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Myths & MisconceptionsMYTHS & MISCONCEPTIONSCausesSexuality is related to obscenity or vulgarity. Therefore there is secrecy. Nobody talks about it openly though there is tremendous curiosity, especially during the adolescence and youth. Secrecy leads to ignorance. They turn to their friends for information, who are equally ignorant and may provide misinformation. Since they cannot dare to ask their parents or teachers, they try it through pornographic literature. They expect quacks to solve their problems. Myths and misconceptions gathered are propagated from generations to generations.Affects Many myths are responsible for Fear, Anxiety, depression Guilt feeling, Poor self esteemOver expectationsSexual dysfunctionsMarital disharmony, conflict, divorceSuicideVictimization by quacks Some of the common myths are mentioned below in italics, followed by their scientific explanations:PenisMen can will an erectionNo. Erection is controlled by parasympathetic part of autonomic nervous system. Like salivation and perspiration, erection is a situational reflex. Therefore sensate focus is the most important factor for getting erection.To satisfy a woman, the man needs a long, thick and straight penis.No. Like the shape of the nose, each penis is different. As a long and big nose does not improve the smell of a rose, A long and thick penis is not required for the pleasure of the self or of the woman. Penis is never straight like the railway signal. In some, it has a shape of banana. Vagina accommodates any shape of penis. Since the length of the vagina is 3.5 inches and only outer one inch is sensitive to touch, any erect penis over 1 inch in length is sufficient.Testes Both the testes should be at the same level. Using tight underwear (Langot) prevents hydrocele and hernia.No, the left testis is usually at a lower level, for some anatomical reasons. If the testes are brought near the body by using tight underwear, their temperature rises and adversely affects the formation of sperms.Semen is a precious fluid.No, semen is like any other secretion to be thrown out of body. Semen is a mixture of secretions from prostate, seminal vesicles and bulbo-urethral glands plus sperms. Semen provides nutrition, helps motility and acts as a vehicle for the transport of sperms.Losing Dhaat in sleep or passing it in urine is a disease. Passing semen Dhaat in sleep is known as wet dreams or nocturnal emission. This is a normal event and a sign of puberty, the beginning of adolescence. It also proves that the reproductive system has started functioning. When the reproductive glands are full with secretions and person gets a sensuous dream, like escape of steam from the cooker, he ejaculates in sleep. This does not cause weakness or loss of vitality.The sphincter of urinary bladder closes during ejaculation. Therefore, semen cannot be mixed with urine. If prostration secretion accumulates in the urethra at night the individual will see milky white secretion of prostate while passing urine next morning. This is physiological. Passing phosphates in the urine is sometimes mistaken for semen. Losing semen through masturbation does not cause not any harm. Masturbation is not a bad habit. It cannot be overdone, since it is controlled by autonomic nervous system. The frequency of masturbation depends upon the hormone, testosterone and the secretions of reproductive glands. Those who have never masturbated since puberty, the ejaculatory reflex do not work after the marriage and hence the man cannot father a child.Masturbation does not cause pimples, weakness, impotence or any other disease. It does not bend the penis. Masturbation or nocturnal emissions are inversely proportional to each other.Not only young people but married persons, old people and the females also masturbate.It is not the loss of semen, masturbation or wet dreams that harm a person, but the anxiety and fear about it harm him. VAGINA.Presence of hymen is the surest test for virginity.No. There is no surest test for proving virginity. A woman may or may not bleed from her vagina at the first intercourse after marriage; even then she could be a virgin. Sports, cycling, horse riding or exercise can be responsible for the tear of the hymen. Hymen, if lax, can remain intact even after the child birth.Hymen is a vestigial structure formed at the junction of external and internal genitals during the embryonic life. It may or may not be present at birth. Character is in the mind and not in the genitals. Secondly, there is a double standard for virginity. Man takes pride in mentioning about the number of women with whom he had sex. Such man deserves no right to ask his wife about premarital sex.Vagina is a sensuous organ. Woman gets orgasm by stimulation of vagina.No. Like esophagus, vagina is developed from endoderm and therefore there is no sensation in vaginal barrel. Vaginal orgasm is a myth. Orgasm in a woman is always clitoral in origin. Clitoris is the homologous organ of penis. The area of vestibule and the outer inch of vagina is developed from ectoderm and hence it is erotically sensitive to touch; only next to clitoris.There is no homologous organ like vagina in man. If men were to have vagina the site of opening would be on the median scrotal raphe, one inch in front of the anus. Vagina is considered as the organ of honor and character. However, physiologically, vagina is a passage for the menstrual flow and baby to outside it is the side of sensuous pleasure for male, where gets maximum erection that terminates in ejaculation for fertility. MENSTRUATION Bad blood is passed out menstruation. Woman becomes impure during menstruation. Menarche (beginning of menstruation) is the first indication that girl has been promoted to become a woman, Every month the inner lining of the wall of the uterus becomes thickened and engorged with blood vessels and mucus glands, ready to nourish the fertilized egg. If the egg is not fertilized, this lining breaks down and is discharged with little blood and mucus through the vagina. This is menstruation. Neither the blood is bad, nor does the woman become impure. A woman can lead a normal and usual life during menstruation. Breasts Small breasts produce less of milk. Their size can be augmented by hormones/ massage. The size of breast has no relation to the production of milk in it.. Even a small breast can produce enough of milk breast- feeding. The size of the breast depends upon the amount of fatty tissue in it.Massage or hormones do not help in increasing the size. For aesthetic reasons, silicon gel implant or fatty tissues injection can help in augmentation of the size of breast. The simplest way is to use a padded bra.Having unequal size of the breast is a normal variation and does not need any treatment. INTERCOURSE The first wedding night is the most sensuous and the most memorable experience. Sex with a virgin woman gives maximum pleasure.No.A virgin woman being a novice may not be able to enjoy sex herself. In fact, love, caring and sharing with the partner is needed. She inhibitions, feel relaxed, establish a loving relationship with partner, engage in foreplay, and then only she will be able to enjoy herself and herself and give the pleasure of sex to him. On the first wedding night, though the expectations are high, both being ignorant about the genitals, having pressure of performance and fear of failure, the intercourse may be unsuccessful and both may disappointed.My friend says that he performs three times every night and each times he lasts for half an hour.He is exaggerating his performance. Researchers have proved that the duration of intercourse from the time of penetration to the time of ejaculation is 1 to 3 minutes. The frequency becomes less and less. However, frequency and duration varies from person to person. For fertility it should be daily or on alternate days especially during the sexual performance is controlled by autonomic nervous system. Man cannot will an erection. If he tries to imitate his friend, nature does not cooperate and he may not be able to get an erection as he desires.Simultaneous orgasm of the two is necessary for pregnancy.No, It is not possible, since every individual has /her own speed. However, women should have orgasm prior to man’s, either by manual stimulation of clitoris or by ‘woman-on-top position. Simultaneous orgasm is not necessary for the pregnancy to occur. A woman is capable of becoming pregnant even without having an orgasm.Sex during menstruation and oral-genital sex are harmful There is no medical evidence to prove that sex during menstruation or oral genitals sex is harmful, provided:1. The mouth and the genitals are cleaned before the act He/she has no dislike or objection to it.Intercourse causes weakness or objection to it.Intercourse causes weakness. Sex tonic improves the performance During the intercourse, the tension in the muscles rises. This is followed by fatigue which recovers in a day. There is nothing like ‘sex tonic’. Masters and Johnson used to say “Sound health, interested and interesting partner is the best sex tonic.Hysterectomy/ menopause is the end of sex life.No. individuals can indulge in sex till the end of life. ‘Use it, or lose it’ is the rule applicable to it. Those who have regular sexual outlet do not find any discomfort or pain during sex.HomosexualityHomosexuality is abnormal. A Homosexual can be identified.A homosexual is normal in every respect except that his sexual orientation is different. There are 4% of male and 2 to 3% of female homosexuals in any society. No definite cause has been found. A homosexual cannot be identified by his look or behavior.Infertility Woman is always responsible for infertility in the couple.In 40 to 50 percent of the couples, man is responsible for infertility.The female is responsible for giving birth to male or female child Male is responsible. It depends on the sex chromosome that fertilizes the egg, If the sperm containing Y sex chromosome fertilize the egg, it will be a boy, and if X sex chromosome fertilizes. It will be a girl.However, this too is not under his control, Whatever the outcome is one has to accept and love the child.Family Planning Pill causes cancer, Coper T leads to profuse menstruation, Papaya causes abortion, and vasectomy leads to impotence.All these are myths. Pill contains minimum amount of hormones. Numerous studies done on the usage of pill show that it does not causes cancer. Copper T may cause little excessive menstrual flow in some cases that too initially only. Papaya or any other food stuff or hormone injection does not cause abortion. Manual vacuum aspiration is the only way (up to 6 weeks) for the termination of pregnancy. Vasectomy does not interfere with person sexual desire, erection or sexual performance. The quantity of semen also remains as before only that it does not contain sperms.STI/ HIV/ AIDSA Person using public toilet, using cloths of the patient or touching him, is liable to get STI or HIV infection NO. These diseases are transmitted through sexual contact. The germs of these diseases do not thrive in open. Using the public toilet, using the clothes or utensils used by the patient cannot transmit these diseases.Miscellaneous female has ten times the sex desire than that in the maleNo. the hormone responsible for the sex desire testosterone is more abundant in the male than in the female. She is interest in love, caring and sharing than in intercourse. For that reason there are no male sex workers to service the females. Hysteria is the female is due to sex starvation. Marriage is the solution Hysteria is a psychological disorder sex starvation does not cause any disease. Marriage in such a mental state complicates the problem.Blood group of both should be matched before marriage.Blood groups need not be matched, but the compatibility of Rh factor in blood of both should be examined. If the female is Rh negative and male is Rh negative, then the second child of this couple may get jaundice and may not survive. To avoid this Rh negative female is given Anti D immunoglobulin injection immediately after first delivery (or after abortion).Posted by Dr. Ramesh Maheshwari, Wnho Clinic, 2014 sadashiv peth, Tilak road, Pune. Free to call for further information.
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Galvanic current is used to create two significant reaction in esthetics : Chemical (Disincrustation)and ionic (Iontophoresis)DEFINATION-IONTOPHORESIS- GK=(Introduction of ions)is defined as the introduction , by means of an electric current , of soluble salts in to body tissues for therapeutic purposes.Skin type--All skin types depending on substance used-Dry dehydrated skin-Dull sallow skinPROCEDURE—1.Ensure machine is in good working order and on a stable trolley.2. Remove jewelry from patient and self.3. Cleanse patients face and neck thoroughly and check for contraindication.4. Explain routine procedure to patient and reassure about any sensation i.e. pricking metallic taste , and slight warmth.5. Place inactive electrode in patient s hand.6. Remove substance in to bowl and with help of brush apply on patient's face and work round with one active roller electrode.7. Place active electrode on patients forehead and another at base of neck. Check intensity dial at zero. Make sure that the polarity switch is at negative. Switch on the machine and turn up the intensity dial gradually until patient feels pricking sensation.8. For 2 mins, taking care not to lose contact with the skin and avoid over stimulation of an area.9. After 2 mins switch off machine , turn intensity dial to zero and remove the active electrode from the skin.10. Turn polarity switch to positive. Place the active electrode on electrode on forehead and the base of neck, and switch on machine and turn up the intensity dial as before. Move the electrode for another 8 mins, slowly over the face and neck.11. Switch off the machine, turn off intensity and remove electrodes.12. Tone and moisturize face , or blot and continue with other treatments.13. No make up is to be worn for at least 2 hours or if possible for the rest of the day. If possible, for the rest of the day. If make up is necessary, then apply medicated foundation and then the rest of the make-up.14. Positive polarity is for penetration. Negative polarity is for opening up. So in cases of acne, boils , pustules , give 8 min negative.For pigmentation , dryness , whitening, fairness give 8 mins positive.DURATION—2-3 mins( negative) and 6-8 mins(positive)INTENSITY—2-3 miliampsBENEFITS-CHEMICAL EFFECTS –When the active electrode becomes +ve it attracts the –ve chloride ion.This produces a chemical reaction whereby chloride ions react with hydrogen ions to form hydrochloric acid.This hydrochloric acid restores the acid mantle.PHYSICAL EFFECTS—-Restores acid mantle.-Contracts skin tissue-Tightness pores .-Reduces vascularity.-Overall refining of skin condition due to its astringent effect.EFFECTS OF IONTOPHORESIS-1. Beneficial substances for correcting different skin problems are penetrated into skin.2. Opens the pores.3. Stimulates circulations.4. Generally improves texture and tone of skin.IONTOPHORESIS IS SUITABLE FOR-1. All skin types depending on substance used.2. The contents of substances are specialized which are beneficial , pure, water soluble for various skin problems.EXAMPLES:1. Retinoic acidAcne (0.05%)Acne scarsPigmentationFine linesDark circles2. Glycolic acid(6%, 12%)PigmentationFine linesOily skin3. Kojic acid (2%) and VIT-C for periorbital melanosis.4. Aloe + Vit E for dry and dehydrated skinSeaweed jellyPositive galvanic gelAloe vera gelContraindication1 Hyper- sensitive skin, loss of skin Sensation2 Excessive filling, metal pins, plates, coils3 Epileptics4 Diabetes5 Patient with pacemaker6 Pregnancy7 Skin diseases, infection, sepsis8 Cuts, abrasion, inflammations9 Highly strung and nervous client10 Highly Vascular skin11 Defective circulationPRECAUTION FOR IONTOPHORESIS1 Check for Contraindications2 Ensure machine is in good working order3 Remove jewellary from clients and self4 Explain to client about sensations which she will be feeling5 Place correct Electrode on client’s face6 Select correct polarity7 Time treatment correctly8 Do not remove electrode from skin when machine is still on9 Avoid over stimulation of any one part of the skin10 Try not to touch patient during treatment as the currently may be earthed by you .11 Ensure machine is placed is safely on a stable trolley.DisincrustationsIt is used to facilitate deep pore cleansing , to emulsify sebum, remove surface oiliness, Blockage and help to regulate secreation. During this process galvanic current is used to create a chemical reaction that emulsifies or liquefies sebum and debris.When conducting disincrustation , the client holds the positive electrode, the positive polarity. The therapist uses the negative electrode (negative polarity) on the client’s skin surface. This creates a chemical reaction that transforms the sebum present in the skin into soap. When the electrical current interacts with the salts in the skin, it creates the chemical sodium hydroxide i.e this soapy substance helps dissolve excess oil, clogged pores, comedones and other debris on the skin, while softening it at same timeSkin typeOily skin Acne Prone skinCombination skinPost-acne scarsProducts-Saline solutionDisincrustation lotionNegative galvanic gelDuration-6-8 min (Negative ) and 2-3 min (positive)Intensity-2-3 miliampsProcedure-Ensure that machine is in good working order and placed on a stable trolley.Remove all jewellery from client and selfCleanse clients face and neck thoroughly and check for any contraindications.Explain and reassure client of routine procedure, sensation(prickling and warmth ) she may feelCarry out the thermal and skin sensitivity test on face.-apply some petroleum jelly around the eyes-apply the product with the help of mask brush-give the client the bar electrode (with a damp cotton tissue wrapped around it) to hold . this is anode.Make contact with the negative roller/cathode(covered with damp cotton) on the skin and turn up the currently gradually until the client feels a tingling sensation.The movement should start from the chin and move towards the sides in overlapping strokes.Use slow, even, rhythmic movements all over the face.Continue for 6-8 minLower the intensity and switch off the machineRemove the product and proceed with extractions.Reverse polarity for 2 min and then switch off the machine.BenefitsChemical effects-When sodium chloride is dissolved in water, it produces sodium ions and chlorides ions.The active electrode which is – vely charged , attracts +vely sodium ions.This produces a chemical reaction forming NAoH, which is an alkaline that destroys the acid mantle on the face and emulsifies the sebum on the skin surface. It also neutralizes the sebum.Physical effects-Destroy acid mantle.Soften skin tissue.Open pores.Emulsifies sebum and therefore aiding flow and drawing out impuritiesIncrease vascularity i.e produces erythema y the stimulation action of current. Therefore increases blood circulation, which nourishes the tissues and improves lymph drainage, which aids removal of waste products.Overall improvements of skin condition due to its deep cleansing action.
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Microdermabrasion, or particle skin resurfacing, is the latest technology for skin exfoliation.Micro meaning small , minuteDerma meaning skinAbrasion meaning removing, scrapingTypesMicrodermabrasion can be done in two ways1) Crystal (Aluminium Oxide)2) DiamondDefinationMicrodermabrasion is micro peeling of the uppermost layer of the epidermis (stratum corneum) through abrasion thus reducing thickness of the same and allowing a brighter and smoother skin to emerge.Crystal MicrodermabrasionThe micro dermabarber uses a controlled vacuum to move the sterile microcrystals to abrade the stratum corneum which is the layer of dead cells on the skin. The microcrystals and abraded skin are then vacuumed away thus leaving behind a smooth and shiny glowing skin.After multiple treatments, this skin renewal procedure can eliminate pigmented spots. It improves post trauma scars and acne scars.Microdermabrasion helps in removing dead and flaking skin cells to create an immediate improvement in your skin appearance. The unique approach stimulates the production of fresh young skin cells and collagen. It is the ultimate advancement in non surgical, non invasive skin conditioning.Microdermabrasion is a safe non surgical approach to skin care when used alone, or in combination with other treatments.BENEFITS:--Gives the skin an overall fresh , healthy- looking glowImproves blood circulation.Non surgical , safe, effective lunch hour procedure.Effective on all skin colors and types.No anesthetic required.Excellent activities can be resumed immediately.Normal activities can be resumed immediately.OTHER CONSIDERATIONS:--Requires multiple sessions and maintence treatments.Patients with good skin tone will show best results.IN addition to the face, microdermabrasion can be successfully performed the neck , chest , hands, back, elbows, feet –just about anywhere! It is also beneficial for patients with darker skin types.INDICATIONS:--Acne scars , chicken pox scarsUneven skin colorDull or dry patchesClogged poresBlackheadsOpen PoresFine linesRough, thick or dry skinSun spotsAge spotsKeloid scars from burns post trauma and post surgical.CONTRAINDICATIONS:--Herpes SimplexCrystal SensitivityDiabetesActive acneRosaceaEczema and seborrheic dermatitisAsthmaTECHNIQUE---Microdermabrasion is performed with jet of fine crystals, which are propelled and then vacuumed across the skin surface. Removing the damaged cells to reveal fresh , invigorated skin.resulting in a gentle abrasion or polishing process.Each treatment takes from 30 mins to an hour. Approximately 10-12 sessions are required once in every 15 days . Maintenance of result required periodic repeat treatments after the initial regimen is completed.PROCEDURE—1. Cleanse the face and dry it completely.2. Adjust the vacuum depending upon the indication.3. Put cotton buds in the ears so that crystals do not enter in the ears.4. Remove lens if you are using once as that crystals can abrade the lens5. Crystal sensitivity test is done on the forearm.6.Stretch the skin and quickly move the hand piece across the skin in horizontal and vertical strokeswithout unnecessary pressure.8.Clean the face with a wet tissue to ensure that all the crystals are completely removed from from the face.9.Then apply hydrating or cooling masks for 20 mins.10. Finally apply sunscreen.DIAMOND MICRODERMABRASIONThis also works on same principle of exfoliation. But here instead of aluminum oxide crystals particles of diamond are used. These particles are embedded on the tip of the wand like device. Diamond particles used are finest . They are gentle as well abrasive.The exfoliated cells of stratum corneum are collected on a cotton .BENEFITS OF DIAMOND SKIN POLISHING OVER CRYSTALCan be done on sensitive skinCan be performed on asthmatic patient.Microdermabrasion can also be combined with various other procedures to obtain maximum results.1) DSP with ultrasonic and or galvanic . Also called as ULTRASONIC DIAMOND microdermabrasion.2) AHA/ BHA masks for 20 mins followed by DSP and end the procedure with galvanic using neutral products like vit.c serums , aloe vera gel, natural lighteners containing licorice , vitamin, niacinamide etc.Instructions :⦁ Do not wash face with soap, can clean with plain water. Soap to be used after 12hrs.⦁ As the crystals are sharp there is sensation of writing on the face.⦁ Slight redness will be seen for 1-2 hours⦁ There may be peeling of the skin on day 3, 4 & 5⦁ Feeling of heaviness and soreness which lasts for few hours⦁ No make –up to be applied on the same day⦁ No heavy exercises and swimming for 3-4 days⦁ No direct exposure of sunlight. Sunscreen to be applied half hr before going in sunResultsPoor health, diet , ageing, stress, and the elements of nature can slow down the skin’s cell turnover process. By speeding up the cellular turnover process, microdermabrasion brings you closer to healthier, younger looking skin. It allows you to gradually improve your skin without the risks, side effects, and down time of more aggressive alternatives. In as little as twenty minutes, this gentle, abrasive technique efficiently prodoces satisfying results. Further improvements in appearance and texture will occur with each treatment. Microdermabrasion can be used aggressively to achieve dramatic results, but does not take the place of surgical or laser procedures.Best of all there is no “down time” One can resume regular activities immediately. To achive good results , several treatments 10-12 are recommended .treatments are typically scheduled two weeks apart . you will experience a progressive improvement throughout your treatment program.conclusionmicrodermabrasion leaves your skin feeling SOFT AND SILKYwith a healthy glow .you leave the office with only a mild , temporary pinkness in the treated area.FAQ(Frequently asked question)What is microdermabrasion?Microdermabrasion is a mini procedure that is used to rejuvenate skin , lessens the sign of scarring , and removes fine lines and the effects of acne . the top layers of dead skin is removed during treatment, while promoting the production of new cells in the deepest layer of skin.How is it done?The skin is sandblasted with aluminum oxide crystals through a wand –like device that suction itself. As the treatments are relatively painless , anesthesia is generally not administered. Treatments last about 20-30 minutes if only the face is being treated, and can last up to an hour if the neck and upper chest are included. Courses of microdermabrasion consist of 10-12 treatments at 2 week interval . all treatments can preformed at your doctor s office , salon , or spa.What precautions are to be taken before the procedure?Discontinue use of topical exfoliating creams for 3-4 days before & after the procedure .Remove lens just before the treatment if you are using one as crystals can abrade the lens.Recovery /post op expectationsMicrodermabrasion has been branded with the cosmetic nickname , the lunch –time’’ peel because it can be performed in a short period of time and patients can return immediately to their daily routine including applying makeup . patients typically experience a slight irritation or wind – burnt sensation during treatment that can last for a few hours afterward. In addition , skin usually takes on a pink hue that lasts an a average of one day but can last three or more in severe cases.complications-Almost all patients experience no complications associated with these types of treatments. With the more powerful, medical grade machines , there is a slight possibility of hyperpigmentation or bleeding , and if the machine is improperly sterilized, there is a risk of infection.Am I A candidateGood candidates for microdermabrasion have minor surface scars or slight pigmentation or acne problems and wish to have have minor surface scars or slight pigmentation or acne problems and wish to have younger – looking healthier skin. Patients with severe acne, warts, recent herpes outbreaks, and other diseases are not the candidates for treatment. Is maintenance is required ?Yes, maintenance is required once a month.
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Peeling is the application of chemical agent to bring about exfoliation of the epidermis with remodeling of the collagen and elastic fibers in the dermis .A peel removes several layers of sun damaged skin cells, leaving fresh skin, which has a more even surface and colour.It may stimulate new collagen to be formed improving texture.The result of the first peel may be disappointing, but after repeated peels, significant improvements is usually evident.Principles of chemical peels⦁ Exfoliation of superficial dead layer of skin (Stratum Corneum)⦁ Promotes collagen production⦁ Stimulates new cell growth ⦁ Cleansing of clogged pores⦁ Reduces production of the sebum by the oil glands⦁ Regulation of moisture levelChemical Agents used for peeling⦁ AHA----Alpha Hydroxy Acids- i.e Glycolic Acid , Lactic Acid, Mandelic acid⦁ BHA----Beta Hydroxy Acids- i.e Salicylic Acid⦁ PHA----poly Hydroxy Acids – combination peel⦁ TCA----Trichloroacetic Acid⦁ Phenols----Carbolic AcidTypes of peels⦁ Very Superficial ----Glycolic acid⦁ Superficial ----Lactic acid⦁ Medium ----PHA, Salicylic acid, TCA⦁ Deep ----PhenolsOf these peels the Alpha Hydroxy Acids are the most commonly used.Introduction –Benefits of AHA’s were first discovered by Dr. Eugene van scott in 1970.AHA- Alpha hydroxyl acids----They are also called as fruit acids as they occur naturally in certain fruits. Different AHA’s with their sources-----⦁ Glycolic Acid – Sugarcane⦁ Lactic acid – Fermented milk⦁ Mandelic Acid –Bitter Almonds⦁ Malic acid – Apples⦁ Tartaric acid- GrapesOf these the Glycolic acid & Lactic acids are used generously.Glycolic acid has the smallest molecular weight and is easily able to penetrate the skin. It is a weak acid. It has a keratolytic action .with higher pH it acts as a moisturizer . since it is a weak acid it does not a self neutralizing action by coagulation of proteins hence it has neutralized with water or weak buffer.Glycolic acid result in superficial skin injury and are well tolerated-the ‘lunchtime’ peel. They remove thin lesion on the skin surface, reducing pigment and surface dryness.There are newer glycolic peels which are most potent and still do not irritate. These peels contain Strontium Nitrate. One such brand widely used is Refinity(70% glycolic acid+strontium nitrate) and Cosmoderm(50%glycolic acid+strontium nitrate)INDICATION OF GLYCOLIC ACID1) Acne2) Hyperpigmentation3) Freckles4) Fine lines and wrinkles5) Sun spot6)Open pores7) Clogged pores8) Under eye dark circlesCONTRAINDICATIONS:1)Active infection2) Open cuts3) Photosensitivity4) Past reaction to peel5) Facial surgery in three monthsQUALITIES OF GLYCLIC ACID:Full face or spotsVery superficialExpensiveLong lifeAvailable as liquidDifficult to preparePRMING:Preparing the skin before the peelPriming is done for period of 10 days daily with a lower concentration of glycolic acid (6%) applied only at night. Stop application on day 11, 12, 13th and the pel is done on the 14th day.BENEFITS OF PRIMING :1) More uniform penetration of the peel2) Reduces the risk of hyper pigmentation3) Reduces wound healing timePEEL SENSITIVITY TEST:It is done on the side of the neck to detect sensitivity to the peeling agent .During this first apply 20% GA and watch for 3 mins. Patient will feel slight burning or itching sensation. If this sensation is mild with no redness on the area for 3 mins that means the patient can tolerate the peel on face. So wash the peel with cold water and proceed for the face.On the hand if after application you notice redness with 1-2 mins then immediately neutralize the part . Dilute the peel with 2 drops of rose water , repeat the test patch on other side of neck. If patients tolerates this then do the diluted peel on the face.On the day of peel:Materials Required for peel----⦁ Required peel⦁ Neutraliser⦁ Measuring cups x2⦁ Brush x 2⦁ Cleanser⦁ Vaseline⦁ Ear bud⦁ Head band⦁ Cotton⦁ Rose water⦁ Eye pads⦁ Mask⦁ Sun screenPROCEDURE:1)Elevate the client's head by 45 degrees.2) Tie Head band3) Cleanse of the face with pre- peel cleanser ( to be used according to the skin texture , I. e. oily, normal , dry etc)4)Apply Vaseline to sensitive areas like outer and inner canthi of eyes , angle of month and nose with ear bud.5) If client is about to undergo peeling for the first time, then a Peel Sensitivity Test should be performed.6) Apply 1 ml 20 % Glycolic acid in stroke with peel brush . As you touch the peel brush on face start the timer. Strokes should be outward to inward , single stroke application approximately time of application should be 45 secs, and peel to be kept for 3 mins only. This 3 mins includes your time of application also.7) Mild itching and burning sensation is experienced, which is normal.8) After 3 mins, dab the under eye and upper eye with cold water 1st then neutralize the rest of the face with 2ml of neutralizer.9) Neutralization of peel can be done 2-3 times in same manner During neutralization patient feels warm sensation. This is due to acid base reaction.10) Then clean the face with cold water and give cold compress the face when patient complaining of any of any burning .11) Apply face mask for 20 mins.12) Remove the mask and apply sunscreen according to the skin type .Precautions: While doing peel if there is unbearable burning , stinging , frosting immediately neutralize the peel with cold compress.POST PEELING CARE –1) Can wash with plain water after 2 hours. Soap can be applied after 12 hours.2) There will be mild redness for 1-2 hours.3) Avoid direct sunlight . Apply sunscreen 20 min before sun exposure.4) Avoid swimming and sweating for 2-3 days.5) No facial bleach , treading , waxing , plucking for 7 day before and after peel.6) Avoid make up for 12 hours.7) Do not use medicated cream 2days before and after peel.8) Do not pick, Picking delays healing causes scarring.9) Moisturize- use moisturizers after peel.OTHER PEELS-1 ) BETA HYROXY ACID – SALICYLIC ACID –Salicylic acid is derived from sweet birch , willow bark and wintergreen leaves. It is lipophilic and act as a kerotolytic agent by dissolving the intercellular lipids, surrounding the keratinized epithelial cells. Due to its lipophilic nature it acts on the sebaceous follicle, has excellent comedolytic activity and hence is very useful for acne. It has anti inflammatory and antimicrobial properties. INDICATIONS:# Active pustular acne# Open poresPROCEDURE—Salicylic acid is used only as spot peel.DO NOT USE ON FULL FACE.Used inA combination with glycolic peel.2) POLY-HYDROXY ACID PEEL-Also called as body peel .To be used only on body.INDICATION:Fine lines and wrinklesRehydration of skinDark back , elbow , forearmsPigmented feet , handsPROCEDURE-Same as glycolic acid. Only in this case test patch not required as we are doing on body. Cleaning, application, timer , neutralization remains the same. Post Peel Instructions remains same for all peel procedures.SKIN WHITENING PEEL—(PEEL BOOSTER)---INDICATIONS*Tanned skin*Pigmented skin*Melasma*Dark underarms , hands, feet…PROCEDURE: *Elevate the clients head by 45 degrees*Tie hand –band*Cleanse of the face with pre-peel cleanser( to be used according to the skin texture .i.e.oily , normal dry etc.)* Apply Vaseline to sensitive areas like outer and inner canthi of eyes, angle of mouth and nose with ear bud.*Take 1 ml of peel booster in a measuring cup and with the brush apply it in same direction on the entire face. NO TIMER is required .After application let it dry completely.* After drying now over the booster apply 1ml of glycolic acid 20% ( here timer is necessary)* Time for 3 mins if patient is comfortable then neutralize after 3 min.2)LACTIC ACID PEEL:-INDICATIONS:-Sensitive skin-Dehydrated dull skin-Under eye dark circles4) DARK CIRCLE PEEL:-INDICATIONS:--⦁ Under eye dark circles.⦁ Periorbital melanosis⦁ Fine lines, wrinkles⦁ Open pores.5)ANTIACNE PEEL:-INDICATIONS:-*Acne*Boils , Pustules.*FolliculitisDIFFERENCE BETWEEN AHA and BHA AHA BHA1) They are water soluble 1)They are lipid soluble2) Has keratolytic action. 2) Anti-inflammatory, anti-microbial, comedolytic3) Requires neutralization 3) No neutralizer required4) No frosting occurs 4) Pseudofrost occurs5) Glycolic 5)Salicylic6)For pigmentation 6) For acne7) Prepared from sugarcane 7) Prepared from Sweet birch, willow bark, Wintergreen leaves.Combination Peels – Multiple peeling agents in combinations are used to compliment their synergistic activity and inhance their efficacy and depth.E.g. Salicylic acid with a Mandelic acid targets the Seborrhea, residual acne, post acne pigmented early grade 1 scars as well as textural improvement. Mandelic acid has antibacterial properties and is safer for dark skin types.Sequential Peels – One peel is printed and terminated and followed sequentially by another peel in the same sitting which can be termined or left on slow release peel.E.g. Salicylic acid followed by Mandelic acid, Glycolic acid or Retinol peel. Salicylic acid peel followed by a TCA obtains moderate depth effects.Switch Peels – Includes usage of different peeling agents in rotation in subsequent sittings. E.g. Salicylic acid or a Retinol peel in comedogenic or Inflammatory acne switched over after clearance to Glycolic , Mandelic or phytic in subsequent sessions to improve scars and texture.Slow Release Peels – Some peels works on controlled (gradual)release of the product progressively and ensures complete penetration and full action of all components in the solution. Easy phytic peel composed of three hydroxyl acids with phytic acid, 3 AHA are glycolic acid, lactic acid and mandelic acid.
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Infertility in Men - Causes And SymptomsTip ImageBoth women and men suffer from infertility troubles. There are a host of causes that may lead to infertility in men such as lifestyle choices and obesity. Male infertility is characterized by irregular sperm function or reduced sperm count. Infertility has emerged as a common problem as a result of the modern day lifestyle. Extremely hectic schedules, stress, burnout, depression, unhealthy diets; all of these can contribute to fertility issues.The various reasons for infertility in men are:If you are overweight, then it is time to lose those extra kilos. Obesity leads to a number of health problems, one of them being erectile dysfunction.Various hormonal problems such as complications of the hypothalamus, pituitary and adrenal glands may lead to low testosterone levels in the body.Various infections such as inflammation of the testicles and epididymis that causes blockage of the tubes carrying the sperm can be a cause.Various medications such as using anabolic steroids, antifungal medications and chemotherapy may hamper production of the sperm and thus hit fertility.Both alcohol and cigarettes may cause problems in sperm production, and cause erectile dysfunction. Excessive drinking may lead to complications in the liver resulting in infertility.The reasons of infertility may range from medical causes to lifestyle choices; some of the causes may be related to the environment. A common cause of infertility is due to problems with transportation of the sperm. These are mainly due to blockages in the tubes that carry the sperm.Symptoms of infertility in men are:You may experience low libidoYour sperm count may be lowYou may experience lumps or swellings in the testiclesChromosomal complications such as reduced body hairYou may have chronic respiratory problems If you wish to discuss about any specific problem, you can consult an urologist and ask a free question.
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Infertility in Men - Causes And SymptomsTip ImageBoth women and men suffer from infertility troubles. There are a host of causes that may lead to infertility in men such as lifestyle choices and obesity. Male infertility is characterized by irregular sperm function or reduced sperm count. Infertility has emerged as a common problem as a result of the modern day lifestyle. Extremely hectic schedules, stress, burnout, depression, unhealthy diets; all of these can contribute to fertility issues.The various reasons for infertility in men are:If you are overweight, then it is time to lose those extra kilos. Obesity leads to a number of health problems, one of them being erectile dysfunction.Various hormonal problems such as complications of the hypothalamus, pituitary and adrenal glands may lead to low testosterone levels in the body.Various infections such as inflammation of the testicles and epididymis that causes blockage of the tubes carrying the sperm can be a cause.Various medications such as using anabolic steroids, antifungal medications and chemotherapy may hamper production of the sperm and thus hit fertility.Both alcohol and cigarettes may cause problems in sperm production, and cause erectile dysfunction. Excessive drinking may lead to complications in the liver resulting in infertility.The reasons of infertility may range from medical causes to lifestyle choices; some of the causes may be related to the environment. A common cause of infertility is due to problems with transportation of the sperm. These are mainly due to blockages in the tubes that carry the sperm.Symptoms of infertility in men are:You may experience low libidoYour sperm count may be lowYou may experience lumps or swellings in the testiclesChromosomal complications such as reduced body hairYou may have chronic respiratory problems If you wish to discuss about any specific problem, you can consult an urologist and ask a free
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AIDSTip ImageACQUIRED IMMUNO DEFICIENCY SYNDROME (AIDS)CAUSE:HIV I OR HIV II virusROUTE:1. SexualHomosexualHeterosexual (often Prostitutes)Multiple sexual partners2. Blood and body fluidsContaminated blood and blood productsa) Blood transfusionb) Blood products eg. Factor VIII3. Contaminated needles and syringes a) Inadequately sterilized medical equipment. b) Intravenous drug abuser (Drug addicts)4. Mother to childIn uteroAt birthBreast milk5.Organ and tissue donationsSemenKidney, skin, corneaBone marrowSYMPTOMS:Low grade fever of unknown origin.Unexplained diarrhoeaTB (atypical Mycobacterium) withEvening rise of feverWeight lossAppetite lossCoughChest painBlood stained sputumRespiratory infections like Pneumonia ( P. Carinii)Cancers ( increased chances )It is important to know that a patient may be infected with HIV virus but may not check the positive in the routine tests. This is called the window period where the level of antibodies is not detectable hence the person test negative for HIV.DO'S AND DON'TS:Use condom during intercoursePatient with antibodies to HIV should not be allowed to donate blood, semen or tissue i.e. Individual who knows that he has AIDS should not donate blood.Avoid having more than one sexual partner Avoid IV drug abuse.Confirm with the physician whether he is using disposable syringes, Sterile needles and infusion sets.Avoid intercourse with prostitutesMother having AIDS should not breast feed her childIf even required to receive blood transfusion confirm thatthe blood has been tested for HIVCONSULT YOUR DOCTOR:Consult your doctor if there is presence of one or more of:Fever more than 100*F for 1 month in absence of other cause Involuntary weight loss more than 10% of body weight or more than 15 lbs in a short period.Intermittent or continuous diarrhoea persisting for more than 1month in absence of any other causeSwellings in any part of the bodyBleeding associated with weight loss and appetite loss Leukoplakia (white patches in mouth or on tongue) or skin rashes which are recurrent and not resolving Respirating disorders with fever, malaise, blood tinged sputum.
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Medico Legal Aspect of Sex TherapyTip Image Medico legal aspects of sex therapyIntroductionSex and human sexuality are sensitive subject. To deal effectively with any problem of human sexuality, one has to constantly evaluate its merits and demerits from social, scientific, moral, ethical and most importantly from the legal angle. Following are some of the guidelines for therapist to keep in mind while dealing with clients with sexual problems.ConsentTaking informed and expressed consent is of utmost importance while managing any patient. Examining and / or treating a patient without consent would amount to assault and battery which is punishable under criminal law irrespective of absence of negligence or successful outcome of treatment. The consent should be free willed, informed, intelligent, specific and express. Person giving consent should be competent to do so, failing which, consent should be obtained from the lawful guardian of the patient (in cases of minor and/or mentally retarded).Examinition of a female clientBesides obtaining a valid consent, in case of female patient, the therapist should always have a female assistant present when examining a female patient this is important for the therapist in order to protect himself from a possible charge of indecent behaviour molestation or even sexual offence like rape ect. Being llevelled against him. Mere presence of husband or any male companion of the female patient is not enough. A sex therapist, in particular, is most vulnerable and therefore should be most careful.Use of surrogate partnersUse of surrogate partners for sex therapy is questionable both ethically as well as legally. Sexual involvement of the therapist is universally accepted as unethical. There have been a number of cases where the therapists themselves, having acted as surrogates, have been punished for sexual molestion of their patients. It may also invite a criminal charge of adultery in some countries, including india. There are cases on record where the therapists have been charged with and convicted of rape.Unlike some other countries, the socio cultural set up in india is different. The laws governing sexual behaviour are neither liberal nor evolved as much as in some of the western countries. Besides, surrogacy is likened to prostitution by many. Even if one were to consider surrogate partner as a therapist, then the ethical code prevents a sexual relationship with a client. Moreover, there is every possibility of a disease being transmitted. Particularly the hiv infection, in view of sex with multiple partners by a surrogate person.Therapist should have uppermost in mind the special values of intimacy and love that our culture teaches us to nurture.Professional competencyIt is the ethical responsibility of every sex therapist to maintain high standards of professional competence and integrity. Competence without integrity or integrity without competence is an unsatisfactory compromise of professionalism. It is most important to protect the public and the other professionals from persons who represent themselves as sex therapists who are in fact lacking in competence and intergrity.Competence in another primary discipline such as psychology, psychiatry or counselling is not equivalent to competence in sex therapy.A sex therapist should possess adequate knowledge of the following: 1. Sexual and reproductive anatomy and physiology.2. Developmental sexuality from a psychobiological point of view.3. Marital, family and interpersonal relationship and socio-cultural factors in sexual values4. Physiological and medical factors that may influence sexual functions such as pregnancy, contraception and fertility, illness, disability, medications.5. Multimodel techniques and theory of sex therapy and psychotherapy.6. Pharmacology of the medications used to treat sexual dysfunctions particularly with respect to their adverse effects and interactions with the drugs being consumed for other ailments.7. Ethical issues in sex therapy and principles of evaluation and referral.8. Laws related to sexual behaviour. Points to bear in mind all forms of sex therapy which violate the local laws should be handled with care recommending oral sex as a part of therapy is violative of section 377 of the indian penal code which deal with unnatural sexual offences.the hippocratic oath forbids the physician to take advantage of the therapeutic context in order to engage in either homosexual or heterosexual relationship.it is a universal rule that whenever dealing with reproductive functions is involved, express consent of both the spouses should be obtained.proof of competence is the ability to provide objective and responsible services to the clients.there does exist a potential liability under the laws of the land prohibiting consensual conduct such as prostitution, fornication, lewd and lascivious behaviour and adultery which might arise from therapeutic or non- therapeutic sex research activities.sex between therapist and client is always unethical. No matter how therapeutic the rationale might appear, there is no justification for a therapist having sex with a client. The purpose of sex therapy is to improve function, not to change values or beliefs of the client.
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PSORIASISPsoriasis is red scaly (silvery white) patches which can appear any where on the skin.Cause: Unknown.Possibly genetically determined.Common between 15-30 years.Precipitating factors are:–Psychological emotional stress.–Cold weather.–Injury.–Septic focus.–Drugs like Steroids, Brufen, Lithium, Antimalarials and Beta - adrenergic blockers.Sign and symptoms:Usually affects both sides of body symmetrically.Well circumscribed red, dry plaques(flat areas on the skin) of various sizes, covered with scales.Removal of scales gives rise to pin-point bleeding points.Sites can be anywhere on the body especially on e.g. elbow, knees, sacrum and occiput.Lesions are coin shaped or circular with central clearing.Joints can get affected especially finger joints.Nails frequently become pitted and thick with brownish black discoloration.Dietary management:Avoid:Avoid precipitating or trigger factors.Avoid food you are allergic to.Avoid smoking and alcohol.Avoid foods high in fat or sugar.Avoid non-vegetarian food – meat, poultry.Do:Warmth may help to control relapses.Do regular exercise helps by improving blood circulation.Practice yoga will help in reducing stress.Consume:Drink plenty of water.Eat fresh and raw fruits and vegetables as they provide antioxidants and flavanoids which help in reducing inflammation and boosting up immunity.Consume figs and fish oil might help you feel better.Eat a well-balanced diet - Proper nutrition will improve general health and reduce the severity of the disease.Do not over eat even healthy foods.Limit intake of red meat and dairy products.Eat foods that contain psoralen before you walk out in sun - Celery, carrots, citrus, figs, fennel, and parsnips. It makes the skin more sun-sensitive to the positive effects of UV light. But do not over expose to sun.Consume oily fish, may help reduce the inflammation associated with psoriasis - mackerel, salmon, black cod, albacoretuna, herring and sardines.Have a low-calorie diet if you are over weight - about 1, 200 calories per day. Some researches have shown relations between psoriasis and obesity.Consume gluten free diet, it benefits individuals with psoriasis (Gluten is a mixture of proteins found in some cereals, particularly wheat) – avoid wheat, rye, barley and oats they contain gluten.Increase intake of vitamin D.Increase intake of omega 3 fatty acids and reduce intake of omega 6 fatty acids (ratio of 2:1), omega 3 fatty acid has anti-inflammatory properties.Food rich in omega 3:–Canola oil, flaxseed, flax seed oil, walnuts and green leafy vegetables like purslane, fish - Atlantic salmon, Atlantic halibut, Atlantic mackerel, Atlantic and Pacific herring, sardines, bluefish, tuna and cold water fish.Reduce (do not completely avoid)intake of food rich in omega 6:-Cereals, vegetable oils, whole-grain breads, baked goods and margarines, eggs and poultry.Consume diet rich in vitamin A and zinc, helps in regeneration of the skin.Increase intake of vitamin C, it helps maintain healthy skin.Have coriander leaves frequently, its high in vitamin C and helps to maintain healthy skin.You can have 3-4 strands of saffron in milk, it is beneficial for skin.Basil leaves (tulsi) are said to be helpful in skin ailments, eat 3-4 fresh leaves daily.Consult physician:You can take vitamin and cod liver oil supplements under guidance of your physician.In case of prolonged duration or change in rash pattern take physicians opinion immediately.If symptoms get worse or if you see any Signs of infection (fever, redness of the affected area, pain) occur, see your physician immediately.
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