Delayed or retarded ejaculation is a rare male problem; the far more common issue is premature ejaculation, where men ejaculate too soon. According to sexual health physician and medical sex therapist Dr Vijaysarathi Ramanthan, ‘A delayed ejaculation is when a person has a normal erection but cannot get to a ‘point of inevitability’ (i.e. he cannot not stop ejaculation happening). Long-time masturbators would have developed different points of climax and different source of stimuli (e.g. viewing images on the internet of a girl in a micro bikini on a beach). If this is the case, then it is hard to get that point of climax with sexual intercourse with a real person.’ 

Scientists have found various different causes for the problem – psychological and physiological. Sometimes it’s caused due to various ailments like hypogonadism (decreased functioning of sexual organs), thyroid-related problems or due to prostate surgery. It’s also common among substance abusers like alcoholics and drug users. Some medications like medicine for hypertension and drugs for psychosis can cause this problem too.

Some additional factors which can cause delayed ejaculation include psychological reasons, insufficient sleep, distraction during sex, stress, anxiety, guilt and relationship issues.

Another common reason is frequent masturbation. Sexual arousal is dependent on many things, particularly how the brain reacts to situations. Sexual intercourse and artificial stimulation due to masturbation are very different, particularly the grip and pressure and getting used to masturbation can be bad for actual intercourse.

Now unless delayed ejaculation is being caused due to physiological reasons, there are two simple solutions. One solution is to stop masturbating for a while and see if the problem persists. Another solution is the following sex therapy.

 First, the male partner has to masturbate in front of his partner. The next step involves the woman stimulating the male partner’s penis. The final step involves inserting the male partner’s penis into the vagina a little while before he is about to ejaculate.

In most cases, this simple procedure is known to solve the problem and in time he should be able to climax normally during sex. If this therapy doesn’t help, one should consult a sex therapist or expert. 

The researchers found that vitamin C has strong bactericidal (ability to kill bacteria) against TB bacteria through a study that suggests that it might be worthwhile to explore the addition of vitamin C to standard anti-TB treatment. The results of the study were published today in the journal, Nature Communications.

‘Vitamin C has never been shown to kill TB bacilli,’ William Jacobs Jr, professor of microbiologist at the Albert Einstein College of Medicine in New York and principal investigator of the study, told The Telegraph. ‘The observation that vitamin C can sterilise (laboratory) cultures of drug-susceptible, multi-drug resistant and extreme-drug resistant strains of TB bacilli is striking and totally unexpected,’ Jacobs said in a telephone interview to the Calcutta Telegraph.

Three years ago, microbiologists at AIIMS, Delhi had observed that vitamin C can arrest the growth of TB bacilli and make them dormant.  Jaya Sivaswamy Tyagi and her colleagues at AIIMS had also speculated about the ‘protective role’ of vitamin C against TB through mechanisms that the role of vitamin C to bolster immunity.  The study also suggests that the acidity of vitamin C is dependent on iron. In the experiments, iron came from the culture medium – the nutrients in which TB bacilli is grown. Vit C reduces ferric ion into ferrous ion, which forms a reactive oxygen species that can kill bacteria.  ‘We’re hoping this study will spur interest in testing the addition of vitamin C to current TB treatment regimen,’ Jacobs said.

But medical researchers don’t know whether  this work for human patients.

‘I would call this a proof-of-concept study,’ said Madhukar Pai, an associate professor who leads a Tuberculosis Research Group at the McGill University in Canada. ‘The question is whether we’ll see this effect of oxidative burst occur exactly at the sites of infection when vitamin C is administered orally,’ Pai, who was not associated with either the US or the AIIMS study, told the same newspaper.

What is tuberculosis?

 Tuberculosis is a common infectious disease caused by bacteria called mycobacterium tuberculosis which affects the lungs. Main symptoms of TB are severe cough that lasts for three weeks or longer, bloody or discoloured sputum, night sweats, fever, fatigue and weakness, pain in the chest, loss of appetite, and pain during breathing or coughing. India had the highest total number of TB cases worldwide in 2010 partly due to poor disease management by the private healthcare sector. TB can be prevented by vaccination and maintaining high levels of hygiene. One infected, the patient should follow the medication regimen properly. By not doing so, there are chances of developing resistance to anti-TB drugs resulting in an aggressive form of TB called MDR-TB (multi-drug resistant TB). 

 India, 2 patients succumb every three minutes to TB disease. Urban metros like Mumbai with have it worse because of poor hygienic condition and widespread poverty.  Despite our best efforts to control this disease, mortality has been increasing. What makes it worse are the new drug resistant forms of TB which are leaving many doctors flummoxed. Here are some things you should know about the deadly disease:

Did you know?

Most of us have latent TB foci inside our lungs. We all are exposed to the organism early on in life and would have formed foci of infection in the lungs (primary TB). Our immune system would have contained the infection and prevented us from suffering the disease. It is when our immune system becomes weak for some reason or is overwhelmed by the infection or any other cause, that we suffer the disease (reactivation). The organisms can travel from the foci of infection in the lungs to other sites leading to secondary infection (TB of lymph nodes, spine, etc.).Click here to read more facts.

The company also pleaded guilty to the criminal charges of manufacturing and distributing certain adulterated drugs manufactured at its two Indian facilities and the company agreed to pay a staggering $500 million dollars to resolve false claim allegations. Experts are unanimous that these events will give Indian pharma a bad name and other companies may have to bear the brunt of Ranbaxy’s follies. Incidentally, Ranbaxy is no longer an Indian company and is now owned by Japan’s Diiachi Sankyo.

Hemant Bakhru, an analyst from a brokerage firm told the Economic Times, ‘Indian companies have been under tight scrutiny since the Ranbaxy scandal broke out in 2008. We have seen that the number of inspections by USFDA has substantially gone up, and there have also been surprise visits by them; so Indian companies have been tightening their norms since then.’ 

The US generic market is estimated to be $90 billion out of which India’s share would be somewhere around 6% or $5.4 billion dollars. DG Shah, the Sec General of the Indian Pharmaceutical Association said, ‘Ranbaxy’s mistake was that it deliberately hid the fact, this is a lesson that Indian industry must learn. It must avoid this temptation of covering up wrong doing’ Though warning letters and settlements are not uncommon, what’s worrying is that Ranbaxy’s follies will tarnish India’s image as a safe drug manufacturing country. 

Be prepared

Before you hop into the treadmill it’s important that you are dressed appropriately. Wear a proper t-shirt and shorts/track pants. In short, get dressed ready for a sweaty experience. Also make sure you’ve on a decent pair of running shoes with a good grip on the sole. Do not run barefoot on a treadmill. It’s also a good idea to keep a hand towel handy to wipe off the sweat, especially if you’re using a treadmill in a gym which other people use as well.

Get familiar with the controls

If it’s the first time you’re using the machine ask someone at the gym to show you how it works. Figure out the buttons which are used to increase and decrease speed and inclination. Also figure out the screen indicators which show calories burnt, heart rate, speed, time, inclination and the emergency stop button.

Find the pre-set programs

You should also see which pre-set programs (most new generation ones come loaded with them) are available on the machine because these will help you follow a controlled regime. There are different programs for interval training, controlled inclined climbing, etc. which will help you train and burn more calories. Here are some common pre-set programs which will help you improve:

• Cardiovascular: It’s designed to change the speed so that your heart rate remains between 50-85% of your maximum heart rate. Your maximum heart rate is (220 – age) for men and (226 – age) for women.
• Fat burning zone: It’s designed to change the speed so that your heart rate remains between 80-85% of your maximum heart rate.
• Alpine Pass: This is a harder regime which increases the incline constantly and then declines it so that it mimics walking or running uphill and downhill.  
• Random Hill: This is a program which randomly changes the incline and speed to keep you on your toes.
• Interval training: This program allows you to set a jogging speed and a sprint speed and then switch at the press of a button. It’s excellent if you want a program which allows you to switch between speeds quickly for interval training.
• 5K run: This is a long running program where the user has to complete 5 kilometres on the treadmill. 
• Fitness Test: This is a program which helps you keep track of your fitness levels by monitoring your heart rate. It should be taken every three months.  

 Always warm up

One of the most common mistakes people make while using the treadmill is that they start running at breakneck speed from the get go. What you need to do is begin gradually at a lower speed and give your body time to adjust to the motion. Not warming up can lead to cramps and other problems. When you begin you should start at a slow, moderate pace like 6 km/hr. This gives your body time to adjust and loosens up your muscles. Warm up for at least 3-5 minutes before you start heavy duty running.

Do not hold the bars

Once you get used to the treadmill that is. Most beginners are advised to hold on to the bars of the treadmill either on the sides or in the front and they just don’t let go. Even holding on during incline runs/walks is a bad idea. In fact, if you’ve to hold on to stay on a treadmill then the chances are that you’re overdoing it and need to decrease the speed or incline. Holding on prevents you from finding your natural running/walking stance and posture and also burns lesser calories.

Watch your step

One important aspect of running and not just on the treadmill is landing your foot properly. Most experts agree that runners should land midsole – neither on your toes nor on your heels. If you land on your toes, you’re likely to put too much pressure on your calves and also develop shin pain. Landing on your heel means you’re not putting everything into your forward momentum and putting unnecessary stress on your knees. It’s also vital to keep your toes pointed straight and avoid keeping them either in or out. Of course this won’t happen the first time you start running and you’ll have to work on it consciously.

Use it for interval training

One of the major plusses of the treadmill is that it makes interval training much easier than the open road. For those not in the know, interval training or it’s more high intensity variety called High Intensity Interval Training or in short HIIT is an amazing cardio routine to lose weight fast and burn excess calories. Based on a study by Japanese professor Izumi Tabata, it involves periods of high intensity training followed by lower intensity. You can incorporate HIIT into your cardio regime on the treadmill to take it to the next level. Here’s an example of a sample plan:

• Warm up for 3 minutes at 6 km/h
• Switch the speed to 10km/h for 2 minutes and then bring it back to 6 km/h
• Repeat this for at least 4 sets so that total exercise lasts 15 minutes
• Walk on the treadmill at 6 km/h for a cool down period

Give it some incline

If you’ve ever run anywhere you’ll know that running uphill is always harder than running on level ground. This is why it’s important to use the incline feature of treadmills to reap the maximum benefits from the machine. Even a 1% incline (most machines 1-15) will help you burn more calories than walking on level ground.

Here’s a chart for an average user (65kg) walking at 6.5 k/h at different inclines:

 You can calculate your calories burn per hour by using this app. As we can see, even a slight incline increases your calories burnt tremendously and it would be a good idea to use this feature effectively to get the most out of your exercise time.

Keep on pushing yourself

And the last and most important tip when it comes to using the treadmill is to not to let yourself get comfortable. If you’re getting comfortable increase the speed or incline. Try and do longer runs. If you’re doing interval training, try and increase the high intensity time. This stops your body from getting used to the exercise and hitting a plateau.

Keep these tips in mind the next time you’re on the machine and you’ll realise what a powerful tool it is for weight loss and general fitness levels. 

Cancer survivor Yuvraj Singh

What is cervical cancer?

Cervical cancer refers to the cancer of the cervix and is one of the most common forms of cancer in women along with breast cancer. Most cases of cervical cancer are caused by the human papillomavirus (HPV). Cervical cancer can be considered one of the few types of cancer that are contagious because the HPV can spread through unprotected intercourse. The Pap smear test, a cervical screening test to identify precancerous changes is the best way to diagnose cervical cancer early. 

In recent times it has beaten breast cancer as the leading cause of cancer deaths in women in India; it kills around 33,000 women every year in India. Cervical cancer is known to occur because of a virus called the Human Papilloma Virus (HPV) transmitted through sexual contact. Bad local hygiene, too many children, not enough spacing between children, low nutrition levels and early marriage all contribute to the risk factors. The high risk group includes girls who have had premature sex as teenagers, those who have had multiple pregnancies or multiple sex partners and don’t use contraceptives. The disease remains asymptomatic for a long time till it starts invading neighbouring tissues.

Masina Hospital on the other hand refuted these allegations saying she wasn’t stable and therefore couldn’t perform tests to find out if she was suffering from any damage in the throat region.  ‘She was never stable since the time she was brought here. We couldn’t do her endoscopy all these days as she was bleeding from upper end of the food pipe,’ said one of the treating doctors from Masina Hospital. ‘If we had preponed the gastroscopy, the area would have perforated and there were high chances of her dying due to the shock,’ he added

On Monday, Preeti underwent a bronchoscopy to figure out the extent of damage to her chest cavity.  ‘She has developed chemical pneumonitis as she had ingested the acid,’ said Dr Ashok Gupta, plastic surgeon, Bombay Hospital.

Another doc told DNA that they would wait for her wounds to heal completely before conducting a reconstruction surgery for the hole.  ‘Till then, she will take nutrition through the feeding tube. We have done a minor surgery where we introduce a feeding tube inserted through the skin into the stomach through a small hole in the abdomen,’ said the doctor.

Preeti Rathi had come to Mumbai to join duty as a nurse in the Naval Hospital when she suffered an acid attack at Bandra station. She sustained severe burns to her face, neck, chest and arms and was critical for a few days after admission. Doctors treated her for her injuries but she had lost vision in her right eye. While she subsequently regained consciousness and could communicate only with written notes, she pleaded with the doctors to help restore her vision.  She underwent stem cell therapy, where cells from her left eye were used to restore vision in her right eye. Read more about the full procedure which Dr Yasmin Bhagat, her treating surgeon explained to us. 

According to reports, doctors were initially reluctant to carry out the procedure as prostate removal can have various consequences. For starters, it makes the patient infertile and can also lead to permanent incontinence and sexual dysfunction. Initially, the man’s prostate appeared fine but further tests showed a microscopic malignant growth. When experts examined the prostate after surgery, they were shocked to find that it had a considerable level of undetected cancer. Surgeon, Roger Kirby, a leading prostate cancer specialist, told The Sunday Times: ‘The relatively low level of cancerous cells we found in this man’s prostate before the operation would these days not normally prompt immediate surgery to remove the gland, but given what we now know about the nature of BRCA2, it was definitely the right thing to do for this patient.’

‘A number of these BRCA families have now been identified, and knowing you are a carrier is like having the sword of Damocles hanging over you. You are living in a state of constant fear. I am sure more male BRCA carriers will now follow suit.’

What is prostate cancer?

Prostate cancer forms in tissues of the prostate (a gland in the male reproductive system) and is one of the leading causes of cancer in men above the age of 60.  Most cases could be slow growing and may even go undetected and not cause any problem. Some could be aggressive and can spread to other parts of the body and are difficult to treat. It usually presents with difficulty and pain during urination, blood in the urine along with sexual dysfunction. Advanced cases may present with bone pain in addition to the urinary symptoms. Prostate cancer is very rare before the age of 40 but the risk increases with age and most cases are detected in the late 60s.

Viagra is passé, the new way to treat impotence or erectile dysfunction is with shockwaves

A healthy blood supply is crucial for maintaining an erection. In most cases, erection is caused due to the narrowing of blood vessels which hinders blood flow to the penis. Viagra (Sildenafil) is the most common drug to beat ED but it doesn’t work for various. This technique on the other hand uses a technology called extracorporeal shockwave therapy.  The device resembles a mobile phone uses 10 per cent of power of kidney stone machines. The device is based on the theory that shockwaves stimulate blood flow in damaged heart tissues. In patients, with angina, the treatment was found to promote the blood flow in damaged tissue and promote the growth of new blood vessels.

The sessions lasts 20 min and causes a slight tingling sensation. Most men are given four sessions of treatment. In one study at Rambam Hospital, Israel, published in the journal European Urology, the device was used on 20 men, aged 33 to 68, who had suffered impotence for an average of three years.

In these men, they no longer required drugs and there was a significant increase in the duration of erection and penile rigidity. In a second study by the same hospital, the treatment was compared to placebo in 84 men. Those having the treatment saw a significant improvement in their ability to achieve and maintain an erection — three times greater than compared to those who had the sham therapy. The treatment will however be useless for those who suffer from nerve damage caused by conditions like prostate cancer.

What is erectile dysfunction?

 Erectile dysfunction (ED) aka impotence is the inability to develop or maintain an erection of the penis during sex. Impotence is different from infertility. While impotence is the inability to maintain an erection, infertility is the inability to father children. An erection is caused by the hydraulic effect of blood entering and being retained in spongy bodies within the penis.  ED can be caused by alcohol consumption, smoking, diabetes, medicinal side-effects or obesity. Some psychological issues which can cause ED include stress, depression, performance anxiety or low self-esteem. Prescription medicines like Viagra are usually used to treat impotence. 

Preeti Rathi had come to Mumbai to join duty as a nurse in the Naval hospital when she suffered an acid attack at Bandra station. She sustained severe burns to her face, neck, chest and arms and was critical for a few days after admission. Doctors treated her for her injuries but she had lost vision in her right eye. While she subsequently regained consciousness and could communicate only with written notes, she pleaded with the doctors to help restore her vision.  She underwent stem cell therapy, where cells from her left eye were used to restore vision in her right eye. Read more about the full procedure which Dr Yasmin Bhagat, her treating surgeon explained to us. 

The new venture might hamper the rural health program and also hinder other plans to fight specified diseases. During the budget session this year, the Finance Minister had said that the NUHM and the NRHM would be clubbed under a common program called the National Health Mission. However, experts believe that re-christening the scheme won’t really help it take off. The 12^th Five Year Plan had allocated Rs 16,955 crore to the scheme which means it should have approximately Rs 3,300 crore per year. However, a media report by TOI suggests that unified mission was cleared by the Cabinet on the assurance that the funds for the urban sub-mission will be cobbled together from other sources. The NUHM is set to cover approximately 7.75 crore people in 779 cities but that proposal is set to be postponed to the next fiscal, which won’t really give the UPA any pre-poll bragging rights.

If on the other hand the health ministry uses NRHM funds, the former will be badly hit considering it has only got a 2.5% increase from last year. This means that other targets under the government’s ‘Health for All’ axiom is going to be missed including the move to provide free essential drugs and free diagnostic testing at government hospitals – a project that would need Rs 2000 crore annually.

Also the plan to strengthen the capacity of the district hospitals would be hit as would the universal healthcare system that has been discussed for a long, long time and sources suggest that all of them will be put off till the next fiscal. Experts are wary that the untenable funds will make it hard for the government to reach the aforementioned targets which will lead to an outcry later on.

While large funds had been promised for public health and education, there was a lot of controversy with Planning Commission’s suggestions which many believed would corporatise healthcare and hand the healthcare baton to the private sector. Though the differences were resolved with creation of the National Health Mission, experts are worried that the current year’s budget is simply inadequate for the NUHM to take off.