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Living With: Acute Postural ANS Dysfunction, Cerebellar Ataxia, Gastroparesis, Hyperkinetic Circulation, Hypothyroid, Hypovolemia, IBS, Mesangial Proliferative Glomerulonephritis, Migraines, Orthostatic Hypotension, Peripheral Neuropathy, POTS, Small Fiber Neuropathy and SVT.
VIDEO: www.youtube.com/watch?v=mAWemp5rv3A
••• SCRIPT/LYRICS: •••
MOLEMAN'S EPIC RAP BATTLES!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
SHINJI IKARI…
…VS…
RORSCHACH!!!!!!!!!!!!!!!!
BEGIN!!!
Shinji Ikari:
Expecting a breakdown? I'll do no such thing this match:
I'll display all of my pain and suffering like a bloody badge
As I show the world my true worth as the greater deconstruction;
Teach this so–called "tortured" soul the meaning of dysfunction!
I'm anything but aloof, but I'll provide eternal proof
Of my superiority to any Charlton spoof…
…Oh, what's the point in trying; who am I even fooling?
I'm almost as fucked up as this maniac I'm dueling!
…Wa-wait, No! Get it together… you mustn't run away;
Just remember all that stuff from Warhammer 40k…
…Oh, wipe that look off your inky face! You don't understand me,
And I'd expect no different from a murderous vigilante!
I'm the better person here, and I say that with rare confidence;
I'll be the first to admit to my cowardice and incontinence,
But compared to this ungodly sloven, I'm Adam and Lilith's freaking gift to women,
With scoring from Beethoven… though, then again, you've got Bob Dylan…
…Look, how my story ends is something no one seems to know,
But I'm pretty sure I didn't become a bloodstain in the snow!
And speaking of blood, forget your smiley face of doom,
'Cause that's nothing next to the mark that I left on the moon
When I… Oh God, the horror; the sea of human orange juice…
…Oh man, I can't do this; it's hopeless, there's no use!
I'm a terrible person, and I ought to be dead;
Oh, maybe I should have let them send in Rei to rap instead...
Rorschach:
Rorschach's Journal, December, 2015:
The streets echo with the cries of this teenage drama queen.
Definitely perverted; no need to inspect further:
Jerks off to girls in comas and clones of his own mother.
Like Pagliacci, he's a sad, pathetic, self–loathing clown,
And while men get arrested, dogs get put down,
And tonight, a little bitch dies in Tokyo–3 City
For the crime of having the sheer NERV to mess with me!
Gaze upon my face, and I stare back from the abyss;
I'm cruel like an angel when I spit out my thesis:
If my "battle" with this emo waste is meant to be a joke,
That's sicker humor than what the Comedian evokes!
What are you, stupid?! To step to me, you must be!
I live in ebony and ivory, like Fearful Symmetry;
Well I may be a psycho, but I guess that's better than being weak–willed!
I'll go Third Impact on your face, and see to it that You Can (Not) Rebuild.
And on faces: even without mine, I'm one cool ginger;
Don't bother crying for help, 'cause you know what I'll whisper.
While you're sulking in depression; I dish out righteous aggression!
I'm based on Vic Sage, and yet there's still no Question
That the end is nigh for this whimpering little whiner;
One minute to midnight on his personal doomsday timer,
And as he speaks last words, a new world record will be set:
The first person in history to flunk the Rorschach Test.
(Cut back to Shinji doing what he does best: sobbing like a whiny little tool)
ANNOUNCER: SHINJI, GET BACK IN THE FUCKING ROB– ERM… BATTLE!
Shinji Ikari:
Aaaugh, okay… alright, alright, I'm fine…
Listen here, Mr. Short, Slim, Smelly and Scary:
I'll disgrace you so badly, you can call me Happy Harry!
I'm not locked in here with you, nor are you locked in here with me;
I realize now that both of us are screwed up equally,
And yet in spite of my faults, I at least know who I am,
While you hide under a dress-cut mask, you schizophrenic sham!
Why do I pilot the Eva? That's not even consequential,
Because just like Ren and Stimpy, I'm way existential!
I'm the one who's misunderstood and worthy of sympathy;
You're just a stubborn sociopath of unwarranted popularity,
So haul your vagrant ass home on some passing garbage truck.
Your basis said it best, Walter: "Rorschach sucks."
Rorschach:
Hurm, convenient. Suddenly you discover your testicles,
And like your balls themselves, the change is barely perceptible.
Even now, you make poor old Daniel look like yours truly.
Your arguments are as full of nonsense as Fooly Cooly!
Don't go off about your so–called existentialist philosophy;
It's phoned–in: all for show, like that religious iconography!
You're delirious again, Ikari; get a freaking grip
Before I break your fingers off, like Tales from the Crypt!
Would say I'd snap your spine, too, but pretty sure you have no vertebrae;
Would go as far as calling you the Willy Loman of anime,
While I even exact justice when I go to take a dump.
I'm like a full–time berserker, so come and get me, chump!
(Cut again to Shinji, now in the midst of yet another breakdown)
Shinji Ikari: I… I can't do this… help me! Somebody, help me! Somebody, anybody, please?! I'm begging you!!!
Son, I am disappoint. Yet, you have served your purpose here, and now, just as planned, I will be the one to finish this…
Gendo Ikari:
Out from behind closed doors, I emerge to take the floor;
Heart hardened like an EVA's core, frigid like the Cold War,
Yet I rely on Children no more as I step into the fray
To hijack this verbal melee like the schemings of SEELE!
Yep, it's Gendo, baby, and though my son's a super–wimp,
You'll find the apple falls far, because his dad's an uber–pimp!
Any Akagi will attest that I'm one manly ladies' man;
Looking boss with my shiny shades and steeple–clasped hands.
Such is my power, I've even run for office in real life,
While you're a bigger fool for "justice" than I am for my dead wife,
And though you boast brutal brawling skills and crude grappling gadgetry,
I'm close to David Xanatos in my mastery of gambitry!
You beating me has a one–in–a–billion probability;
Like your one–man war on crime, it's an effort in futility,
Yeah, I got bit in half like a Liu Kang fatality,
But I flow rhymes so seamless, call it rhythm Instrumentality.
I penetrate your mind and soul like Arael; I don't relent,
Because my sync rate with this beat is over four hundred percent!
Why turn all of humanity to one big puddle of orange?
It's simple, really. The truth is, _________________________!
Forget that asshole Joffrey, I'm the king of bastard–kind,
And Francisco Scaramanga's gun has nothing on mine,
'Cause I can one–shot anybody, anywhere, any day;
That's right, it's Gendownage time! Brian, take it away!
Brian Johnson: FOR THOSE ABOUT TO ROCK…
*Gendo fires gun*
… WE SALU– *Record scratch*
(A caped figure suddenly jumps out in front of Rorschach, seemingly taking the bullet for him before landing sprawled on the ground… and getting up moments later, discarding the projectile from his bloodied hand.)
You know, I wasn't really sure that would work…
Adrian Veidt:
Well, folks, this sure has been quite a wild show we've had,
With a psychopath, an emo, and his deadbeat dad.
Here's hoping you've enjoyed the ramblings of these three stooges
As your host wraps up our evening; alright, let's do this!
My name's Adrian Veidt, and as I take over this fight,
I'll try keeping things polite; just call me your white knight.
I'm an enterpriser, mastermind, self–made billionaire;
Feast your ears upon my funky words, ye mighty, and despair!
Yo "bastard king", think you can beat the king of kings?
I'll make you as my puppet; watch me tangle all your strings:
You've put a bullet in my palm, and my hand is badly bleeding,
But at least it's not implanted with any alien seedling!
Strike you like a Thunderbolt with extraordinary grace;
Make you look like Walter White, fallen flat on your face.
I had the balls to do whatever it took to save mankind;
I'd tell this little coward that, but he already seems resigned.
And Rorschach, do we really have go through this again?
There's a whole book< on me beating you: it's called Watchmen,
And don't say your journal took me down, 'cause that's a load of drivel;
Nobody can even read, much less believe, your tome of scribbles!
My Karnak base is cold, but my rhymes flow red–hot;
Slicing yours clean in half like the Gordian Knot!
As the world's smartest man, I'll put this bluntly as I can:
I won this battle half an hour before it began.
WHO WON?
WHO'S NEXT?
I DECIDE!!!!!
(To the tune of "A Cruel Angel's Thesis")
MOLE–MAN'S EP–IC RAP–RAP–RAP–RAP–RAP–RAP BAT–TLES! MOLE–MAN'S EP–IC RAP–RAP–RAP–RAP–RAP BAT–TLES!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
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সাধারণত প্রতি ১০ জনে একজন পুরুষ মানুষের সঙ্গমের সময় দ্রুত বীর্যপাত অথবা ইরেক্টাইল ডিসফাংশনের (erectile dysfunction) মত সমস্যা হয় বলে ধারনা করা হয়। বিশেষজ্ঞদের মতেঃ-
”কোন পুরুষ যৌনক্রিয়ায় ঠিকভাবে অংশগ্রহণ করতে না পারলে সেটিকে যৌন সমস্যা (Sexual dysfunction) বলা হয়। এর প্রধানতম সমস্যাটি হচ্ছে ঠিকমত ইরেকশন (erection) বা লিঙ্গ সুদৃঢ় না হওয়া। এটি লোকে যা মনে করে তার চেয়ে অনেক বেশি দেখা যায়। ২০-৪০ বছর বয়সী পুরুষদের মধ্যে ৭-৮%, এবং ৪০-৫০ বছর বয়সী পুরুষদের মধ্যে ১১% এই সমস্যায় আক্রান্ত হয়। ষাটোর্ধ পুরুষদের ৪০% এবং ৭০ বছরের বেশি বয়সের পুরুষদের অর্ধেকই এই সমস্যায় ভোগেন।” এটি বিপরিত লিঙ্গের প্রতি আকৃষ্ট, সমকামী, বাই-সেক্সুয়াল বা ট্র্যান্সজেন্ডার যে কারো হতে পারে।”
১) ইরেক্টাইল ডিসফাংশন বা ইম্পোটেন্স (Erectile dysfunction (impotence))এই সমস্যাটি হলে পুরুষদের লিঙ্গ সুদৃঢ় হয় না বা হলেও তারা সেটি বেশিক্ষন ধরে রাখতে পারে না। বেশিরভাগ পুরুষেরই জীবনে কখনো না কখনো এই সমস্যাটি হয়। বিশেষজ্ঞদের মতে “এটি তখনই সমস্যা হিসেবে বিবেচনা করা হয় যখন কোন পুরুষ বা তার সঙ্গিনী এটিকে সমস্যা মনে করেন।”
ইরেক্টাইল ডিসফাংশন কেন হয়?অনেকগুলো কারণে এটি হতে পারে। এই কারণগুলোর কয়েকটি মানসিক এবং কয়েকটি শারীরিক। মানসিক কারণে (যেমনঃ নাইট নার্ভ (night nerves)) কম বয়সী পুরুষদের এই সমস্যাটি হয়। বেশিরভাগ সময়ই এই সমস্যাটি দীর্ঘস্থায়ী হয় না। তবে অনেক জটিল মানসিক সমস্যার কারনে এটি হতে পারে যার জন্য সাইকোসেক্সুয়াল থেরাপিস্টের সাহায্য নিতে হতে পারে। কর্মক্ষেত্র, টাকাপয়সা, সম্পর্কের টানাপোড়েন, পারিবারিক সমস্যা এমনকি ইরেকশন না হওয়া নিয়ে দুশ্চিন্তার কারণেও সমস্যাটি হতে পারে। ইরেক্টাইল ডিসফাংশনের শারীরিক কারণগুলোর মধ্যে রয়েছেঃ-
1. হৃদরোগ (heart disease)
2. ডায়বেটিস (diabetes)
3. রক্তচাপ বেড়ে যাওয়া (raised blood pressure)
4. কলেস্টেরল বেড়ে যাওয়া (raised cholesterol): এতে ধমনিগুলো সঙ্কুচিত হয়ে পড়ে। যৌনাঙ্গের ধমনিগুলো এমনিতেই খুব সরু (১-২ মি.মি. ব্যাসার্ধের, যেখানে হৃৎপিণ্ডের ধমনিগুলো ১০ মি.মি.) ব্যাসার্ধের) হয়
5. টেসটোস্টেরনের পরিমাণ কমে যাওয়া (low testosterone): পুরুষদের বয়স বাড়ার সঙ্গে সঙ্গে টেসটোস্টেরনের পরিমাণ কমতে থাকে, তবে সব পুরুষেরাই এর দ্বারা প্রভাবিত হয় না। যারা এর কারণে সমস্যায় পড়েন তারা ক্লান্ত, আনফিট এবং যৌনক্রিয়ায় অসমর্থ বোধ করবেন এবং এর প্রতি আগ্রহ হারিয়ে ফেলবেন।
যে সব ড্রাগ বা ঔষধের কারণে ইরেক্টাইল ডিসফাংশন হয়ঃ
কয়েক ধরনের ঔষধ (some prescription drugs):
1. এগুলো হচ্ছে রক্তচাপ কমাতে ব্যবহৃত ঔষধ (যেমন বেটা ব্লকার) এবং বিষণ্ণতা দূর করতে ব্যবহৃত ঔষধ (antidepressants) ও অ্যান্টিকনভালস্যান্ট/ খিঁচুনি কমানোর ঔষধ।
2. মদ (alcohol)
3. গাঁজা ও কোকেইনের মত ড্রাগ
4. ধূমপান (smoking): নিকোটিনের কারনে ইরেকশন বা লিঙ্গ সুদৃঢ় হওয়ার সময় পুরুষাঙ্গের বিভিন্ন জায়গায় প্রয়োজনীয় রক্ত সরবরাহ বাধাপ্রাপ্ত হয়।
ইরেক্টাইল ডিসফাংশন হলে কী করতে পারি?
ডাক্তার দেখান। উনি পরীক্ষা করে দেখবেন এবং কারন নির্ণয়ের জন্য রক্ত পরীক্ষাও করতে দিতে পারেন। ইরেক্টাইল ডিসফাংশন অন্যান্য সমস্যার নির্দেশকও হতে পারে। এটি উচ্চ রক্তচাপ, উচ্চ মাত্রার কোলেস্টেরল এবং ডায়বেটিসের সাথে সম্পর্ক যুক্ত। এর যে কোনটি ভবিষ্যতে হৃদরোগ হওয়ার পূর্বলক্ষণ হতে পারে। ডাক্তার আপনার প্রয়োজনীয় চিকিৎসা নিশ্চিত করবেন।
যৌন অক্ষমতার (impotence) চিকিৎসা কী?প্রথমে যে কোন ধরনের অভ্যেস যা সমস্যাটির কারণ হতে পারে, তা বর্জন করুন। আপনি ধূমপান, অতিরিক্ত মদ্যপান এবং ড্রাগ নেয়া বন্ধ করে দিলে সমস্যাটি একসময় দূর হয়ে যাওয়ার কথা। তবে এতে কয়েক মাস পর্যন্ত সময় লাগতে পারে। রাতারাতি ভাল করে দিতে পারে এমন কোন ওষুধ নেই। আপনাকে যদি রক্তচাপ নিয়ন্ত্রনের বা বিষণ্ণতা দূর করার ওষুধ খেতে দেয়া হয় তাহলে আপানার ডাক্তার হয়ত সেগুলো পরিবর্তন করে দিতে পারবেন। টেসটোস্টেরনের পরিমাণ কমে গেলে হরমোন প্রতিস্থাপনের মাধ্যমে তার চিকিৎসা করা সম্ভব। তবে এর সাথে সাথে আপনাকে ইরেকশনে সহায়তা করে এমন ওষুধও খেতে হবে। অন্যান্য ক্ষেত্রে যেমন ডায়বেটিস বা উচ্চ রক্তচাপ হলে সেগুলোর চিকিৎসা করে ইরেকশনের উন্নতি ঘটানো সম্ভব। কোন কোন পুরুষ সাইকোসেক্সুয়াল থেরাপি নিলে উপকার পেতে পারেন। এতে আপনি ও আপনার সঙ্গিনী আপনাদের সম্পর্কের যেকোনো বিষয় নিয়ে আলোচনা করতে পারেন।
২) দ্রুত বীর্যপাত (Premature ejaculation)এই সমস্যাটি হলে পুরুষেরা যৌনক্রিয়ার সময় তারা যখন চান তার আগেই বীর্যপাত ঘটে যায়। এটি উনাকে বা উনার সঙ্গিনীকে হতাশ করলেই কেবল সমস্যা হিসেবে বিবেচিত হতে পারে।
দ্রুত বীর্যপাত কেন ঘটে?নতুন সঙ্গীর সাথে অতি উত্তেজিত হয়ে পড়ার কারণে অথবা স্থানীয় স্নায়ুতন্ত্র (local nervous system) তীব্র সংবেদনশীলতার কারনে এটি হতে পারে। এটি যৌন সক্ষমতা নিয়ে দুশ্চিন্তা, স্ট্রেস, দুজনের সম্পর্কের অমীমাংসিত কোন বিষয় বা বিষণ্ণতা (depression) থেকেও হতে পারে।
দ্রুত বীর্যপাত ঘটলে কী করতে পারি?ডাক্তার অথবা সাইকোসেক্সুয়াল থেরাপিস্টের কাছে যান। থেরাপিস্ট আপনাকে বীর্যপাত দেরিতে করার বিভিন্ন টেকনিক শেখাতে পারেন।
এর কী কী ধরনের চিকিৎসা রয়েছে?
1. অনেক পুরুষ এবং তাদের সঙ্গিনীরা এটি নিয়ে বিশেষ চিন্তিত নয়, এবং তারা এটি নিয়ে বিশেষ মাথাও ঘামায় না।
2. বীর্যপাত হয়ে যাওয়ার একটু পরে আবার যৌনক্রিয়া আরম্ভ করুন। যত তাড়াতাড়ি আবার দ্বিতীয়বার যৌন ক্রিয়া শুরু করবেন, তত দেরিতে অর্গাজম হবে। বয়স্ক মানুষদের জন্য এটি কঠিন হতে পারে দ্বিতীয়বার যৌনাঙ্গ সুদৃঢ় হতে অনেক সময় লাগতে পারে।
3. দোকানে এক ধরনের ক্রিম পাওয়া যায় যা মাখলে পুরুষাঙ্গ অনুভূতিহীন হয়ে পড়ে। তবে এটির প্রভাবে আপনার সঙ্গিনীও অনুভূতিহীন হয়ে পড়তে পারেন, যা তারা অনেক সময় পছন্দ করেন না। অনেকে কনডম ব্যবহার করেও উপকার পান।
4. আপনার সঙ্গিনীকে আপনার যৌনাঙ্গে বিশেষ ভঙ্গিতে চাপ দিতে বলতে পারেন যাতে বীর্যপাত না ঘটে। তবে এটির করার জন্য আপনার সঙ্গিনীকে খুবই ইচ্ছুক হতে হবে, এবং অনেকেই এটি করতে বিশেষ আগ্রহী হন না।
5. সিলেক্টিভ সেরোটোনিন রিয়াপটেক ইনহিবিটর (selective serotonin reuptake inhibitors (SSRIs)) নামক একধরনের বিষণ্ণতা দূর করার ওষুধ (Antidepressants) বীর্যপাত প্রক্রিয়াটি ধীর গতির করে দিতে পারে, তবে এটি এক বছরের বেশি কাজ করে না। ওষুধ খাওয়া শুরু করার আগে অন্য সবগুলো উপায়ে চেষ্টা করে দেখুন।
6. সাইকোথেরাপির মাধ্যমে দুজনের সম্পর্কের সমস্যাগুলো খুঁজে বের করতে বা দূর করতে পারেন।
The post পুরুষের যৌন সমস্যার প্রকারভেদসমূহ appeared first on Natural Ayurveda LTD.
ED is generally caused by the insufficient blood supply to the penis or an issue with the nerves that control erections. This is a product of other factors, such as hardening of the heart, elevated blood pressure, and high cholesterol or diabetes.
Stem cell therapy is an advanced and beneficial treatment for diabetes, numerous patients with diabetes have shown noticeable improvement, long-time remission and were able to enjoy a high quality of life after the therapy in SQ1 stem cell medical center.
The Beneficial Effects Of Stem Cell Therapy On Diabetes
Stem cell therapy can improve pancreatic islets function, hepatic glucose, and lipid metabolism while lowering blood sugar.
Clinical research and applications have shown that through stem cell therapy, about 65% of the patients are no longer dependent on insulin or oral drug to treat diabetes, and over 90% of patients reported reduced a dosage of insulin or oral drug or changed from insulin injection to oral drug. Collectively, stem cell therapy greatly diminished the onset and development of diabetes complications.
The era of clinical stem cell therapy for diabetes has come!
Reduction of diabetes medication intake
Maintenance of normal blood sugar levels
Restoration of the sensitivity of peripheral tissue to insulin and increase of insulin levels
Prevention and improvement of related diabetic foot symptoms
Reduction of hepatocyte lipid-related lesions
Improvement in the condition of the arterial walls and reduction of hyperinsulinemia and atherosclerosis
Prevention or reversion of certain complications of diabetes, such as erectile dysfunction and vision loss
Diabetes-Related Diseases That Stem Cell Therapy Can Treat
Type 1 diabetes
Type 2 diabetes
Stem cell therapy also can treat complications of diabetes including:
Diabetic foot: foot infections, ulcers, and deep layer tissue damage.
Diabetic retinopathy: it can cause blurred vision, decreased vision, and even blindness.
Diabetic cardiovascular and cerebrovascular diseases: it can cause a cerebral infarction, cerebral hemorrhage, vascular dementia, etc.
Diabetic neuropathy: it can cause numbness and tingle in hands and feet, orthostatic hypotension, vomiting, urinary, and fecal incontinence, etc.
Diabetic nephropathy(chronic renal failure): it can cause foamy urine, edema, and renal failure.
Capillary and macrovascular complications: diabetes can lead to narrowing of lower extremity arteries, coronary heart disease, stroke, etc.
In 2019, the famous US news magazine “TIME” listed diabetes treatment with stem cell therapy as one of the top 10 innovative medical inventions that will change the future. In the year 2021, Mass General Brigham selected the ground-breaking “stem cell therapies for Diabetes” as one of the Top 12 “Disruptive gene and cell therapy technologies”.
Learn More About Diabetes
Diabetes is a metabolic disorder disease characterized by hyperglycemia(high blood sugar), it is also the third-largest non-infectious chronic disease following cancer and cardiovascular disease. There are approximately 537 million diabetes patients in the world by the year 2021.
Clinically, there are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant). The major incidence populations of type 1 diabetes are adolescents and children, it is recognized by the destruction of pancreatic β-cells which leads to insufficient insulin secretion and hyperglycemia. Type 2 diabetes is caused by genetic, and environmental factors and their interactions. Usually, it is characterized by malfunction of pancreatic β-cell and insulin resistance in cells. Gestational diabetes develops in pregnant women who have never had diabetes before. If you have gestational diabetes, your baby could be at higher risk for health problems. Your baby is more likely to have obesity as a child or teen, and more likely to develop type 2 diabetes later in life too.
Risk Factors For Type 2 Diabetes
Type 2 diabetes is believed to have a strong genetic link, meaning that it tends to run in families. If you have a parent, brother, or sister who has it, your chances rise.
You should ask your doctor about a diabetes test when you have any of the following risk factors:
High blood pressure.
High blood triglyceride (fat) levels. It's too high if it's over 150 milligrams per deciliter (mg/dL).
Low "good" cholesterol level. It's too low if it's less than 40 mg/dL.
Gestational diabetes or giving birth to a baby weighing more than 9 pounds.
Prediabetes. That means your blood sugar level is above normal, but you don't have the disease yet.
Heart disease.
High-fat and carbohydrate diet. This can sometimes be the result of food insecurity when you don’t have access to enough healthy food.
High alcohol intake.
Sedentary lifestyle.
Obesity or being overweight.
Polycystic ovary syndrome (PCOS).
Being of ethnicity that’s at higher risk: African Americans, Native Americans, Hispanic Americans, and Asian Americans are more likely to get type 2 diabetes than non-Hispanic whites.
You're over 45 years of age. Older age is a significant risk factor for type 2 diabetes. The risk of type 2 diabetes begins to rise significantly around age 45 and rises considerably after age 65.
You’ve had an organ transplant. After an organ transplant, you need to take drugs for the rest of your life so your body doesn’t reject the donor. organ. These drugs help organ transplants succeed, but many of them, such as tacrolimus (Astagraf, Prograf) or steroids, can cause diabetes or make it worse.
Clinical Symptoms Of Diabetes
Polyuia
Dry mouth and increased thirst
Strong appetite
Unexplained Weight loss
Fatigue
Obesity
Presence of glucose in urine
Presence of ketones in urine
Abnormal high amount of glycosylated hemoglobin (HbA1c) in serum
Glycated serum protein abnormality
Abnormal amount of insulin and c-peptide in serum
Dyslipidemia(unhealthy level of blood fat)
Stem Cell Therapy For Diabetes At SQ1
Stem cells used in the treatment of diabetes
SQ1 provides access to treatment that utilizes mesenchymal stem cells (MSCs) isolated from the cord blood, placenta, and/or peripheral blood of patients and embryonic stem cells (hESCs) and induced pluripotent stem cells (hiPSCs), into pancreatic endocrine lineages.
A combination MSCs and hESCs delivered via the intravenous route for 30 minutes at a delivery rate of 40 mL/hour to a final dose of 1 × 106 cells/kg of the patient's body weight.
The combination of cells and other treatment details are individual to the patient and is determined by genetically-programmed factors, individual to every human.
The therapeutic scope and efficacy of stem cell therapy for diabetes
A double infusion of hESCs+MSCs through either the intravenous route or the dorsal pancreatic artery route is performed for patients with type 2 Diabetes. The therapy exhibited term efficacy (7-9 months) in patients with type 2 diabetes for less than 10 years (the longest period of remission registered to date is 10 years and the shortest – 2 years) and a BMI <23 kg/m2 and improvement in hyperglycemia, reported blood glucose levels within the normal range.
Our results revealed reductions in the HbA1c and FBG levels during the first 3 months after administration in patients with type 2 Diabetes, deemed clinically significant because the reduction was maintained in a normal range at 12 months after administration.
Factors determining the efficacy of the treatment and remission term are individual and genetically driven.
Advantages Of Stem Cell Treatment For Diabetes
Traditional therapeutic methods, such as daily medication or injections of exogenous insulin, are the most common diabetes treatment, but their use is frequently associated with failure of glucose metabolism control, which leads to hyperglycemia episodes.
Stem cell therapy is a promising strategy for avoiding the problems associated with daily insulin injections. To maintain glucose homeostasis, this therapeutic method is expected to produce, store, and supply insulin. To completely cure diabetes, cell-based therapies aim to produce functional insulin-secreting cells.
Stem cell therapy
Conventional treatment
Curative Treatment or diseases management
The stem cell is a curative treatment for diabetes. Stem cell therapy is designed to rejuvenate the pancreas which helps the body to produce insulin naturally.
If given in the early stages, the dependency on medication and insulin can be reversed.
Insulin and medicine are used to control the amount of glucose in your blood. It is not a cure treatment it is used to control diabetes.
Slowly and gradually, people on medication move to insulin dependency.
Dosage
Stem cell therapy reduces the dosages of medication and insulin as the body starts producing insulin naturally.
If given in the early stages, the dependency on medication and insulin can be reversed.
Stem cell experts based on your current level of disease and other comorbidities will design a customized protocol and decide, the number of stem cells, source of stem cells, and cycles of stem cell therapy.
Patients who are on medication will observe a slow and gradual increase in dosages of medication.
At a certain point in time when medication is not able to manage the sugar levels, external insulin support will be required.
Patients who are on insulin support need to take insulin daily before consumption of food. The doses of insulin also increase with time.
Side-effects
No Side-effects as stem cells are our cells that are used to treat the disease and regenerate the pancreas to regain proper functioning.
Some of the common side-effects that medication and insulin can develop are upset stomach, skin rash or itching, weight gain, tiredness, and if not taken properly can even low blood sugar extremely.
Convenience
Stem cell therapy is performed by stem cell specialists which requires a special laboratory to process the stem cells and the medical set up to extract and inject the stem cell.
The therapy is going to be injection-based and needs to be performed in a hospital.
Medication that can be easily consumed.
Repeated and multiple small pricks for insulin injection for the patients who are currently on insulin.
The strict discipline to take medication or insulin on time as prescribed.
Longevity
Long-term effect and possibly curative treatment which removes the dependency on insulin and medication if taken in the early stage.
If taken in the later stages it reduces your dependency on medication and insulin. In a few cases, a repeat cycle may also be required.
Short-term effects.
Need to take insulin and medication daily as prescribed and the medication and effectiveness are for a few hours or a day.
The patient needs to take the medication and insulin lifetime.
End-stage
Stem cells are the basic building block of our body. The main functionality of stem cells is to regenerate the damaged cells and make copies of their own cells to repair the damaged cells.
Your own body is healing you and deferring the need for a transplant.
A pancreas transplant is the only treatment in the end stage.
There is a high probability that the kidney might also be damaged due to diabetes so in some cases both kidney and pancreas transplants would be required.
The availability of the donor and the waiting period can be a big reason for worry.
How Can Stem Cell Therapy For Diabetes Work
Stem cells were able to lower blood sugar levels and restore islet function in the following three ways:
Improvement of insulin resistance: stem cells will secret a variety of cytokines to improve the insulin resistance conditions in peripheral tissues and promote sugar intake by cells, thus reversing the hyperglycemia status in the body.
Promotion of regeneration of pancreatic islet β cells: Stem cells can reduce the progressive lesion to pancreatic islets from metabolic disorders in diabetes, at the same time can regenerate pancreatic β cells. In addition, stem cells can secret various cytokines to improve the microenvironment and induce the transformation of islet α cells to β cells. This process enables the in-situ regeneration of β cells and leads to the stabilization of blood sugar level.
Immunomodulation effect: stem cells can inhibit the T cell-mediated immune response against newly generated β cells and promote the repair and regeneration of pancreatic islets.
SQ1 Stem Cell Services
During the whole treatment process, we’ll provide complete and first-class medical services to you. And to ensure your treatment effect, you can consult your doctor any time after the treatment.
By far the funniest show I've been to at the Triple Door. Part of the campaign tour across the US for the Presidential election. Excellent show filled with political satire and sexual innuendos.
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first case was identified in Wuhan, China, in December 2019. The disease has since spread worldwide, leading to an ongoing pandemic.
Symptoms of COVID-19 are variable, but often include fever, cough, fatigue, breathing difficulties, and loss of smell and taste. Symptoms begin one to fourteen days after exposure to the virus. Of those people who develop noticeable symptoms, most (81%) develop mild to moderate symptoms (up to mild pneumonia), while 14% develop severe symptoms (dyspnea, hypoxia, or more than 50% lung involvement on imaging), and 5% suffer critical symptoms (respiratory failure, shock, or multiorgan dysfunction). Older people are more likely to have severe symptoms. At least a third of the people who are infected with the virus remain asymptomatic and do not develop noticeable symptoms at any point in time, but they still can spread the disease.[ Around 20% of those people will remain asymptomatic throughout infection, and the rest will develop symptoms later on, becoming pre-symptomatic rather than asymptomatic and therefore having a higher risk of transmitting the virus to others. Some people continue to experience a range of effects—known as long COVID—for months after recovery, and damage to organs has been observed. Multi-year studies are underway to further investigate the long-term effects of the disease.
The virus that causes COVID-19 spreads mainly when an infected person is in close contact[a] with another person. Small droplets and aerosols containing the virus can spread from an infected person's nose and mouth as they breathe, cough, sneeze, sing, or speak. Other people are infected if the virus gets into their mouth, nose or eyes. The virus may also spread via contaminated surfaces, although this is not thought to be the main route of transmission. The exact route of transmission is rarely proven conclusively, but infection mainly happens when people are near each other for long enough. People who are infected can transmit the virus to another person up to two days before they themselves show symptoms, as can people who do not experience symptoms. People remain infectious for up to ten days after the onset of symptoms in moderate cases and up to 20 days in severe cases. Several testing methods have been developed to diagnose the disease. The standard diagnostic method is by detection of the virus' nucleic acid by real-time reverse transcription polymerase chain reaction (rRT-PCR), transcription-mediated amplification (TMA), or by reverse transcription loop-mediated isothermal amplification (RT-LAMP) from a nasopharyngeal swab.
Preventive measures include physical or social distancing, quarantining, ventilation of indoor spaces, covering coughs and sneezes, hand washing, and keeping unwashed hands away from the face. The use of face masks or coverings has been recommended in public settings to minimise the risk of transmissions. Several vaccines have been developed and several countries have initiated mass vaccination campaigns.
Although work is underway to develop drugs that inhibit the virus, the primary treatment is currently symptomatic. Management involves the treatment of symptoms, supportive care, isolation, and experimental measures.
SIGNS AND SYSTOMS
Symptoms of COVID-19 are variable, ranging from mild symptoms to severe illness. Common symptoms include headache, loss of smell and taste, nasal congestion and rhinorrhea, cough, muscle pain, sore throat, fever, diarrhea, and breathing difficulties. People with the same infection may have different symptoms, and their symptoms may change over time. Three common clusters of symptoms have been identified: one respiratory symptom cluster with cough, sputum, shortness of breath, and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhea. In people without prior ear, nose, and throat disorders, loss of taste combined with loss of smell is associated with COVID-19.
Most people (81%) develop mild to moderate symptoms (up to mild pneumonia), while 14% develop severe symptoms (dyspnea, hypoxia, or more than 50% lung involvement on imaging) and 5% of patients suffer critical symptoms (respiratory failure, shock, or multiorgan dysfunction). At least a third of the people who are infected with the virus do not develop noticeable symptoms at any point in time. These asymptomatic carriers tend not to get tested and can spread the disease. Other infected people will develop symptoms later, called "pre-symptomatic", or have very mild symptoms and can also spread the virus.
As is common with infections, there is a delay between the moment a person first becomes infected and the appearance of the first symptoms. The median delay for COVID-19 is four to five days. Most symptomatic people experience symptoms within two to seven days after exposure, and almost all will experience at least one symptom within 12 days.
Most people recover from the acute phase of the disease. However, some people continue to experience a range of effects for months after recovery—named long COVID—and damage to organs has been observed. Multi-year studies are underway to further investigate the long-term effects of the disease.
CAUSE
TRANSMISSION
Coronavirus disease 2019 (COVID-19) spreads from person to person mainly through the respiratory route after an infected person coughs, sneezes, sings, talks or breathes. A new infection occurs when virus-containing particles exhaled by an infected person, either respiratory droplets or aerosols, get into the mouth, nose, or eyes of other people who are in close contact with the infected person. During human-to-human transmission, an average 1000 infectious SARS-CoV-2 virions are thought to initiate a new infection.
The closer people interact, and the longer they interact, the more likely they are to transmit COVID-19. Closer distances can involve larger droplets (which fall to the ground) and aerosols, whereas longer distances only involve aerosols. Larger droplets can also turn into aerosols (known as droplet nuclei) through evaporation. The relative importance of the larger droplets and the aerosols is not clear as of November 2020; however, the virus is not known to spread between rooms over long distances such as through air ducts. Airborne transmission is able to particularly occur indoors, in high risk locations such as restaurants, choirs, gyms, nightclubs, offices, and religious venues, often when they are crowded or less ventilated. It also occurs in healthcare settings, often when aerosol-generating medical procedures are performed on COVID-19 patients.
Although it is considered possible there is no direct evidence of the virus being transmitted by skin to skin contact. A person could get COVID-19 indirectly by touching a contaminated surface or object before touching their own mouth, nose, or eyes, though this is not thought to be the main way the virus spreads. The virus is not known to spread through feces, urine, breast milk, food, wastewater, drinking water, or via animal disease vectors (although some animals can contract the virus from humans). It very rarely transmits from mother to baby during pregnancy.
Social distancing and the wearing of cloth face masks, surgical masks, respirators, or other face coverings are controls for droplet transmission. Transmission may be decreased indoors with well maintained heating and ventilation systems to maintain good air circulation and increase the use of outdoor air.
The number of people generally infected by one infected person varies. Coronavirus disease 2019 is more infectious than influenza, but less so than measles. It often spreads in clusters, where infections can be traced back to an index case or geographical location. There is a major role of "super-spreading events", where many people are infected by one person.
A person who is infected can transmit the virus to others up to two days before they themselves show symptoms, and even if symptoms never appear. People remain infectious in moderate cases for 7–12 days, and up to two weeks in severe cases. In October 2020, medical scientists reported evidence of reinfection in one person.
VIROLOGY
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel severe acute respiratory syndrome coronavirus. It was first isolated from three people with pneumonia connected to the cluster of acute respiratory illness cases in Wuhan. All structural features of the novel SARS-CoV-2 virus particle occur in related coronaviruses in nature.
Outside the human body, the virus is destroyed by household soap, which bursts its protective bubble.
SARS-CoV-2 is closely related to the original SARS-CoV. It is thought to have an animal (zoonotic) origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus Betacoronavirus, in subgenus Sarbecovirus (lineage B) together with two bat-derived strains. It is 96% identical at the whole genome level to other bat coronavirus samples (BatCov RaTG13). The structural proteins of SARS-CoV-2 include membrane glycoprotein (M), envelope protein (E), nucleocapsid protein (N), and the spike protein (S). The M protein of SARS-CoV-2 is about 98% similar to the M protein of bat SARS-CoV, maintains around 98% homology with pangolin SARS-CoV, and has 90% homology with the M protein of SARS-CoV; whereas, the similarity is only around 38% with the M protein of MERS-CoV. The structure of the M protein resembles the sugar transporter SemiSWEET.
The many thousands of SARS-CoV-2 variants are grouped into clades. Several different clade nomenclatures have been proposed. Nextstrain divides the variants into five clades (19A, 19B, 20A, 20B, and 20C), while GISAID divides them into seven (L, O, V, S, G, GH, and GR).
Several notable variants of SARS-CoV-2 emerged in late 2020. Cluster 5 emerged among minks and mink farmers in Denmark. After strict quarantines and a mink euthanasia campaign, it is believed to have been eradicated. The Variant of Concern 202012/01 (VOC 202012/01) is believed to have emerged in the United Kingdom in September. The 501Y.V2 Variant, which has the same N501Y mutation, arose independently in South Africa.
SARS-CoV-2 VARIANTS
Three known variants of SARS-CoV-2 are currently spreading among global populations as of January 2021 including the UK Variant (referred to as B.1.1.7) first found in London and Kent, a variant discovered in South Africa (referred to as 1.351), and a variant discovered in Brazil (referred to as P.1).
Using Whole Genome Sequencing, epidemiology and modelling suggest the new UK variant ‘VUI – 202012/01’ (the first Variant Under Investigation in December 2020) transmits more easily than other strains.
PATHOPHYSIOLOGY
COVID-19 can affect the upper respiratory tract (sinuses, nose, and throat) and the lower respiratory tract (windpipe and lungs). The lungs are the organs most affected by COVID-19 because the virus accesses host cells via the enzyme angiotensin-converting enzyme 2 (ACE2), which is most abundant in type II alveolar cells of the lungs. The virus uses a special surface glycoprotein called a "spike" (peplomer) to connect to ACE2 and enter the host cell. The density of ACE2 in each tissue correlates with the severity of the disease in that tissue and decreasing ACE2 activity might be protective, though another view is that increasing ACE2 using angiotensin II receptor blocker medications could be protective. As the alveolar disease progresses, respiratory failure might develop and death may follow.
Whether SARS-CoV-2 is able to invade the nervous system remains unknown. The virus is not detected in the CNS of the majority of COVID-19 people with neurological issues. However, SARS-CoV-2 has been detected at low levels in the brains of those who have died from COVID-19, but these results need to be confirmed. SARS-CoV-2 could cause respiratory failure through affecting the brain stem as other coronaviruses have been found to invade the CNS. While virus has been detected in cerebrospinal fluid of autopsies, the exact mechanism by which it invades the CNS remains unclear and may first involve invasion of peripheral nerves given the low levels of ACE2 in the brain. The virus may also enter the bloodstream from the lungs and cross the blood-brain barrier to gain access to the CNS, possibly within an infected white blood cell.
The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the glandular cells of gastric, duodenal and rectal epithelium as well as endothelial cells and enterocytes of the small intestine.
The virus can cause acute myocardial injury and chronic damage to the cardiovascular system. An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China, and is more frequent in severe disease. Rates of cardiovascular symptoms are high, owing to the systemic inflammatory response and immune system disorders during disease progression, but acute myocardial injuries may also be related to ACE2 receptors in the heart. ACE2 receptors are highly expressed in the heart and are involved in heart function. A high incidence of thrombosis and venous thromboembolism have been found people transferred to Intensive care unit (ICU) with COVID-19 infections, and may be related to poor prognosis. Blood vessel dysfunction and clot formation (as suggested by high D-dimer levels caused by blood clots) are thought to play a significant role in mortality, incidences of clots leading to pulmonary embolisms, and ischaemic events within the brain have been noted as complications leading to death in people infected with SARS-CoV-2. Infection appears to set off a chain of vasoconstrictive responses within the body, constriction of blood vessels within the pulmonary circulation has also been posited as a mechanism in which oxygenation decreases alongside the presentation of viral pneumonia. Furthermore, microvascular blood vessel damage has been reported in a small number of tissue samples of the brains – without detected SARS-CoV-2 – and the olfactory bulbs from those who have died from COVID-19.
Another common cause of death is complications related to the kidneys. Early reports show that up to 30% of hospitalized patients both in China and in New York have experienced some injury to their kidneys, including some persons with no previous kidney problems.
Autopsies of people who died of COVID-19 have found diffuse alveolar damage, and lymphocyte-containing inflammatory infiltrates within the lung.
IMMUNOPATHOLOGY
Although SARS-CoV-2 has a tropism for ACE2-expressing epithelial cells of the respiratory tract, people with severe COVID-19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated IL-2, IL-7, IL-6, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-γ inducible protein 10 (IP-10), monocyte chemoattractant protein 1 (MCP-1), macrophage inflammatory protein 1-α (MIP-1α), and tumour necrosis factor-α (TNF-α) indicative of cytokine release syndrome (CRS) suggest an underlying immunopathology.
Additionally, people with COVID-19 and acute respiratory distress syndrome (ARDS) have classical serum biomarkers of CRS, including elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer, and ferritin.
Systemic inflammation results in vasodilation, allowing inflammatory lymphocytic and monocytic infiltration of the lung and the heart. In particular, pathogenic GM-CSF-secreting T-cells were shown to correlate with the recruitment of inflammatory IL-6-secreting monocytes and severe lung pathology in people with COVID-19 . Lymphocytic infiltrates have also been reported at autopsy.
VIRAL AND HOST FACTORS
VIRUS PROTEINS
Multiple viral and host factors affect the pathogenesis of the virus. The S-protein, otherwise known as the spike protein, is the viral component that attaches to the host receptor via the ACE2 receptors. It includes two subunits: S1 and S2. S1 determines the virus host range and cellular tropism via the receptor binding domain. S2 mediates the membrane fusion of the virus to its potential cell host via the H1 and HR2, which are heptad repeat regions. Studies have shown that S1 domain induced IgG and IgA antibody levels at a much higher capacity. It is the focus spike proteins expression that are involved in many effective COVID-19 vaccines.
The M protein is the viral protein responsible for the transmembrane transport of nutrients. It is the cause of the bud release and the formation of the viral envelope. The N and E protein are accessory proteins that interfere with the host's immune response.
HOST FACTORS
Human angiotensin converting enzyme 2 (hACE2) is the host factor that SARS-COV2 virus targets causing COVID-19. Theoretically the usage of angiotensin receptor blockers (ARB) and ACE inhibitors upregulating ACE2 expression might increase morbidity with COVID-19, though animal data suggest some potential protective effect of ARB. However no clinical studies have proven susceptibility or outcomes. Until further data is available, guidelines and recommendations for hypertensive patients remain.
The virus' effect on ACE2 cell surfaces leads to leukocytic infiltration, increased blood vessel permeability, alveolar wall permeability, as well as decreased secretion of lung surfactants. These effects cause the majority of the respiratory symptoms. However, the aggravation of local inflammation causes a cytokine storm eventually leading to a systemic inflammatory response syndrome.
HOST CYTOKINE RESPONSE
The severity of the inflammation can be attributed to the severity of what is known as the cytokine storm. Levels of interleukin 1B, interferon-gamma, interferon-inducible protein 10, and monocyte chemoattractant protein 1 were all associated with COVID-19 disease severity. Treatment has been proposed to combat the cytokine storm as it remains to be one of the leading causes of morbidity and mortality in COVID-19 disease.
A cytokine storm is due to an acute hyperinflammatory response that is responsible for clinical illness in an array of diseases but in COVID-19, it is related to worse prognosis and increased fatality. The storm causes the acute respiratory distress syndrome, blood clotting events such as strokes, myocardial infarction, encephalitis, acute kidney injury, and vasculitis. The production of IL-1, IL-2, IL-6, TNF-alpha, and interferon-gamma, all crucial components of normal immune responses, inadvertently become the causes of a cytokine storm. The cells of the central nervous system, the microglia, neurons, and astrocytes, are also be involved in the release of pro-inflammatory cytokines affecting the nervous system, and effects of cytokine storms toward the CNS are not uncommon.
DIAGNOSIS
COVID-19 can provisionally be diagnosed on the basis of symptoms and confirmed using reverse transcription polymerase chain reaction (RT-PCR) or other nucleic acid testing of infected secretions. Along with laboratory testing, chest CT scans may be helpful to diagnose COVID-19 in individuals with a high clinical suspicion of infection. Detection of a past infection is possible with serological tests, which detect antibodies produced by the body in response to the infection.
VIRAL TESTING
The standard methods of testing for presence of SARS-CoV-2 are nucleic acid tests, which detects the presence of viral RNA fragments. As these tests detect RNA but not infectious virus, its "ability to determine duration of infectivity of patients is limited." The test is typically done on respiratory samples obtained by a nasopharyngeal swab; however, a nasal swab or sputum sample may also be used. Results are generally available within hours. The WHO has published several testing protocols for the disease.
A number of laboratories and companies have developed serological tests, which detect antibodies produced by the body in response to infection. Several have been evaluated by Public Health England and approved for use in the UK.
The University of Oxford's CEBM has pointed to mounting evidence that "a good proportion of 'new' mild cases and people re-testing positives after quarantine or discharge from hospital are not infectious, but are simply clearing harmless virus particles which their immune system has efficiently dealt with" and have called for "an international effort to standardize and periodically calibrate testing" On 7 September, the UK government issued "guidance for procedures to be implemented in laboratories to provide assurance of positive SARS-CoV-2 RNA results during periods of low prevalence, when there is a reduction in the predictive value of positive test results."
IMAGING
Chest CT scans may be helpful to diagnose COVID-19 in individuals with a high clinical suspicion of infection but are not recommended for routine screening. Bilateral multilobar ground-glass opacities with a peripheral, asymmetric, and posterior distribution are common in early infection. Subpleural dominance, crazy paving (lobular septal thickening with variable alveolar filling), and consolidation may appear as the disease progresses. Characteristic imaging features on chest radiographs and computed tomography (CT) of people who are symptomatic include asymmetric peripheral ground-glass opacities without pleural effusions.
Many groups have created COVID-19 datasets that include imagery such as the Italian Radiological Society which has compiled an international online database of imaging findings for confirmed cases. Due to overlap with other infections such as adenovirus, imaging without confirmation by rRT-PCR is of limited specificity in identifying COVID-19. A large study in China compared chest CT results to PCR and demonstrated that though imaging is less specific for the infection, it is faster and more sensitive.
Coding
In late 2019, the WHO assigned emergency ICD-10 disease codes U07.1 for deaths from lab-confirmed SARS-CoV-2 infection and U07.2 for deaths from clinically or epidemiologically diagnosed COVID-19 without lab-confirmed SARS-CoV-2 infection.
PATHOLOGY
The main pathological findings at autopsy are:
Macroscopy: pericarditis, lung consolidation and pulmonary oedema
Lung findings:
minor serous exudation, minor fibrin exudation
pulmonary oedema, pneumocyte hyperplasia, large atypical pneumocytes, interstitial inflammation with lymphocytic infiltration and multinucleated giant cell formation
diffuse alveolar damage (DAD) with diffuse alveolar exudates. DAD is the cause of acute respiratory distress syndrome (ARDS) and severe hypoxemia.
organisation of exudates in alveolar cavities and pulmonary interstitial fibrosis
plasmocytosis in BAL
Blood: disseminated intravascular coagulation (DIC); leukoerythroblastic reaction
Liver: microvesicular steatosis
PREVENTION
Preventive measures to reduce the chances of infection include staying at home, wearing a mask in public, avoiding crowded places, keeping distance from others, ventilating indoor spaces, washing hands with soap and water often and for at least 20 seconds, practising good respiratory hygiene, and avoiding touching the eyes, nose, or mouth with unwashed hands.
Those diagnosed with COVID-19 or who believe they may be infected are advised by the CDC to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask before entering the healthcare provider's office and when in any room or vehicle with another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal household items.
The first COVID-19 vaccine was granted regulatory approval on 2 December by the UK medicines regulator MHRA. It was evaluated for emergency use authorization (EUA) status by the US FDA, and in several other countries. Initially, the US National Institutes of Health guidelines do not recommend any medication for prevention of COVID-19, before or after exposure to the SARS-CoV-2 virus, outside the setting of a clinical trial. Without a vaccine, other prophylactic measures, or effective treatments, a key part of managing COVID-19 is trying to decrease and delay the epidemic peak, known as "flattening the curve". This is done by slowing the infection rate to decrease the risk of health services being overwhelmed, allowing for better treatment of current cases, and delaying additional cases until effective treatments or a vaccine become available.
VACCINE
A COVID‑19 vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus causing coronavirus disease 2019 (COVID‑19). Prior to the COVID‑19 pandemic, there was an established body of knowledge about the structure and function of coronaviruses causing diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), which enabled accelerated development of various vaccine technologies during early 2020. On 10 January 2020, the SARS-CoV-2 genetic sequence data was shared through GISAID, and by 19 March, the global pharmaceutical industry announced a major commitment to address COVID-19.
In Phase III trials, several COVID‑19 vaccines have demonstrated efficacy as high as 95% in preventing symptomatic COVID‑19 infections. As of March 2021, 12 vaccines were authorized by at least one national regulatory authority for public use: two RNA vaccines (the Pfizer–BioNTech vaccine and the Moderna vaccine), four conventional inactivated vaccines (BBIBP-CorV, CoronaVac, Covaxin, and CoviVac), four viral vector vaccines (Sputnik V, the Oxford–AstraZeneca vaccine, Convidicea, and the Johnson & Johnson vaccine), and two protein subunit vaccines (EpiVacCorona and RBD-Dimer). In total, as of March 2021, 308 vaccine candidates were in various stages of development, with 73 in clinical research, including 24 in Phase I trials, 33 in Phase I–II trials, and 16 in Phase III development.
Many countries have implemented phased distribution plans that prioritize those at highest risk of complications, such as the elderly, and those at high risk of exposure and transmission, such as healthcare workers. As of 17 March 2021, 400.22 million doses of COVID‑19 vaccine have been administered worldwide based on official reports from national health agencies. AstraZeneca-Oxford anticipates producing 3 billion doses in 2021, Pfizer-BioNTech 1.3 billion doses, and Sputnik V, Sinopharm, Sinovac, and Johnson & Johnson 1 billion doses each. Moderna targets producing 600 million doses and Convidicea 500 million doses in 2021. By December 2020, more than 10 billion vaccine doses had been preordered by countries, with about half of the doses purchased by high-income countries comprising 14% of the world's population.
SOCIAL DISTANCING
Social distancing (also known as physical distancing) includes infection control actions intended to slow the spread of the disease by minimising close contact between individuals. Methods include quarantines; travel restrictions; and the closing of schools, workplaces, stadiums, theatres, or shopping centres. Individuals may apply social distancing methods by staying at home, limiting travel, avoiding crowded areas, using no-contact greetings, and physically distancing themselves from others. Many governments are now mandating or recommending social distancing in regions affected by the outbreak.
Outbreaks have occurred in prisons due to crowding and an inability to enforce adequate social distancing. In the United States, the prisoner population is aging and many of them are at high risk for poor outcomes from COVID-19 due to high rates of coexisting heart and lung disease, and poor access to high-quality healthcare.
SELF-ISOLATION
Self-isolation at home has been recommended for those diagnosed with COVID-19 and those who suspect they have been infected. Health agencies have issued detailed instructions for proper self-isolation. Many governments have mandated or recommended self-quarantine for entire populations. The strongest self-quarantine instructions have been issued to those in high-risk groups. Those who may have been exposed to someone with COVID-19 and those who have recently travelled to a country or region with the widespread transmission have been advised to self-quarantine for 14 days from the time of last possible exposure.
Face masks and respiratory hygiene
The WHO and the US CDC recommend individuals wear non-medical face coverings in public settings where there is an increased risk of transmission and where social distancing measures are difficult to maintain. This recommendation is meant to reduce the spread of the disease by asymptomatic and pre-symptomatic individuals and is complementary to established preventive measures such as social distancing. Face coverings limit the volume and travel distance of expiratory droplets dispersed when talking, breathing, and coughing. A face covering without vents or holes will also filter out particles containing the virus from inhaled and exhaled air, reducing the chances of infection. But, if the mask include an exhalation valve, a wearer that is infected (maybe without having noticed that, and asymptomatic) would transmit the virus outwards through it, despite any certification they can have. So the masks with exhalation valve are not for the infected wearers, and are not reliable to stop the pandemic in a large scale. Many countries and local jurisdictions encourage or mandate the use of face masks or cloth face coverings by members of the public to limit the spread of the virus.
Masks are also strongly recommended for those who may have been infected and those taking care of someone who may have the disease. When not wearing a mask, the CDC recommends covering the mouth and nose with a tissue when coughing or sneezing and recommends using the inside of the elbow if no tissue is available. Proper hand hygiene after any cough or sneeze is encouraged. Healthcare professionals interacting directly with people who have COVID-19 are advised to use respirators at least as protective as NIOSH-certified N95 or equivalent, in addition to other personal protective equipment.
HAND-WASHING AND HYGIENE
Thorough hand hygiene after any cough or sneeze is required. The WHO also recommends that individuals wash hands often with soap and water for at least 20 seconds, especially after going to the toilet or when hands are visibly dirty, before eating and after blowing one's nose. The CDC recommends using an alcohol-based hand sanitiser with at least 60% alcohol, but only when soap and water are not readily available. For areas where commercial hand sanitisers are not readily available, the WHO provides two formulations for local production. In these formulations, the antimicrobial activity arises from ethanol or isopropanol. Hydrogen peroxide is used to help eliminate bacterial spores in the alcohol; it is "not an active substance for hand antisepsis". Glycerol is added as a humectant.
SURFACE CLEANING
After being expelled from the body, coronaviruses can survive on surfaces for hours to days. If a person touches the dirty surface, they may deposit the virus at the eyes, nose, or mouth where it can enter the body cause infection. Current evidence indicates that contact with infected surfaces is not the main driver of Covid-19, leading to recommendations for optimised disinfection procedures to avoid issues such as the increase of antimicrobial resistance through the use of inappropriate cleaning products and processes. Deep cleaning and other surface sanitation has been criticized as hygiene theater, giving a false sense of security against something primarily spread through the air.
The amount of time that the virus can survive depends significantly on the type of surface, the temperature, and the humidity. Coronaviruses die very quickly when exposed to the UV light in sunlight. Like other enveloped viruses, SARS-CoV-2 survives longest when the temperature is at room temperature or lower, and when the relative humidity is low (<50%).
On many surfaces, including as glass, some types of plastic, stainless steel, and skin, the virus can remain infective for several days indoors at room temperature, or even about a week under ideal conditions. On some surfaces, including cotton fabric and copper, the virus usually dies after a few hours. As a general rule of thumb, the virus dies faster on porous surfaces than on non-porous surfaces.
However, this rule is not absolute, and of the many surfaces tested, two with the longest survival times are N95 respirator masks and surgical masks, both of which are considered porous surfaces.
Surfaces may be decontaminated with 62–71 percent ethanol, 50–100 percent isopropanol, 0.1 percent sodium hypochlorite, 0.5 percent hydrogen peroxide, and 0.2–7.5 percent povidone-iodine. Other solutions, such as benzalkonium chloride and chlorhexidine gluconate, are less effective. Ultraviolet germicidal irradiation may also be used. The CDC recommends that if a COVID-19 case is suspected or confirmed at a facility such as an office or day care, all areas such as offices, bathrooms, common areas, shared electronic equipment like tablets, touch screens, keyboards, remote controls, and ATM machines used by the ill persons should be disinfected. A datasheet comprising the authorised substances to disinfection in the food industry (including suspension or surface tested, kind of surface, use dilution, disinfectant and inocuylum volumes) can be seen in the supplementary material of.
VENTILATION AND AIR FILTRATION
The WHO recommends ventilation and air filtration in public spaces to help clear out infectious aerosols.
HEALTHY DIET AND LIFESTYLE
The Harvard T.H. Chan School of Public Health recommends a healthy diet, being physically active, managing psychological stress, and getting enough sleep.
While there is no evidence that vitamin D is an effective treatment for COVID-19, there is limited evidence that vitamin D deficiency increases the risk of severe COVID-19 symptoms. This has led to recommendations for individuals with vitamin D deficiency to take vitamin D supplements as a way of mitigating the risk of COVID-19 and other health issues associated with a possible increase in deficiency due to social distancing.
TREATMENT
There is no specific, effective treatment or cure for coronavirus disease 2019 (COVID-19), the disease caused by the SARS-CoV-2 virus. Thus, the cornerstone of management of COVID-19 is supportive care, which includes treatment to relieve symptoms, fluid therapy, oxygen support and prone positioning as needed, and medications or devices to support other affected vital organs.
Most cases of COVID-19 are mild. In these, supportive care includes medication such as paracetamol or NSAIDs to relieve symptoms (fever, body aches, cough), proper intake of fluids, rest, and nasal breathing. Good personal hygiene and a healthy diet are also recommended. The U.S. Centers for Disease Control and Prevention (CDC) recommend that those who suspect they are carrying the virus isolate themselves at home and wear a face mask.
People with more severe cases may need treatment in hospital. In those with low oxygen levels, use of the glucocorticoid dexamethasone is strongly recommended, as it can reduce the risk of death. Noninvasive ventilation and, ultimately, admission to an intensive care unit for mechanical ventilation may be required to support breathing. Extracorporeal membrane oxygenation (ECMO) has been used to address the issue of respiratory failure, but its benefits are still under consideration.
Several experimental treatments are being actively studied in clinical trials. Others were thought to be promising early in the pandemic, such as hydroxychloroquine and lopinavir/ritonavir, but later research found them to be ineffective or even harmful. Despite ongoing research, there is still not enough high-quality evidence to recommend so-called early treatment. Nevertheless, in the United States, two monoclonal antibody-based therapies are available for early use in cases thought to be at high risk of progression to severe disease. The antiviral remdesivir is available in the U.S., Canada, Australia, and several other countries, with varying restrictions; however, it is not recommended for people needing mechanical ventilation, and is discouraged altogether by the World Health Organization (WHO), due to limited evidence of its efficacy.
PROGNOSIS
The severity of COVID-19 varies. The disease may take a mild course with few or no symptoms, resembling other common upper respiratory diseases such as the common cold. In 3–4% of cases (7.4% for those over age 65) symptoms are severe enough to cause hospitalization. Mild cases typically recover within two weeks, while those with severe or critical diseases may take three to six weeks to recover. Among those who have died, the time from symptom onset to death has ranged from two to eight weeks. The Italian Istituto Superiore di Sanità reported that the median time between the onset of symptoms and death was twelve days, with seven being hospitalised. However, people transferred to an ICU had a median time of ten days between hospitalisation and death. Prolonged prothrombin time and elevated C-reactive protein levels on admission to the hospital are associated with severe course of COVID-19 and with a transfer to ICU.
Some early studies suggest 10% to 20% of people with COVID-19 will experience symptoms lasting longer than a month.[191][192] A majority of those who were admitted to hospital with severe disease report long-term problems including fatigue and shortness of breath. On 30 October 2020 WHO chief Tedros Adhanom warned that "to a significant number of people, the COVID virus poses a range of serious long-term effects". He has described the vast spectrum of COVID-19 symptoms that fluctuate over time as "really concerning." They range from fatigue, a cough and shortness of breath, to inflammation and injury of major organs – including the lungs and heart, and also neurological and psychologic effects. Symptoms often overlap and can affect any system in the body. Infected people have reported cyclical bouts of fatigue, headaches, months of complete exhaustion, mood swings, and other symptoms. Tedros has concluded that therefore herd immunity is "morally unconscionable and unfeasible".
In terms of hospital readmissions about 9% of 106,000 individuals had to return for hospital treatment within 2 months of discharge. The average to readmit was 8 days since first hospital visit. There are several risk factors that have been identified as being a cause of multiple admissions to a hospital facility. Among these are advanced age (above 65 years of age) and presence of a chronic condition such as diabetes, COPD, heart failure or chronic kidney disease.
According to scientific reviews smokers are more likely to require intensive care or die compared to non-smokers, air pollution is similarly associated with risk factors, and pre-existing heart and lung diseases and also obesity contributes to an increased health risk of COVID-19.
It is also assumed that those that are immunocompromised are at higher risk of getting severely sick from SARS-CoV-2. One research that looked into the COVID-19 infections in hospitalized kidney transplant recipients found a mortality rate of 11%.
See also: Impact of the COVID-19 pandemic on children
Children make up a small proportion of reported cases, with about 1% of cases being under 10 years and 4% aged 10–19 years. They are likely to have milder symptoms and a lower chance of severe disease than adults. A European multinational study of hospitalized children published in The Lancet on 25 June 2020 found that about 8% of children admitted to a hospital needed intensive care. Four of those 582 children (0.7%) died, but the actual mortality rate could be "substantially lower" since milder cases that did not seek medical help were not included in the study.
Genetics also plays an important role in the ability to fight off the disease. For instance, those that do not produce detectable type I interferons or produce auto-antibodies against these may get much sicker from COVID-19. Genetic screening is able to detect interferon effector genes.
Pregnant women may be at higher risk of severe COVID-19 infection based on data from other similar viruses, like SARS and MERS, but data for COVID-19 is lacking.
COMPLICATIONS
Complications may include pneumonia, acute respiratory distress syndrome (ARDS), multi-organ failure, septic shock, and death. Cardiovascular complications may include heart failure, arrhythmias, heart inflammation, and blood clots. Approximately 20–30% of people who present with COVID-19 have elevated liver enzymes, reflecting liver injury.
Neurologic manifestations include seizure, stroke, encephalitis, and Guillain–Barré syndrome (which includes loss of motor functions). Following the infection, children may develop paediatric multisystem inflammatory syndrome, which has symptoms similar to Kawasaki disease, which can be fatal. In very rare cases, acute encephalopathy can occur, and it can be considered in those who have been diagnosed with COVID-19 and have an altered mental status.
LONGER-TERM EFFECTS
Some early studies suggest that that 10 to 20% of people with COVID-19 will experience symptoms lasting longer than a month. A majority of those who were admitted to hospital with severe disease report long-term problems, including fatigue and shortness of breath. About 5-10% of patients admitted to hospital progress to severe or critical disease, including pneumonia and acute respiratory failure.
By a variety of mechanisms, the lungs are the organs most affected in COVID-19.[228] The majority of CT scans performed show lung abnormalities in people tested after 28 days of illness.
People with advanced age, severe disease, prolonged ICU stays, or who smoke are more likely to have long lasting effects, including pulmonary fibrosis. Overall, approximately one third of those investigated after 4 weeks will have findings of pulmonary fibrosis or reduced lung function as measured by DLCO, even in people who are asymptomatic, but with the suggestion of continuing improvement with the passing of more time.
IMMUNITY
The immune response by humans to CoV-2 virus occurs as a combination of the cell-mediated immunity and antibody production, just as with most other infections. Since SARS-CoV-2 has been in the human population only since December 2019, it remains unknown if the immunity is long-lasting in people who recover from the disease. The presence of neutralizing antibodies in blood strongly correlates with protection from infection, but the level of neutralizing antibody declines with time. Those with asymptomatic or mild disease had undetectable levels of neutralizing antibody two months after infection. In another study, the level of neutralizing antibody fell 4-fold 1 to 4 months after the onset of symptoms. However, the lack of antibody in the blood does not mean antibody will not be rapidly produced upon reexposure to SARS-CoV-2. Memory B cells specific for the spike and nucleocapsid proteins of SARS-CoV-2 last for at least 6 months after appearance of symptoms. Nevertheless, 15 cases of reinfection with SARS-CoV-2 have been reported using stringent CDC criteria requiring identification of a different variant from the second infection. There are likely to be many more people who have been reinfected with the virus. Herd immunity will not eliminate the virus if reinfection is common. Some other coronaviruses circulating in people are capable of reinfection after roughly a year. Nonetheless, on 3 March 2021, scientists reported that a much more contagious Covid-19 variant, Lineage P.1, first detected in Japan, and subsequently found in Brazil, as well as in several places in the United States, may be associated with Covid-19 disease reinfection after recovery from an earlier Covid-19 infection.
MORTALITY
Several measures are commonly used to quantify mortality. These numbers vary by region and over time and are influenced by the volume of testing, healthcare system quality, treatment options, time since the initial outbreak, and population characteristics such as age, sex, and overall health. The mortality rate reflects the number of deaths within a specific demographic group divided by the population of that demographic group. Consequently, the mortality rate reflects the prevalence as well as the severity of the disease within a given population. Mortality rates are highly correlated to age, with relatively low rates for young people and relatively high rates among the elderly.
The case fatality rate (CFR) reflects the number of deaths divided by the number of diagnosed cases within a given time interval. Based on Johns Hopkins University statistics, the global death-to-case ratio is 2.2% (2,685,770/121,585,388) as of 18 March 2021. The number varies by region. The CFR may not reflect the true severity of the disease, because some infected individuals remain asymptomatic or experience only mild symptoms, and hence such infections may not be included in official case reports. Moreover, the CFR may vary markedly over time and across locations due to the availability of live virus tests.
INFECTION FATALITY RATE
A key metric in gauging the severity of COVID-19 is the infection fatality rate (IFR), also referred to as the infection fatality ratio or infection fatality risk. This metric is calculated by dividing the total number of deaths from the disease by the total number of infected individuals; hence, in contrast to the CFR, the IFR incorporates asymptomatic and undiagnosed infections as well as reported cases.
CURRENT ESTIMATES
A December 2020 systematic review and meta-analysis estimated that population IFR during the first wave of the pandemic was about 0.5% to 1% in many locations (including France, Netherlands, New Zealand, and Portugal), 1% to 2% in other locations (Australia, England, Lithuania, and Spain), and exceeded 2% in Italy. That study also found that most of these differences in IFR reflected corresponding differences in the age composition of the population and age-specific infection rates; in particular, the metaregression estimate of IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. These results were also highlighted in a December 2020 report issued by the WHO.
EARLIER ESTIMATES OF IFR
At an early stage of the pandemic, the World Health Organization reported estimates of IFR between 0.3% and 1%.[ On 2 July, The WHO's chief scientist reported that the average IFR estimate presented at a two-day WHO expert forum was about 0.6%. In August, the WHO found that studies incorporating data from broad serology testing in Europe showed IFR estimates converging at approximately 0.5–1%. Firm lower limits of IFRs have been established in a number of locations such as New York City and Bergamo in Italy since the IFR cannot be less than the population fatality rate. As of 10 July, in New York City, with a population of 8.4 million, 23,377 individuals (18,758 confirmed and 4,619 probable) have died with COVID-19 (0.3% of the population).Antibody testing in New York City suggested an IFR of ~0.9%,[258] and ~1.4%. In Bergamo province, 0.6% of the population has died. In September 2020 the U.S. Center for Disease Control & Prevention reported preliminary estimates of age-specific IFRs for public health planning purposes.
SEX DIFFERENCES
Early reviews of epidemiologic data showed gendered impact of the pandemic and a higher mortality rate in men in China and Italy. The Chinese Center for Disease Control and Prevention reported the death rate was 2.8% for men and 1.7% for women. Later reviews in June 2020 indicated that there is no significant difference in susceptibility or in CFR between genders. One review acknowledges the different mortality rates in Chinese men, suggesting that it may be attributable to lifestyle choices such as smoking and drinking alcohol rather than genetic factors. Sex-based immunological differences, lesser prevalence of smoking in women and men developing co-morbid conditions such as hypertension at a younger age than women could have contributed to the higher mortality in men. In Europe, 57% of the infected people were men and 72% of those died with COVID-19 were men. As of April 2020, the US government is not tracking sex-related data of COVID-19 infections. Research has shown that viral illnesses like Ebola, HIV, influenza and SARS affect men and women differently.
ETHNIC DIFFERENCES
In the US, a greater proportion of deaths due to COVID-19 have occurred among African Americans and other minority groups. Structural factors that prevent them from practicing social distancing include their concentration in crowded substandard housing and in "essential" occupations such as retail grocery workers, public transit employees, health-care workers and custodial staff. Greater prevalence of lacking health insurance and care and of underlying conditions such as diabetes, hypertension and heart disease also increase their risk of death. Similar issues affect Native American and Latino communities. According to a US health policy non-profit, 34% of American Indian and Alaska Native People (AIAN) non-elderly adults are at risk of serious illness compared to 21% of white non-elderly adults. The source attributes it to disproportionately high rates of many health conditions that may put them at higher risk as well as living conditions like lack of access to clean water. Leaders have called for efforts to research and address the disparities. In the U.K., a greater proportion of deaths due to COVID-19 have occurred in those of a Black, Asian, and other ethnic minority background. More severe impacts upon victims including the relative incidence of the necessity of hospitalization requirements, and vulnerability to the disease has been associated via DNA analysis to be expressed in genetic variants at chromosomal region 3, features that are associated with European Neanderthal heritage. That structure imposes greater risks that those affected will develop a more severe form of the disease. The findings are from Professor Svante Pääbo and researchers he leads at the Max Planck Institute for Evolutionary Anthropology and the Karolinska Institutet. This admixture of modern human and Neanderthal genes is estimated to have occurred roughly between 50,000 and 60,000 years ago in Southern Europe.
COMORBIDITIES
Most of those who die of COVID-19 have pre-existing (underlying) conditions, including hypertension, diabetes mellitus, and cardiovascular disease. According to March data from the United States, 89% of those hospitalised had preexisting conditions. The Italian Istituto Superiore di Sanità reported that out of 8.8% of deaths where medical charts were available, 96.1% of people had at least one comorbidity with the average person having 3.4 diseases. According to this report the most common comorbidities are hypertension (66% of deaths), type 2 diabetes (29.8% of deaths), Ischemic Heart Disease (27.6% of deaths), atrial fibrillation (23.1% of deaths) and chronic renal failure (20.2% of deaths).
Most critical respiratory comorbidities according to the CDC, are: moderate or severe asthma, pre-existing COPD, pulmonary fibrosis, cystic fibrosis. Evidence stemming from meta-analysis of several smaller research papers also suggests that smoking can be associated with worse outcomes. When someone with existing respiratory problems is infected with COVID-19, they might be at greater risk for severe symptoms. COVID-19 also poses a greater risk to people who misuse opioids and methamphetamines, insofar as their drug use may have caused lung damage.
In August 2020 the CDC issued a caution that tuberculosis infections could increase the risk of severe illness or death. The WHO recommended that people with respiratory symptoms be screened for both diseases, as testing positive for COVID-19 couldn't rule out co-infections. Some projections have estimated that reduced TB detection due to the pandemic could result in 6.3 million additional TB cases and 1.4 million TB related deaths by 2025.
NAME
During the initial outbreak in Wuhan, China, the virus and disease were commonly referred to as "coronavirus" and "Wuhan coronavirus", with the disease sometimes called "Wuhan pneumonia". In the past, many diseases have been named after geographical locations, such as the Spanish flu, Middle East Respiratory Syndrome, and Zika virus. In January 2020, the WHO recommended 2019-nCov and 2019-nCoV acute respiratory disease as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations (e.g. Wuhan, China), animal species, or groups of people in disease and virus names in part to prevent social stigma. The official names COVID-19 and SARS-CoV-2 were issued by the WHO on 11 February 2020. Tedros Adhanom explained: CO for corona, VI for virus, D for disease and 19 for when the outbreak was first identified (31 December 2019). The WHO additionally uses "the COVID-19 virus" and "the virus responsible for COVID-19" in public communications.
HISTORY
The virus is thought to be natural and of an animal origin, through spillover infection. There are several theories about where the first case (the so-called patient zero) originated. Phylogenetics estimates that SARS-CoV-2 arose in October or November 2019. Evidence suggests that it descends from a coronavirus that infects wild bats, and spread to humans through an intermediary wildlife host.
The first known human infections were in Wuhan, Hubei, China. A study of the first 41 cases of confirmed COVID-19, published in January 2020 in The Lancet, reported the earliest date of onset of symptoms as 1 December 2019.Official publications from the WHO reported the earliest onset of symptoms as 8 December 2019. Human-to-human transmission was confirmed by the WHO and Chinese authorities by 20 January 2020. According to official Chinese sources, these were mostly linked to the Huanan Seafood Wholesale Market, which also sold live animals. In May 2020 George Gao, the director of the CDC, said animal samples collected from the seafood market had tested negative for the virus, indicating that the market was the site of an early superspreading event, but that it was not the site of the initial outbreak.[ Traces of the virus have been found in wastewater samples that were collected in Milan and Turin, Italy, on 18 December 2019.
By December 2019, the spread of infection was almost entirely driven by human-to-human transmission. The number of coronavirus cases in Hubei gradually increased, reaching 60 by 20 December, and at least 266 by 31 December. On 24 December, Wuhan Central Hospital sent a bronchoalveolar lavage fluid (BAL) sample from an unresolved clinical case to sequencing company Vision Medicals. On 27 and 28 December, Vision Medicals informed the Wuhan Central Hospital and the Chinese CDC of the results of the test, showing a new coronavirus. A pneumonia cluster of unknown cause was observed on 26 December and treated by the doctor Zhang Jixian in Hubei Provincial Hospital, who informed the Wuhan Jianghan CDC on 27 December. On 30 December, a test report addressed to Wuhan Central Hospital, from company CapitalBio Medlab, stated an erroneous positive result for SARS, causing a group of doctors at Wuhan Central Hospital to alert their colleagues and relevant hospital authorities of the result. The Wuhan Municipal Health Commission issued a notice to various medical institutions on "the treatment of pneumonia of unknown cause" that same evening. Eight of these doctors, including Li Wenliang (punished on 3 January), were later admonished by the police for spreading false rumours and another, Ai Fen, was reprimanded by her superiors for raising the alarm.
The Wuhan Municipal Health Commission made the first public announcement of a pneumonia outbreak of unknown cause on 31 December, confirming 27 cases—enough to trigger an investigation.
During the early stages of the outbreak, the number of cases doubled approximately every seven and a half days. In early and mid-January 2020, the virus spread to other Chinese provinces, helped by the Chinese New Year migration and Wuhan being a transport hub and major rail interchange. On 20 January, China reported nearly 140 new cases in one day, including two people in Beijing and one in Shenzhen. Later official data shows 6,174 people had already developed symptoms by then, and more may have been infected. A report in The Lancet on 24 January indicated human transmission, strongly recommended personal protective equipment for health workers, and said testing for the virus was essential due to its "pandemic potential". On 30 January, the WHO declared the coronavirus a Public Health Emergency of International Concern. By this time, the outbreak spread by a factor of 100 to 200 times.
Italy had its first confirmed cases on 31 January 2020, two tourists from China. As of 13 March 2020 the WHO considered Europe the active centre of the pandemic. Italy overtook China as the country with the most deaths on 19 March 2020. By 26 March the United States had overtaken China and Italy with the highest number of confirmed cases in the world. Research on coronavirus genomes indicates the majority of COVID-19 cases in New York came from European travellers, rather than directly from China or any other Asian country. Retesting of prior samples found a person in France who had the virus on 27 December 2019, and a person in the United States who died from the disease on 6 February 2020.
After 55 days without a locally transmitted case, Beijing reported a new COVID-19 case on 11 June 2020 which was followed by two more cases on 12 June. By 15 June there were 79 cases officially confirmed, most of them were people that went to Xinfadi Wholesale Market.
RT-PCR testing of untreated wastewater samples from Brazil and Italy have suggested detection of SARS-CoV-2 as early as November and December 2019, respectively, but the methods of such sewage studies have not been optimised, many have not been peer reviewed, details are often missing, and there is a risk of false positives due to contamination or if only one gene target is detected. A September 2020 review journal article said, "The possibility that the COVID-19 infection had already spread to Europe at the end of last year is now indicated by abundant, even if partially circumstantial, evidence", including pneumonia case numbers and radiology in France and Italy in November and December.
MISINFORMATION
After the initial outbreak of COVID-19, misinformation and disinformation regarding the origin, scale, prevention, treatment, and other aspects of the disease rapidly spread online.
In September 2020, the U.S. CDC published preliminary estimates of the risk of death by age groups in the United States, but those estimates were widely misreported and misunderstood.
OTHER ANIMALS
Humans appear to be capable of spreading the virus to some other animals, a type of disease transmission referred to as zooanthroponosis.
Some pets, especially cats and ferrets, can catch this virus from infected humans. Symptoms in cats include respiratory (such as a cough) and digestive symptoms. Cats can spread the virus to other cats, and may be able to spread the virus to humans, but cat-to-human transmission of SARS-CoV-2 has not been proven. Compared to cats, dogs are less susceptible to this infection. Behaviors which increase the risk of transmission include kissing, licking, and petting the animal.
The virus does not appear to be able to infect pigs, ducks, or chickens at all.[ Mice, rats, and rabbits, if they can be infected at all, are unlikely to be involved in spreading the virus.
Tigers and lions in zoos have become infected as a result of contact with infected humans. As expected, monkeys and great ape species such as orangutans can also be infected with the COVID-19 virus.
Minks, which are in the same family as ferrets, have been infected. Minks may be asymptomatic, and can also spread the virus to humans. Multiple countries have identified infected animals in mink farms. Denmark, a major producer of mink pelts, ordered the slaughter of all minks over fears of viral mutations. A vaccine for mink and other animals is being researched.
RESEARCH
International research on vaccines and medicines in COVID-19 is underway by government organisations, academic groups, and industry researchers. The CDC has classified it to require a BSL3 grade laboratory. There has been a great deal of COVID-19 research, involving accelerated research processes and publishing shortcuts to meet the global demand.
As of December 2020, hundreds of clinical trials have been undertaken, with research happening on every continent except Antarctica. As of November 2020, more than 200 possible treatments had been studied in humans so far.
Transmission and prevention research
Modelling research has been conducted with several objectives, including predictions of the dynamics of transmission, diagnosis and prognosis of infection, estimation of the impact of interventions, or allocation of resources. Modelling studies are mostly based on epidemiological models, estimating the number of infected people over time under given conditions. Several other types of models have been developed and used during the COVID-19 including computational fluid dynamics models to study the flow physics of COVID-19, retrofits of crowd movement models to study occupant exposure, mobility-data based models to investigate transmission, or the use of macroeconomic models to assess the economic impact of the pandemic. Further, conceptual frameworks from crisis management research have been applied to better understand the effects of COVID-19 on organizations worldwide.
TREATMENT-RELATED RESEARCH
Repurposed antiviral drugs make up most of the research into COVID-19 treatments. Other candidates in trials include vasodilators, corticosteroids, immune therapies, lipoic acid, bevacizumab, and recombinant angiotensin-converting enzyme 2.
In March 2020, the World Health Organization (WHO) initiated the Solidarity trial to assess the treatment effects of some promising drugs: an experimental drug called remdesivir; anti-malarial drugs chloroquine and hydroxychloroquine; two anti-HIV drugs, lopinavir/ritonavir; and interferon-beta. More than 300 active clinical trials were underway as of April 2020.
Research on the antimalarial drugs hydroxychloroquine and chloroquine showed that they were ineffective at best, and that they may reduce the antiviral activity of remdesivir. By May 2020, France, Italy, and Belgium had banned the use of hydroxychloroquine as a COVID-19 treatment.
In June, initial results from the randomised RECOVERY Trial in the United Kingdom showed that dexamethasone reduced mortality by one third for people who are critically ill on ventilators and one fifth for those receiving supplemental oxygen. Because this is a well-tested and widely available treatment, it was welcomed by the WHO, which is in the process of updating treatment guidelines to include dexamethasone and other steroids. Based on those preliminary results, dexamethasone treatment has been recommended by the NIH for patients with COVID-19 who are mechanically ventilated or who require supplemental oxygen but not in patients with COVID-19 who do not require supplemental oxygen.
In September 2020, the WHO released updated guidance on using corticosteroids for COVID-19. The WHO recommends systemic corticosteroids rather than no systemic corticosteroids for the treatment of people with severe and critical COVID-19 (strong recommendation, based on moderate certainty evidence). The WHO suggests not to use corticosteroids in the treatment of people with non-severe COVID-19 (conditional recommendation, based on low certainty evidence). The updated guidance was based on a meta-analysis of clinical trials of critically ill COVID-19 patients.
WIKIPEDIA
In 2013 Thierry Geoffroy / Colonel is represented at the Malives pavilion at the Venice Biennale and then went further and received hospitality at the Zimbabwe pavilion with the Emergency Room Mobile
www.emergencyrooms.org/biennalist.html
Meanwhile Thierry Geoffroy is in Copenhagen the work about todays emergencies continue at the gallery Marianne Friis on the WARM UP Wall established for this occasion since 6sept 2013
thierrygeoffroy.blogspot.dk/2013/09/colonel-s-warm-up-wal...
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other pavilions at Venice Biennale
Andorra Artists: Javier Balmaseda, Samantha Bosque, Fiona Morrison
Commissioner: Henry Périer Deputy Commissioners: Francesc Rodríguez, Ermengol Puig, Ruth Casabella
Curators: Josep M. Ubach, Paolo De GrandisAngola Artist: Edson Chagas Commissioner: Ministry of Culture
Curators: Beyond Entropy (Paula Nascimento, Stefano Rabolli Pansera), Jorge Gumbe, Feliciano dos Santos
Argentina Artist: Nicola Costantino Commissioner: Magdalena Faillace Curator: Fernando Farina
Armenia Artist: Ararat SarkissianCurator: Arman Grogoryan /AustraliaArtist: Simryn Gill Commissioner: Simon Mordant Deputy Commissioner: Penelope Seidler Curator: Catherine de Zegher /AustriaArtist: Mathias Poledna ,Curator: Jasper Sharp /AzerbaijanArtists: Rashad Alakbarov, Sanan Aleskerov, Chingiz Babayev, Butunay Hagverdiyev, Fakhriyya Mammadova, Farid Rasulov /Commissioner: Heydar Aliyev FoundationCurator: Hervé Mikaeloff
Bahamas Artist: Tavares Strachan Commissioner: Nalini Bethel, Ministry of Tourism Curators: Jean Crutchfield, Robert HobbsDeputy Curator: Stamatina Gregory/BangladeshChhakka Artists’ Group: Mokhlesur Rahman, Mahbub Zamal, A. K. M. Zahidul Mustafa, Ashok Karmaker, Lala Rukh Selim, Uttam Kumar Karmaker. Dhali Al Mamoon, Yasmin Jahan Nupur, Gavin Rain, Gianfranco Meggiato, Charupit School/Commissioner/Curator: Francesco Elisei. , Curator: Fabio Anselmi./BahrainArtists: Mariam Haji, Waheeda Malullah, Camille Zakharia /Commissioner: Mai bint Mohammed Al Khalifa, Minister of Culture /Curator: Melissa Enders-Bhatiaa/BelgiumArtist: Berlinde De Bruyckere
Commissioner: Joke Schauvliege, Flemish Minister for Environment, Nature and Culture .Curator: J. M. Coetzee ,Deputy Curator: Philippe Van Cauteren /Bosnia and Herzegovina
Artist: Mladen Miljanovic .Commissioners: Sarita Vujković, Irfan Hošić
Brazil Artists: Hélio Fervenza, Odires Mlászho, Lygia Clark, Max Bill, Bruno Munari
Commissioner: Luis Terepins, Fundação Bienal de São Paulo,Curator: Luis Pérez-Oramas ,Deputy Curator: André Severo
CanadaArtist: Shary Boyle /Commissioner: National Gallery of Canada / Musée des beaux-arts du Canada ,Curator: Josée Drouin-Brisebois/Central AsiaArtists: Vyacheslav Akhunov, Sergey Chutkov, Saodat Ismailova, Kamilla Kurmanbekova, Ikuru Kuwajima, Anton Rodin, Aza Shade, Erlan Tuyakov
Commissioner: HIVOS (Humanist Institute for Development Cooperation)
Deputy Commissioner: Dean Vanessa Ohlraun (Oslo National Academy of the Arts/The Academy of Fine Art)
Curators: Ayatgali Tuleubek, Tiago Bom
Scientific Committee: Susanne M. Winterling
ChileArtist: Alfredo JaarCommissioner: CNCA, National Council of Culture and the Arts Curator: Madeleine Grynsztejn
ChinaArtists: He Yunchang, Hu Yaolin, Miao Xiaochun, Shu Yong, Tong Hongsheng, Wang Qingsong, Zhang Xiaotao
Commissioner: China Arts and Entertainment Group (CAEG) ,Curator: Wang Chunchen
Costa Rica Artists: Priscilla Monge, Esteban Piedra, Rafael Ottón Solís, Cinthya Soto
Commissioner: Francesco EliseiCurator: Francisco Córdoba, Museo de Arte y Diseño Contemporáneo (Fiorella Resenterra)
Croatia Artist: Kata Mijatovic ,Commissioner/Curator: Branko Franceschi.
CubaArtists: Liudmila and Nelson, Maria Magdalena Campos & Neil Leonard, Sandra Ramos, Glenda León, Lázaro Saavedra, Tonel, Hermann Nitsch, Gilberto Zorio, Wang Du, H.H.Lim, Pedro Costa, Rui Chafes, Francesca Leone ,Commissioner: Miria ViciniCurators: Jorge Fernández Torres, Giacomo Zaza
CyprusArtists: Lia Haraki, Maria Hassabi, Phanos Kyriacou, Constantinos Taliotis, Natalie Yiaxi, Morten Norbye Halvorsen, Jason Dodge, Gabriel Lester, Dexter Sinister /Louli Michaelidou
Deputy Commissioners: Angela Skordi, Marika Ioannou/Curator: Raimundas Malašauskas
Czech Republic & Slovak RepublicArtists: Petra Feriancova, Zbynek Baladran ,Commissioner: Monika Palcova, Curator: Marek Pokorny /DenmarkArtist: Jesper Just in collaboration with Project ProjectsEgypt
Artists: Mohamed Banawy, Khaled Zaki
EstoniaArtist: Dénes Farkas ,Commissioner: Maria Arusoo ,Curator: Adam Budak
FinlandArtist: Antti Laitinen , Commissioner: Raija Koli , Curators: Marko Karo, Mika Elo, Harri Laakso
FranceArtist: Anri Sala ,Curator: Christine Macel
GeorgiaArtists: Bouillon Group,Thea Djordjadze, Nikoloz Lutidze, Gela Patashuri with Ei Arakawa and Sergei Tcherepnin, Gio Sumbadze/Commissioner: Marine Mizandari, First Deputy Minister of Culture Curator: Joanna Warsza
GermanyArtists: Ai Weiwei, Romuald Karmakar, Santu Mofokeng, Dayanita Singh Commissioner/Curator: Susanne Gaensheimer /Great BritainArtist: Jeremy Deller ,Commissioner: Andrea Rose , Curator: Emma Gifford-Mead
Holy SeeArtists: Lawrence Carroll, Josef Koudelka, Studio Azzurro ,Curator: Antonio Paolucci
Hungary , Artist: Zsolt Asztalos , Curator: Gabriella Uhl
Iceland , Artist: Katrín Sigurðardóttir ,Commissioner: Dorotheé Kirch
Curators: Mary Ceruti , Ilaria Bonacossa/IndonesiaArtists: Albert Yonathan Setyawan, Eko Nugroho, Entang Wiharso, Rahayu Supanggah, Sri Astari, Titarubi
Deputy Commissioner: Achille Bonito Oliva , Assistant Commissioner: Mirah M. Sjarif
Curators: Carla Bianpoen, Rifky Effendy
IraqArtists: Abdul Raheem Yassir, Akeel Khreef, Ali Samiaa, Bassim Al-Shaker, Cheeman Ismaeel, Furat al Jamil, Hareth Alhomaam, Jamal Penjweny, Kadhim Nwir, WAMI (Yaseen Wami, Hashim Taeeh)
Commissioner: Tamara Chalabi (Ruya Foundation for Contemporary Culture)Curator: Jonathan Watkins.
IrelandArtist: Richard MosseCommissioner, Curator: Anna O’Sullivan
Israel , Artist: Gilad Ratman , Commissioners: Arad Turgeman, Michael GovCurator: Sergio Edelstein
ItalyArtists: Francesco Arena, Massimo Bartolini, Gianfranco Baruchello, Elisabetta Benassi, Flavio Favelli, Luigi Ghirri, Piero Golia, Francesca Grilli, Marcello Maloberti, Fabio Mauri, Giulio Paolini, Marco Tirelli, Luca Vitone, Sislej Xhafa ,Commissioner: Maddalena Ragni
Curator: Bartolomeo Pietromarchi /Ivory Coast Artists: Frédéric Bruly Bouabré, Tamsir Dia, Jems Koko Bi, Franck Fanny
Commissioner: Paolo De Grandis , Curator: Yacouba Konaté
Japan ,Artist: Koki Tanaka ,Curator: Mika Kuraya
KenyaArtists: Kivuthi Mbuno, Armando Tanzini, Chrispus Wangombe Wachira, Fan Bo, Luo Ling & Liu Ke, Lu Peng, Li Wei, He Weiming, Chen Wenling, Feng Zhengjie, César MeneghettiCommissioner: Paola Poponi ,Curators: Sandro Orlandi, Paola Poponi /Korea (Republic of)Artist: Kimsooja
KosovoArtist: Petrit Halilaj ,Commissioner: Erzen Shkololli ,Curator: Kathrin Rhomberg
KuwaitArtists: Sami Mohammad, Tarek Al-Ghoussein
Commissioner: Mohammed Al-Asoussi ,Curator: Ala Younis /Latin AmericaIstituto Italo-Latino Americano
Artists:Marcos Agudelo, Miguel Alvear & Patricio Andrade, Susana Arwas, François Bucher, Fredi Casco, Colectivo Quintapata (Pascal Meccariello, Raquel Paiewonsky, Jorge Pineda, Belkis Ramírez), Humberto Díaz, Sonia Falcone, León & Cociña, Lucía Madriz, Jhafis Quintero, Martín Sastre, Guillermo Srodek-Hart, Juliana Stein, Simón Vega, Luca Vitone, David Zink Yi. /Harun Farocki & Antje Ehmann. In collaboration with: Cristián Silva-Avária, Anna Azevedo, Paola Barreto, Fred Benevides, Anna Bentes, Hermano Callou, Renata Catharino, Patrick Sonni Cavalier, Lucas Ferraço Nassif, Luiz Garcia, André Herique, Bruna Mastrogiovanni, Cezar Migliorin, Felipe Ribeiro, Roberto Robalinho, Bruno Vianna, Beny Wagner, Christian Jankowski ,Commissioner: Sylvia Irrazábal ,Curator: Alfons Hug
Deputy Curator: Paz Guevara /Latvia Artists: Kaspars Podnieks, Krišs Salmanis ,Commissioners: Zane Culkstena, Zane Onckule ,Curators: Anne Barlow, Courtenay Finn, Alise Tifentale
LithuaniaArtist: Gintaras Didžiapetris, Elena Narbutaite, Liudvikas Buklys, Kazys Varnelis, Vytaute Žilinskaite, Morten Norbye Halvorsen, Jason Dodge, Gabriel Lester, Dexter SinisterCommissioners: Jonas Žokaitis, Aurime Aleksandraviciute Curator: Raimundas Malašauskas /LuxembourgArtist: Catherine LorentCommissioner: Clément Minighetti Curator: Anna Loporcaro /MexicoArtist: Ariel Guzik ,Commissioner: Gastón Ramírez Feltrín ,Curator: Itala Schmelz
Montenegro ,Artist: Irena Lagator Pejovic .Commissioner/Curator: Nataša Nikcevic
The Netherlands ,Artist: Mark Manders
Commissioner: Mondriaan Fund ,Curator: Lorenzo Benedetti
New Zealand Artist: Bill Culbert ,Commissioner: Jenny Harper ,Deputy Commissioner: Heather Galbraith ,Curator: Justin Paton /Finland: ,Artist: Terike Haapoja ,Commissioner: Raija Koli ,Curators: Marko Karo, Mika Elo, Harri Laakso
Norway:Artists: Edvard Munch, Lene Berg
Curators: Marta Kuzma, Pablo Lafuente, Angela Vettese
Paraguay Artists: Pedro Barrail, Felix Toranzos, Diana Rossi, Daniel Milessi ,Commissioner: Elisa Victoria Aquino Laterza
Deputy Commissioner: Nori Vaccari Starck , Curator: Osvaldo González Real
Poland Artist: Konrad Smolenski Commissioner: Hanna Wróblewska Curators: Agnieszka Pindera, Daniel Muzyczuk
Portugal Artist: Joana Vasconcelos Curator: Miguel Amado
RomaniaArtists: Maria Alexandra Pirici, Manuel Pelmus Commissioner: Monica Morariu Deputy Commissioner: Alexandru Damia Curator: Raluca VoineaArtists: Anca Mihulet, Apparatus 22 (Dragos Olea, Maria Farcas,Erika Olea), Irina Botea, Nicu Ilfoveanu, Karolina Bregula, Adi Matei, Olivia Mihaltianu, Sebastian MoldovanCommissioner: Monica Morariu ,Deputy Commissioner: Alexandru Damian ,Curator: Anca Mihulet
Russia Artist: Vadim Zakharov ,Commissioner: Stella Kasaeva ,Curator: Udo Kittelmann
Serbia Artists: Vladimir Peric, Miloš Tomic .Commissioner: Maja Ciric
SloveniaArtist: Jasmina CibicCommissioner: Blaž Peršin ,Curator: Tevž Logar
South Africa Commissioner: Saul Molobi ,Curator: Brenton Maart
Spain Artist: Lara Almarcegui , Commissioner/Curator: Octavio Zaya
Switzerland Artist: Valentin Carron Commissioners: Pro Helvetia - Sandi Paucic and Marianne Burki
Curator: Giovanni CarmineVenue: Pavilion at Giardini
Syrian Arab RepublicArtists: Giorgio De Chirico, Miro George, Makhowl Moffak, Al Samman Nabil, Echtai Shaffik, Giulio Durini, Dario Arcidiacono, Massimiliano Alioto, Felipe Cardena, Roberto Paolini, Concetto Pozzati, Sergio Lombardo, Camilla Ancilotto, Lucio Micheletti, Lidia Bachis, Cracking Art Group, Hannu Palosuo
Commissioner: Christian Maretti Curator: Duccio Trombadori
Taiwan Artists: Bernd Behr, Chia-Wei Hsu, Kateřina Šedá + BATEŽO MIKILU Curator: Esther Lu
Thailand Artists: Wasinburee Supanichvoraparch, Arin Rungjang
Curators: Penwadee Nophaket Manont, Worathep Akkabootara
Turkey Artist: Ali Kazma Commissioner: Istanbul Foundation for Culture and Arts Curator: Emre Baykal
Ukraine Artists: Ridnyi Mykola, Zinkovskyi Hamlet, Kadyrova Zhanna Commissioner: Victor Sydorenko
Curators: Soloviov Oleksandr, Burlaka Victoria
United Arab Emirates Artist: Mohammed Kazem /Commissioner: Dr. Lamees Hamdan Curator: Reem Fadda
Uruguay Artist: Wifredo Díaz Valdéz
Commissioner: Ricardo Pascale Curators: Carlos Capelán, Verónica Cordeiro
USA Artist: Sarah Sze Commissioners/Curators: Carey Lovelace, Holly Block
Venezuela Colectivo de Artistas Urbanos Venezolanos , Commissioner: Edgar Ernesto González Curator: Juan Calzadilla
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Encyclopedic Palace is curated by Massimiliano Gioni
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What Exactly Is Sexual Dysfunction? You should be aware of Sexual Arousal Disorder, Male Erectile Dysfunction (Impotence), Premature Ejaculation, and other conditions.
Sexual Dysfunction is a problem that can happen during any phase of the sexual response cycle. It prevents you from experiencing satisfaction from sexual activity.
The sexual response cycle traditionally includes excitement, plateau, orgasm, and resolution. Desire and arousal are both parts of the excitement phase of the sexual response. It’s important to know women don’t always go through these phases in order.
While research suggests that sexual dysfunction is common, many people don’t like talking about it. Because treatment options are available, though, you should share your concerns with your partner and healthcare provider.
Medical techniques for treatment of female sexual dysfunction, including painful intercourse and low sex drive to enable women achieve sexual health and satisfying female sexuality. www.centerforfemalesexuality.com/
A man invites a sexually frustrated wife to a gang bang with his friends from the military. sounderotica.com/stories/cheating-wife
Medical techniques for treatment of female sexual dysfunction, including painful intercourse and low sex drive to enable women achieve sexual health and satisfying female sexuality. www.centerforfemalesexuality.com/
Medical techniques for treatment of male and female sexual dysfunction, male infertility, impotence, male menopause, vasectomy, premature ejaculation, sperm cryobanking and semen analysis to enable men and women achieve sexual health and satisfying male and female sexuality. Clinics in Purchase, NY and Norwalk, CT. www.wernermd.com/
No matter whether you are a male or female. If you are suffering from any of sex related issue such as ED, PME, night fall, low sex desire, absent orgasm? Contact Dr. Nilesh Dehariya, he can treat all such problems in just one day. Call 7509655565 and book your appointment. visit: sexologistinindore.com/services/
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Dear friend, in this video we are going to discuss about Bluze capsules reviews. Many men these days suffer with sexual health issues and they have difficulty in sharing this detail with others.
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Bluze Capsules Reviews
Medical techniques for treatment of male and female sexual dysfunction, male infertility, impotence, male menopause, vasectomy, premature ejaculation, sperm cryobanking and semen analysis to enable men and women achieve sexual health and satisfying male and female sexuality. Clinics in Purchase, NY and Norwalk, CT. www.wernermd.com/
Paige was diagnosed with West syndrome or West's Syndrome (September 2010) it is an uncommon to rare epileptic disorder in infants.
The syndrome is age-related, generally occurring between the third and the twelfth month, generally manifesting around the fifth month. There are various causes ("polyetiology"). The syndrome is often caused by an organic brain dysfunction whose origins may be prenatal, perinatal (caused during birth) or postnatal.
It is either Cryptogenic or Idiopathic.
Cryptogenic
When a direct cause cannot be determined but the child has other neurological disorder, the case is referred to as cryptogenic West syndrome, where an underlying cause is most likely but, even with modern means, cannot be detected. Currently the cryptogenic group is often combined with idiopathic while referred to as "cryptogenic".
Sometimes multiple children within the same family develop West syndrome. In this case it is also referred to as cryptogenic, in which genetic and sometimes hereditary influences play a role. There are known cases in which West syndrome appears in successive generations in boys; this has to do with X-chromosomal heredity.
[edit] Idiopathic
Occasionally the syndrome is referred to as idiopathic West syndrome, when a cause cannot be determined. Important diagnostic criteria are:
Regular development until the onset of the attacks or before the beginning of the therapy no pathological findings in neurological or neuroradiological studies no evidence of a trigger for the spasms
Those are becoming rare due to modern medicine.
Clinical presentation
The epileptic seizures which can be observed in infants with West syndrome fall into three categories, collectively known as infantile spasms. Typically, the following triad of attack types appears; while the three types usually appear simultaneously, they also can occur independently of each other:
Lightning attacks: Sudden, severe myoclonic convulsions of the entire body or several parts of the body in split seconds, and the legs in particular are bent (flexor muscle convulsions here are generally more severe than extensor ones).
Nodding attacks: Convulsions of the throat and neck flexor muscles, during which the chin is fitfully jerked towards the breast or the head is drawn inward.
Salaam or jackknife attacks: a flexor spasm with rapid bending of the head and torso forward and simultaneous raising and bending of the arms while partially drawing the hands together in front of the chest and/or flailing. If one imagined this act in slow motion, it would appear similar to the oriental ceremonial greeting (Salaam), from which this type of attack derives its name.
Paige was first put on Vigabatrin which she outgrew a month later. She was admitted again into Kingston General Hospital to begin a treatment called ACTH.
Therapy
Compared with other forms of epilepsy, West syndrome is difficult to treat. To raise the chance of successful treatment and keep down the risk of longer-lasting effects, it is very important that the condition is diagnosed as early as possible and that treatment begins straight away. However, there is no guarantee that therapy will work even in this case.
Insufficient research has yet been carried out into whether the form of treatment has an effect upon the long-term prognosis. Based on what is known today, the prognosis depends mainly on the cause of the attacks and the length of time that hypsarrhythmia lasts. In general it can be said that the prognosis is worse when the patient does not react as well to therapy and the epileptic over-activity in the brain continues. Treatment differs in each individual case and depends on the cause of the West syndrome (etiological classification) and the state of brain development at the time of the damage.
Due to their side-effects, two drugs are currently being used as the first-line treatment: ACTH and Vigabatrin.
[edit] ACTH
ACTH - Use primarily in United States
Side effects are: Weight gain, especially in the trunk and face, hypertension, metabolic abnormalities, severe irritability, osteoporosis, sepsis, and congestive heart failure.
[edit] Vigabatrin
Vigabatrin (Sabril) - Approved in several countries, including most of Europe, Canada, Mexico, and more recently the United States.
Side effects are: Somnolence, headache, dizziness, fatigue, weight gain, decreased vision or other vision changes
Vigabatrin is known for being effective, especially in children with tuberous sclerosis, with few and benign side effects. But due to some recent studies[4] showing visual field constriction (loss of peripheral vision), it was not approved in the United States until mid-2009. It is currently debated that a short use (6 months or less) of Vigabatrin will not affect vision. Also, considering the effect of frequent seizures on day to day life and mental development, some parents prefer to take the risk of some vision loss.
Other
When those two are proving ineffective, other drugs may be used in conjunction or alone. From those, corticosteroids (prednisone) are often used. In Japan, there is a good experience with pyridoxine therapy. Further, topiramate (Topamax), lamotrigine (Lamictal), levetiracetam (Keppra) and zonisamide (Zonegran) are amongst those drugs most widely used.
The ketogenic diet has been shown to be effective in treating infantile spams,[5] up to 70% of children having a 50% or more reduction in seizure.
You can read more on Infantile Spasms by going to : en.wikipedia.org/wiki/West_syndrome
You can also view my youtube channel:
www.youtube.com/user/Shaeree624
I have uploaded videos for those who wonder what the Syndrome is and looks like.
I posted pictures of my beautiful baby girl because people need to understand being chubby or overweight may not always be caused by overfeeding. My daughters was caused by the ACTH treatment which is a steroid.
Under the pressure of a fast-paced lifestyle nowadays, male erectile dysfunction is becoming more and more common, and the occurrence tends to trend toward the younger population.In recent years, stem cells have been used in the treatment of ED, and more and more cases have shown that stem cells can effectively improve ED in men.
The Beneficial Effects Of Stem Cell Therapy On Erectile Dysfunction
As the stem cells enter the body, their homing effect could help them reach the lesions of the male reproductive system accurately and stem cells could completely repair the damaged tissue from all aspects. Stem cells can promote the vascular regeneration and nerve repair of the corpus cavernosum. At the same time, stem cells can also increase the blood supply speed and volume of the dorsal penile artery to the corpus cavernosum, therefore enhancing the hardness and size of the penis during erection. In addition, the new cells differentiated from stem cells can play the role of secreting male hormones like normal testicular cells, which can maximize sperm motility and enhance testicular function. The patient’s overall physical condition will also be improved, thus becoming healthier, younger, and more energetic, all together stem cell therapy will significantly improve the quality of life.
Stem cell therapy has significant effects in the following aspects:
Regulates hormone levels to normal status
Restores erectile function
Increases sexual desire
Increases hardness and size of the penis during erection
Improves sperm motility
Improves sex experience
Improves sleep quality and reduces anxiety
Anti-aging
Improves overall immune system function
The Conditions Of Erectile Dysfunction That Stem Cell Therapy Can Treat
When ED occurs, patients will have obvious symptoms, including, physical and psychological ones, and we can judge whether they have ED based on these symptoms. When conventional treatment methods can’t achieve a good enough therapeutic effect, stem cell therapy will be a good choice, as the following symptoms can be well improved by stem cell therapy:
Difficulty during erection
Short erection time
Low sexual desire
Pain during sex
Ejaculation disorder
Depression
Listlessness, low mood
Sore back and weak limbs/legs
A large number of preclinical studies and clinical cases have shown that stem cell treatment for ED is safe and effective, and stem cells have become the most advanced means of treating ED caused by various reasons!
Learn More About Erectile Dysfunction
Erectile dysfunction (ED) refers to the inability of men to consistently achieve or maintain a sufficient erection to complete satisfactory sexual intercourse, which usually lasts for more than 3 months. ED is one of the most common sexual dysfunctions in men. It is a chronic disease that affects physical and mental health. It not only affects the life quality of patients and their partners but also may be an early symptom and danger signal of cardiovascular disease.
Penile erection is a series of complex and coordinated physiological processes, which is the result of the interactions among multiple factors such as neuroendocrine regulation, hemodynamic changes, and psychological effects. Abnormality in any of them may lead to erectile dysfunction. Nowadays, the number of ED patients is increasing globally and more and more young people are suffering from the disease. A study carried out in Massachusetts focusing on male aging found that among 1290 randomly selected men aged between 40 and 70, the prevalence of ED was 52%, ED has become one of the most concerning diseases that threaten men’s health.
Risk Factors For Erectile Dysfunction
Generally, intermittent, or occasional ED is common and experienced by many men, usually caused by stress or emotional changes, which is not very concerning. But frequent ED is to be watched out for. Any behavior that may damage cardiovascular or neural system health increases the risk of ED, an unhealthy lifestyle can also lead to ED.
The most common risk factors for ED include:
Arteriosclerosis (atherosclerosis)
Diabetes
Side effects from prostate surgery
Taking certain medications (especially those for high blood pressure or depression)
ED can also be caused by:
Low testosterone level
Smoking, alcohol consumption, or drug use such as cocaine
High-stress level, anxiety, depression, and overwork
Neurological disorders such as stroke, multiple sclerosis, and spinal cord injury
Cardiovascular diseases
Overweight or obesity
Advantages Of Stem Cell Therapy For Erectile Dysfunction
For ED patients, conventional methods of treating ED include mechanical devices, medications, and prosthesis implantation. Compared with those treatment methods, the SQ1 stem cell medical center utilizes intravenous infusion or locally targeted transplantation to introduce stem cells into the patient’s body. On one hand, stem cells repair damaged tissues and organs, on the other hand, they can regulate the patients’ immune system.
In our clinic, we use stem cells with a positive testosterone receptor, which increases the levels of endogenous and exogenous testosterone. Compared with conventional treatment methods, stem cell therapy has unique advantages:
Stem cell therapy
Conventional treatment
Curative Treatment or diseases management
Stem cell therapy is a new treatment for ED, stem cells can reach various organs and tissues that affect male erection function. Stem cells will repair all damaged parts and promote angiogenesis and nerve repair in the corpus cavernosum, therefore enabling patients to eliminate their dependence on drugs and achieve a spontaneous erection.
Including a mechanical device and medication therapy, mechanical devices can help achieve an erection but are not able to maintain it, medication can only help to temporarily achieve an erection, the dosage will increase over time, and drug resistance may occur.
Those treatments temporarily improve the erection function but cannot completely cure ED.
Dosage
After 3-6 months of stem cell therapy, the patients can stop taking medications completely and achieve a spontaneous erection.
Stem cell experts will customize an individualized treatment plan based on your current physical condition to decide the number and source of stem cells for the therapy, as well as how many cycles of stem cell therapy are needed.
Patients who are taking medications will find the dosage increases slowly and gradually, and the effect is less and more limited over time, patients may develop drug resistance gradually, and need to take a larger dose or switch to another medication to achieve a normal erection.
Side-effects
No side effects, because the stem cells come from the body itself, their immunogenicity is extremely low, stem cells are produced under very strict quality control, and there are guaranteed no side effects.
Stem cell transplantation, while treating ED, can also repair or enhance the function of other systems such as the immune and neural systems. Stem cells can secrete a variety of anti-inflammatory cytokines, which prevent potential inflammation reactions in advance and improve overall health status.
Many side effects are rooted in conventional therapies. Mechanical device therapy can cause problems such as abrasions and edema. Long-term usage of medications can lead to permanent erectile dysfunction, cardiovascular disease, headache, dizziness, glaucoma, and even infertility. Those side effects can cause irreversible damage to the body.
Surgery is also an option for patients who wish not to take medications. But surgery procedure carries an innate risk of infection and prosthesis dysfunction, additionally, another surgery is needed to replace the prosthesis after its expiration date.
Convenience
Stem cell therapy is performed by stem cell experts and requires specialized laboratories to process stem cells and medical equipment to extract and inject stem cells, After the treatment, the patient does not need to receive repeated or frequent treatment, patients can return to a high-quality life.
The patients treated by medication will require regular maintenance of drugs. And the effect can only be achieved sometime after drug intake. The patients are not able to perform spontaneous erection and are prone to drug dependence and drug resistance development.
Longevity
After the stem cells are transplanted into to patient’s body, they will repair damaged organs and tissues of men, and completely restore the erectile function of the male patient. The effect is long-lasting. In patients with ED treated by us previously, they all reported no signs of erectile dysfunction. Those patients were also able to return to normal sexual activities during the subsequent one-year follow-up period.
The effect of the medication is short-term. It is necessary to take the medication or use a mechanical device to cooperate with medication before sex. The effectiveness is generally half an hour to one hour.
How Can Stem Cells Therapy For Erectile Dysfunction Work
Clinical studies and patient cases have shown that stem cells can repair and regenerate the reproductive system, delay the aging of reproductive organs, and restore the sexual function of male patients. Stem cells work primarily through the following mechanisms:
Multi-directional differentiation potential: With self-replication and multi-directional differentiation potential, stem cells can produce new cells to replace damaged or dead cells. Stem cells promote angiogenesis and nerve repair in the corpus cavernous and regenerate small blood vessels, repair damaged or blocked arterioles and capillaries, and therefore improve vascular microcirculation and fundamentally increase the speed and volume of blood flow into the corpus cavernous, resulting in a faster erection response and increased penile hardness.
Paracrine effect: Stem cells can secrete a variety of bioactive growth factors such as nerve growth factor (NGF), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF), and brain-derived growth factor (BDNF) after being infused into the body. Among them, NGF, IGF, and BDNF have the effect of promoting neuron regeneration, and VEGF promotes angiogenesis. Taking all together, stem cells will promote nerve repair and angiogenesis at the injured site. thereby reducing the fibrosis of cavernous tissue, while inhibiting other inflammatory diseases that may affect erectile function, including prostatitis, nephritis, etc.
Immunomodulatory effect: Stem cell therapy regulates and produces cytokines to repair damaged tissue cells, and inhibit the immune response from damaged cell proliferation, thus fundamentally eliminating the basis for the disease.
SQ1 Stem Cell Services
During the whole treatment process, we’ll provide complete and first-class medical services to you. And to ensure your treatment effect, you can consult your doctor any time after the treatment.
www.sq1stemcell.com/stem-cell-therapy-for-erectile-dysfun...
Medical techniques for treatment of male and female sexual dysfunction, infertility, male menopause, sperm cryobanking and semen analysis to enable men and women achieve sexual health and satisfying male and female sexuality.
Medical techniques for treatment of male and female sexual dysfunction, male infertility, impotence, male menopause, vasectomy, premature ejaculation, sperm cryobanking and semen analysis to enable men and women achieve sexual health and satisfying male and female sexuality. Clinics in Purchase, NY and Norwalk, CT. www.wernermd.com/
Dr Tahira Rubab Hafeez is an internationally authorized clinical psychologist. Her passion and approach to growing together brought Tahira Rubab to the personal development sector and her 10 years of experience does not limit to the provision of mental health services to the general population, sexual minorities, and marginalized groups but also to developing and implementing mental health projects for different organizations, schools, and institutions.
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Magnesium for Erectile Dysfunction
You may have read about how important vasodilators are to erectile function. That’s because healthy blood flow to your penis and the surrounding tissue is the core process behind erections.
If your blood vessels are too narrow or tight, that healthy blood flow can’t happen.
Age-related arterial stiffness is a common complaint of growing older, and a contributing factor to age-related erectile dysfunction.
In 2011, Dr. Van Laecke and his team at the Ghent University Hospital in Belgium examined the impact of low magnesium on age-related arterial stiffness in a study of 512 men.
Over the course of six years, the team examined over 10 factors that could impact arterial stiffness. Some of the other factors included age, diabetes and smoking status, body weight, blood pressure, and various hormone levels.
Van Laecke concluded that low magnesium levels correlated strongly with levels of arterial stiffness, enough to stand out from the crowd of other factors. They declared low magnesium an “independent predictor” of arterial stiffness.
They also found this impact was strongest in patients over 55 years old.
Bottom line: there’s no guarantee that extra magnesium will fix your ED. But if you have low magnesium, getting it back to normal levels can fix this particular cause of erectile dysfunction.
The Medical Center for Female Sexuality provides medical techniques to enable women to achieve sexual health and satisfying female sexuality and treatment of female sexual dysfunction, including painful intercourse and low sex drive. Offices in Purchase, NY and NYC. www.centerforfemalesexuality.com
Dr Tahira Rubab Hafeez is an internationally authorized clinical psychologist. Her passion and approach to growing together brought Tahira Rubab to the personal development sector and her 10 years of experience does not limit to the provision of mental health services to the general population, sexual minorities, and marginalized groups but also to developing and implementing mental health projects for different organizations, schools, and institutions.
#Testosterone Boosting #Diet Plan For Men : Lose Weight Fast And Improve Fertility Naturally :)Low testosterone levels in men causes fatigue, hair loss,#low libido, muscle loss , Sexual Weakness, Night Fall , Pre mature Ejaculation, Eractile Dysfunction, Over Weight and mood swings.
But there are certain testosterone foods and supplements that can naturally boost and increases testosterone levels in men. This male hormone is essential for the proper functioning of the body, for energy and sex drive. We take a close look at the causes, treatment and foods, which promise to boost testosterone levels.
The reasons for low testosterone levels or male hormones vary from damage to the testicles, malfunction of the hypothalamus and pituitary gland, brain tumour and inflammation of the testes. Age, drinking alcohol, smoking, illness, surgery and mental health also causes low testosterone levels.
#Treatment for low testosterone levels:
A popular treatment is hormone replacement therapy for boosting testosterone levels. This treatment helps increase and balances the testosterone levels in men.
Testosterone foods:
1) Bananas: This fruit increases energy and also helps increase libido by naturally increasing testosterone levels. Bromelain and vitamin B present in bananas can increase the production of testosterone.
2) Pineapple: This fruit is also rich in bromelain, which is important for the production of testosterone, thereby boosting one's sex drive.
3) Eggs: Lack of vitamin D results in low testosterone levels and vitamin D can be sourced from eggs.
4) Oyster: Zinc that is found in oysters helps in the production of testosterone, and also builds muscles, reduces the risk of infertility and boosts endurance.
5) Cruciferous vegetables: This includes broccoli, cabbage and cauliflower, which reduces estrogen levels.fatty foods increase testosterone
6) Garlic: Combine garlic with a high protein diet to naturally increase testosterone levels.
But always remember to maintain a balance with your testosterone levels.
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Medical techniques for treatment of male and female sexual dysfunction, male infertility, impotence, male menopause, vasectomy, premature ejaculation, sperm cryobanking and semen analysis to enable men and women achieve sexual health and satisfying male and female sexuality. Clinics in Purchase, NY and Norwalk, CT. www.wernermd.com/
Dr Tahira Rubab Hafeez is an internationally authorized clinical psychologist. Her passion and approach to growing together brought Tahira Rubab to the personal development sector and her 10 years of experience does not limit to the provision of mental health services to the general population, sexual minorities, and marginalized groups but also to developing and implementing mental health projects for different organizations, schools, and institutions.
Dr Tahira Rubab Hafeez is an internationally authorized clinical psychologist. Her passion and approach to growing together brought Tahira Rubab to the personal development sector and her 10 years of experience does not limit to the provision of mental health services to the general population, sexual minorities, and marginalized groups but also to developing and implementing mental health projects for different organizations, schools, and institutions.
Erectile disorder (ED), on occasion known as impotence, is defined as failure to obtain or maintain an erection until finishing touch of pleasant sexual interest. A Problem in getting or retaining erection in the time of intercourse is likewise known as erectile dysfunction. Alternative phrases for erectile disorder are impotency, erectile failure, sexual inadequacy, much less erection, reduced erection, failure in intercourse, sexual incompetence, erection hassle, less hardness of penis, looseness of a penis.
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From The Drawing Hope Project - taking drawings done by children born or living with health conditions, and turning them into magical photos for a storybook.
Kasie has Rett Syndrome, a rare disorder that almost exclusively affects girls, with symptoms that include seizures & being non-verbal. Girls with Rett’s arecalled “Silent Angels”. She developed normally until 14 months, when she started having screaming fits,stopped talking, & continued to lose her skills. Now 21,Kasie communicates through smiles and laughter. She knows that just like in her favourite movie Aladdin that anything is possible. Even magic carpet rides.