index (AUASI) and International Prostate Symptom Score (IPSS) are now considered the gold standard measurement tools for the assessment of BPH symptoms and response to treatment. Both questionnaires can be used by a physician in a clinical practice to quantify the subjective symptoms of BPH and monitor therapies. Part II in this series will cover annual examination of the prostate, blood testing, prostate cancer. It will also cover prevention and treatment of prostate cancer. Reference: http://www.prostatehealth.com Lowe, FC. Et al, Phytotherapy in treatment of benign prostatic hyperplasia: a critical review. Urology 48:12-19, 1996 Dreikorn, K. et al, Stellenwert von Phytotherapeutica dei der Behandulng der benighnen Prostatahyperplasia. Urologe (A)34:119-129, 1995 Fitzpatrick, J.M. et al, Phytotherapeutic Agents in Management of Symptomatic Benign Prostatic Hyperplasia. Urological Clinics of North America. 22:407-412, 1995 Wilt T, Ishani A, Mac Donald R.. Serenoa repens for benign prostatic hyperplasia. The Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD001423. DOI: 10.1002/14651858.CD001423. [Research by Sagalowski and Wilson, 1998] © 2005 pennis enlargement pills home penis enhancement penis enargement technique vimax penis enhancement fact plastic surgery pennis enlargement vig rx review male penile enlargment compare penis enlarement pills

Hypertension (high blood pressure) affects about 50 million individuals in the United States. Of these, about 70% are aware of their diagnosis, but only about a half of those are receiving treatment and only 25% are under control using 140/90 as the cutoff guideline. A new category has been designated as “pre-hypertension” and that is when the blood pressure is 120-139 systolic over a diastolic of 80-89. Blood pressure readings vary greatly in individuals depending on the time of day, where the patient is at when they get it checked, how soon they have eaten, smoked, or even drank a cup of coffee. A diagnosis of hypertension should not be based on one reading unless that reading is extremely high and/or there is evidence of end organ damage such as renal (kidney) or heart involvement. The diagnosis of hypertension should be made only after two or more readings on two or more office visits. The frightening thing about hypertension is that it usually does not cause any symptoms. Unless you are getting your blood pressure regularly checked, you could be walking around for years with elevated blood pressure and not know it. That is why it is referred to as the silent killer. If you are being diagnosed with hypertension for the first time, there are certain tests that your doctor should order. Blood tests including a complete blood count, fasting lipids (cholesterol), fasting blood sugar, renal (kidney) functions, liver functions, and electrolytes (potassium, sodium levels), along with a urinalysis should be checked. You should also have a chest xray to check for enlargement of your heart which can occur over time with hypertension, and an electrocardiogram to check for any cardiac (heart) abnormalities. Treatment of hypertension is multi-faceted. Lifestyle modification should include smoking cessation, daily exercise implementation, dietary changes, alcohol moderation, and sodium restriction. One should consume a diet with plenty of vegetables, fruit, and low dietary fat. Exercise should consist of daily brisk exercise such as walking at least 30 minutes per day most days of the week. A 10% weight loss can make a significant difference in blood pressure readings. Alcohol consumption should be limited to no more than two drinks per day (24 oz. of beer, 10 ounces of wine, or 3 oz. of “hard” liquor such as gin, whiskey, or vodka). You should also reduce salt intake to no more than 2.4 grams of sodium per day. I tell my patients not to add any salt to any foods and restrict high sodium items. If your blood pressure is not extremely elevated, say in the 145/95 range, and you are determined to make substantial lifestyle changes, then perhaps you can bring your blood pressure down to normal range with these measures. I always give my patients in these situations the option to try lifestyle modifications first if they wish as long as their blood pressure is not seriously high. Most patients, however, end up having to take a medication for their hypertension. There are a wide variety of medications available that we can prescribe and the majority of patients require more than one type of medication to reach a desired blood pressure goal. Discuss with your physician the side effects of each and what would be the most suitable medication for you. Medications have come a long way for treating blood pressure in the past twenty years and the side effect profiles are much more favorable than they used to be overall. I have found that a good portion of my patients have an aversion to taking a pill everyday for the rest of their lives. But what I tell them is that they ought to look at it like a vitamin, or better yet, an insurance policy. If it prevents you from having a heart attack or stroke and from either premature death or perhaps becoming confined to a wheel chair and not being able to take care of yourself, then taking a daily pill or two should not even be an issue. Don’t be afraid to talk to your doctor about treatment and asking about the tests I have discussed. Most importantly, please get into your physician at least once a year to get your blood pressure taken, and more often if it has been on the high end of normal. Copyright 2006 Ted Crawford