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Friday, 18 December 2015

A name of Exoplanets( Exo world) as "Dragon Planet "Suggested By Professor Dr Pranab Kumar Bhattacharya Accepted by IAU on 15th december 2015

Professor  Dr Pranab kr Bhattacharya  named an exo planet  as "Dragon planet" in  the Star " Iota Draconis" on 12 th august 2015  through  URL [To vote, go to the Name ExoWorlds site here: http://nameexoworlds.iau.org/exoworldsvote]  [http://www.space.com/30232-exoplanet-naming-contest-iau.html]  and the name Dragon planet  has now been  accepted by  International Astronomical Union USA  rather   for the constellation star formalhaut B   and this "Dragon Planet" was as per his late mother late Mrs Bani. Bhattacharya (1935-2006)  who believed in exo planets,  life in other planet of distant solar system and  she used to point a star  she named it as *Dragon star*
visit URL
https://www.newscientist.com/article/dn16033-first-images-captured-of-alien-solar-system
http://nameexoworlds.iau.org/systems/103
http://nameexoworlds.iau.org/exoworldsvote
http://nameexoworlds.iau.org/names
http://www.iau.org/public/images/detail/iau1514a/
http://www.space.com/30232-exoplanet-naming-contest-iau.html
 He  voted  on 12th august 2015 , going  through URL  to the NameExoWorlds site here: http://nameexoworlds.iau.org/exoworldsvote
Dagon
Dagon, an ancient Syrian “fish god” should be the name of the exo planet orbiting the bright star Fomalhaut (alpha Piscis Austrini) for many reasons. This system resides in, Piscis Australis, or the “Southern Fish”, so it’s only natural to associate a fish deity with this constellation and it is consistent with the current naming of planets as gods from various pantheons. The name Fomalhaut is Arabic for “Fish’s mouth”, further strengthening the fish theme.

In addition to these historical considerations, Dagon has also been used (and recreated) in the 20th century literature of H. P. Lovecraft in his short story “Dagon” (1919) with reference to an “ancient Philistine legend of Dagon, the Fish-God”. A further connection can be traced to a subsequent story written by a purveyor of the Lovecraftian mythos, August Derleth, who wrote “The Dweller in the Darkness” (1944) that features Fomalhaut as the home of beings that assist the protagonists.

Naming the exoplanet Dagon would both honor the established tradition of using mythological deities and possibly establish a doorway to using fictitious god or god-like names in the future. Dagon would also be a posthumous nod to H. P Lovecraft who always strived to write about “cosmic wonder”. 

The name was proposed by Professor Pranab Kumar Bhattacharya of Kolkata, India  for another constellation Star  Draconis in memory of his late mother but accepted  for constellation  Formalhautb
We’d like to show the name‘Leisurely Fish’ for the companion star of Fomalhaut belonging to PsA. The reason why we say it leisurely is that the star moves very slowly. In addition, there is a word ‘fish’ in the name because it belongs to PsA. With the faster and faster speed of modern life, we forget to slow down to enjoy our life. So we want to use the name to remind everyone of slowing down to enjoy the beautiful night sky just as a leisurely fish. Thanks to Professor Bhattacharya 

Monday, 30 November 2015

The Possible Future Treatment of Sickle cell anaemia republished in geneticdisorders.info

The Possible Future Treatment of Sickle cell anemia"

Source:  "The Possible Future Treatment of Sickle cell anemia"    Tag:  sickle cell anemia pathophysiology at 
 geneticdisorders.info

  
Authors;

* Professor Pranab Kumar Bhattacharya MD(cal) FIC path(Ind)- Professor and Head,* Miss Upasana Bhattacharya- daughter of Prof.PK Bhattacharya   ** Mr. Rupak Bhattacharya Bsc(cal) MSc(JU),** Mr Ritwik Bhattacharya B.com(cal); **Miss Rupsa Bhattacharya** Mr .Soumak Bhattacharya BHM, MSc-student(PUSHA) New Delhi;All of Residence- 7/51 Purbapalli, Sodepur, Dist 24 parganas(north) kol-110, ***Oindrila Mukherjee*** Mrs. Dalia Mukherjee BA(Hons) cal;*** Mr Debasis Mukherjee Bsc(cal).   Dr. Ranu Roy Biswas MD(cal) Asst Professor.  *Dr. Anuradha De DCP(cal) MD(AIIMS) Associate Professor; *Dr. Soma Das MBBS(cal) DCH(cal) Demonstrator; **
·       Affiliation-*   Department of Pathology , Calcutta School of Tropical Medicine, CR Avenue ,Kol-73; W.B; India ** 7/51 Purbapalli, Po-Sodepur; Dist 24 pargnas( West Bengal) Kol-20*** Swamijinagar, South Habra, 24 Parganas(north) West Bengal.

Scientists have learned a great deal about sickle cell anaemia during the past 30 years - what causes it, how it affects the patient, and how to treat some of its complications. They also have begun to have success in developing drugs that will prevent the symptoms of sickle cell anaemia and procedures that should ultimately provide a possible cure.
Some researchers are focusing on identifying drugs that will increase the level of fetal hemoglobin in the blood. studies have shown that these people have less severe cases of the disease. Fetal  hemoglobin seems to prevent 
sickling of red cells, and cells containing fetal hemoglobin tend to  survive longer in the bloodstream.
Hydroxyurea appears to work primarily by stimulating production of fetal hemoglobin. There is some evidence that administering hydroxyurea with erythropoietin, a genetically engineered hormone that stimulates red cell 
production, may make hydroxyurea work more better. This combination approach offers the possibility that lower doses of hydroxyurea can be  used to achieve the needed level of fetal haemoglobin to reduce side effects of both toxic drugs to search for safer agents that are just as effective.'Butyrate,- a simple fatty acid tha is widely used as a food additive, is 
also being investigated as an agent that may increase fetal hemoglobin production. Clotrimazole, an over-the-counter medication commonly used to treat fungal infections, is under investigation as a treatment to prevent the loss of 
water from RBC  that contributes to sickling.  Bone marrow transplantation has been shown to provide a cure for severely     affected children with sickle cell disease. Researchers are working on techniques to  f urther reduce some of the risks of bone marrow transplantation for    patients with sickle cell disease. The ultimate cure for sickle cell anemia may be gene therapy.    Gene therapy offers enormous promise as a potential curative therapy for   SCD, but concerns over the safety of random genomic insertion must first   be resolved . Pre-clinical studies in mice have provided the proof of    principle that transduction of bone marrow stem cells with lentiviral   vectors that express a beta-globin gene can prevent Hb S polymerization in  vivo. The wide range of abnormalities engendered by the sickle cell  mutation offers several other opportunities for therapeutic interventions. For example, the NIH Road Map is supporting ongoing investigations in   which high-through put screening approaches are used to discover novel low  -molecular-weight compounds that can alter key aspects of the disease,  I ncluding hemoglobin polymerization, expression of Hb F, and leukocyte    adhesion. Current clinical trials are evaluating the efficacy of Ca2+-  sensitive Gardos channel inhibitors , with or without hydroxyurea, in    preventing dehydration of erythrocytes . Vasoactive drugs (e.g., NO,   sildenafil, endothelin antagonists) are being evaluated for the treatment  i f pulmonary hypertension. Statins are of potentially great interest since they can increase NO production and reduce leukocyte adhesion . Selective antagonists &  Intravenous   gammaglobulins are currently under clinical evaluation following a study   demonstrating a dose-dependent reduction in leukocyte adhesion and in the   number of interactions between rbc and wbc, accompanied by improvements inmicrocirculatory blood flow and survival of sickle transgenic mice . Almost a century after SCD was first 
described, we may be towards the dawn of a new era in which a physician one day might be able to use genetic information to select one or more drugs that target specific aspects of disease pathophysiology that are 
relevant to a particular patient with SCD 


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Cost-Effectiveness of Biologics in Early Rheumatoid Arthritis | Annals of Internal Medicine

Cost-Effectiveness of Biologics in Early Rheumatoid Arthritis | Annals of Internal Medicine

Thursday, 8 October 2015

The Nobel Prize for Physics- 2015 has been awarded for neutrino puzzles for the discovery of neutrino oscillations, which shows that neutrinos have mass The discovery led to the far-reaching conclusion that neutrinos, which for a long time were considered massless, must have some mass, however small

The Nobel Prize for Physics- 2015 has been awarded for neutrino puzzles that physicists had wrestled with for decades had been resolved. Compared to theoretical calculations of the number of neutrinos, up to two thirds of the neutrinos were missing in measurements performed onEarth and also that for the discovery of neutrino oscillations, which shows that neutrinos have mass The discovery led to the far-reaching conclusion that neutrinos, which for a long time were considered massless, must have some mass, however small.
Please readURL http://www.nobelprize.org/.../laureates/2015/press.html 
and also the  advanced Report of the Royal Swedish Academy of Science in PDF for 2015 Nobel prize in Physics 
                                                                                                                                                                                                                                      That the Neutrinos has mass was also published by us in various times  as  in the " Science Blog"  as we told there   "Neutrinos were also non-Zero mass particles according authors , though in standard teaching, it is mass less. There are broadly three (3) species of ‘Neutrinos”. I) Electron neutrinos 2) Muon neutrinos 3) tat neutrinos and 4th variety we say Missing Neutrinos. During first half of twentieth century, physicists were convinced that all stars including our Sun, shines by converting, deep in its interior, hydrogen into helium. According ,this theory, 4 hydrogen nuclei called protons (p) are changed within solar interior into a 4He nucleus, 02 anti-electrons (e+, positively charged electrons), and 02 elusive and mysterious ghostly particles called neutrinos . This process of nuclear conversion, believed responsible for sunshine and therefore for all life on Earth. Conversion process, which involves many different nuclear reactions, can be written schematically as: 4p→4He +2e+ +2ve —-[1] as Bhattacharya Rupak wrote it once in 1995. I.e, two neutrinos produced each time as the fusion reaction (1) within star. Since 4 protons are heavier than a helium nucleus, two positive electrons and two neutrinos, reaction (1) releases lot of energies to Sun, that ultimately reaches earth as sunlight. The reaction occurs very frequently. Neutrinos escape easily from Sun their energy does not appear as solar heat or sunlight in earth. Sometimes neutrinos are produced with relatively low energies and Sun gets lot of heat. Sometimes neutrinos are produced with higher energies and Sun gets less energy. Neutrinos have zero electric charge, interact very rarely with matter, – according to particle physic’s very high reference level textbook version of the standard model of particle physics – they are mass less. About 1000 billion neutrinos from Sun pass through your thumbnail every seconds, but you do not feel them because, they interact so rarely and so weakly with matter. Neutrinos are practically indestructible; almost nothing happens to them. For every hundred billions solar neutrinos passing through Earth every seconds, only about one interacts if at all with stuff of Earth is made. Because they interact so rarely, neutrinos can escape easily from solar interior, where they are created and bring direct information about solar fusion reactions to us on Earth. There are three known types of neutrinos already told. Nuclear fusion in Sun produces only neutrinos that are associated with electrons, the so-called electron neutrinos . The two other types of neutrinos, muon neutrinos and tau neutrinos , are produced, for example, in laboratory accelerators or in exploding stars, together with heavier versions of the electron, the particles muon and tau . But there are some missing neutrinos too. All accepted models in cosmology & in particle physics however accept that neutrinos are mass less or so. But some idea that neutrinos might have mass also was about 40 yearsold."
                                                                                                                 
 See at Science Blogs comment published   titled "Faster Than a Speeding Photon: “Measurement of the neutrino velocity with the OPERA detector in the CNGS beam” Posted by Chad Orzel on September 24, 2011 and the   published comment no 43 by Professor Pranab Kumar Bhattacharya on September 28, 2011 as it was titled "Tachyons is an mathematical Imaginary particle that may move faster then Photons (Light particles) in the universe and yet to be discovered"
click on Links http://scienceblogs.com/.../faster-than-a-speeding.../...

                                                                                                                                                           Please Read also in our published article " Tachyon- Faster than Light Particle Exist in Our Universe or an Imaginary Mathematical Particle" by authors Rupak Bhattacharya Pranab Kumar Bhattacharya, Upasana Bhattachary, Ritwik Bhattacharya,Rupsa Bhattacharya, Dalia Mukherjee, Oaindrila Mukherjee, Aiyshi Mukherjee, Hindole Banerjee,Arunava Das  published at International Journal of Astronomy, Astrophysics and Space Science 2015; 2(3): 12-29 Published online May 10, 2015 (http://www.openscienceonline.com/journal/aass) where we authors clearly told that "...........There is till no confirmed mass evidences that neutrinos have a non zero mass particles............
(Bhattacharjee Rupak and Bhattacharya Pranab Kumar)..........see at Page Nos 15-16                                                                                                        

Click also  on The Guridian UK at URL   http://www.theguardian.com/.../the-lay.../2011/sep/23/1...   Published at journal  Physics Org titled as" Fate of a Star supernovas and mechanism of explosion of supernovas" at physics org of American Physical Society as a published comment of an article "Rare radio supernova in nearby galaxy is nearest supernova in five years" Click on URL https://www.facebook.com/PhysicsToday/posts/10156136212620164                  
See at Face Book of  nobelprize.org  "Questions for David Gross" by Prof Pranab Kr Bhattacharya Click on URL https://www.facebook.com/.../questions.../401404001719...            
Please See the Published articles on  Blogs of Professor Pranab Kumar Bhattacharya at Google Blog.com under blog title : Where from mass came in the universe?- Did the mass originated from mass less particle in Higgs Field - A child like question & quest! Is it really So?" Click on URL https://www.facebook.com/PhysicsToday/posts/10156136212620164 or http://totallydrug-resistanttbemergesinindia.blogspot.in/...                                                                             
  See the article Methods of Evaluation and Extraction of Membership Functions--Review with a New Approach" by authors Dwijesh Dutta Majumder, Rupak Bhattacharyya, Supratim Mukherjee click on URL http://ieeexplore.ieee.org/xpl/articleDetails.jsp...
                                                                                                                                                      Published articles on Blogs of Professor Pranab Kumar Bhattacharya at Google Blog.com under blog title " A smaller particle then quarks-possible at all?" please click on URL http://totallydrug-resistanttbemergesinindia.blogspot.in/...                                                                       
Published articles on Blogs of Professor Pranab Kumar Bhattacharya at Google Blog.com under blog title Where Went the Anti matter?http://totallydrug-resistanttbemergesinindia.blogspot.in/...

[Next Tuesday the Royal Swedish Academy of Sciences will announce the winner (or winners) of this year's Nobel Prize in Physics. AIP's Ben Stein predicts that Kent Ford and Vera Rubin will be honored for their discovery, derived from stellar velocities, that the Andromeda Galaxy contains much more mass than is present in its visible stars. Since Ford and Rubin's paper was published in 1970, additional lines of evidence, including observations by Ford and Rubin of other galaxies, have supported their discovery. Now the only plausible explanation is that galaxies and the space between them are pervaded by an unknown kind of "dark matter," whose interactions with itself and with normal matter are either through the gravitational force or very weak]
https://www.facebook.com/PhysicsToday/posts/10156136212620164

Thursday, 1 October 2015

Can we protect the population from Dengue diseases by a recombinant live attenuated tetravalent dengue vaccine?

Rapid Responses Published in BMJ on 29 September 2015as Letter to Editor

Research News

Trial results raise hope for dengue fever vaccine

BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h141 (Published 09 January 2015) Cite this as: BMJ 2015;350:h141
Authors

Professor Pranab Kumar Bhattacharya MD (Calcutta Univ) FIC Path(India)  now Professor of Pathology at   Murshidabad District Medical College, West Bengal Behrampore Station Road ; Behrampore Court Murshidabad District West Bengal India          
       


Dengue is a mosquito (Ades aegypti) borne viral illness in the tropics and subtropics including in India. Approximately 350 million infections occur annually, of which 96 millions have clinical manifestations on infection with one of four serotypes (DENV 1,2,3.4) of the dengue virus. These may result in asymptomatic infections, mild non-specific viral flu-like illness, classic dengue (DHF), and severe dengue-manifested by plasma leakage, hemorrhage, hepatitis, renal failure, multi-organ failure and finally death. Severe dengue may also manifest with variant types of atypical signs [3] and symptoms, and when a second infection with different serotypes occurs, people are at increased risk of severe dengue.
The incidence of dengue is increasing globally and becoming endemic. Dengue is almost endemic throughout India. The incidence of Dengue in 2014 was 47,000 cases in China as of May 2015; Malaysia reported more cases compared with 2014, and as of June 2015 Brazil reported over a million suspected cases of Dengue. Resource poor health care systems as in India depend on simple to perform and easy to interpret laboratory tests for diagnosis. It is known that early diagnosis of DHF and DSS followed by supportive therapy reduces morbidity and mortality from Dengue. Thrombocytopenia, NS1 antigen IgM & IgG by immunochromatographic tests are the mainstay of diagnosis of Dengue infections in peripheral areas; most tertiary care laboratories have Mac Enzyme Linked immunosorbant Assay for qualitative and quantitative detection, and PCR based diagnostic modality are found in research laboratories and medical colleges of Kolkata metro cities. Ns1 has 30% positivity, becoming more positive when there is more viral load.
There is yet no available medicine or vaccine for treatment and protection against dengue fever. Prevention is protection from mosquito bites and vector control--ie, reducing A. aegypti larvae and pupae.
There is a tetravalent recombinant live attenuated Dengue vaccine (CYT-TDV) having CYD-1 through CYD-4 which requires 3 injections at 0, 6, and 12 months. The efficacy rate was 60.8 (95% CI) and in children 64.7% (95%CI 58.7-69.8). For serotype DNV-1 the efficacy rate was 50.3%, for serotype 2, 42.3%, serotype 3, 74% and serotype-4, 77.4%. This vaccine was tested in 20,869 children in Latin America, where dengue infection is epidemic in age group 9-16 years, during June 2011-March 2012. [1] During follow up for 2 years a total of 10,053 febrile episodes were reported, 8965 (89.2%) blood samples were collected within 5 days of fever and VCD was diagnosed only in 668 cases by Mac ELISA and RTPCR; efficacy was highest for DNEV-4 and lowest for DNV-2 and varied between countries tested in a phase 3 clinical trial. [1]
Adverse effects of CYT-TDV occurred in 121 children, including moderate asthma attacks, allergic urticaria after the 2nd injection, acute peripheral neuropathy after the 1st injection, viral meningitis, unspecified seizure. Efficacy of this vaccine in reducing hospitalization is 80.3% against severe dengue.
The dengue vaccine is facing numerous challenges, according to the authors.[1] Viable dengue vaccine must be capable of protecting against disease caused by any of the 4 serotypes. [2] Problems include the lack of a validated animal model of human dengue disease, [3] incomplete understanding of immunopathology, [4], the release of neutralizing antibodies assays, and cross reactivity among serotypes.
Now the questions remain can we protect our population fom Dengue diseases and can we reduce the population of patients with severe dengue with this CYT-TDV vaccine? Why the disparity in efficacy in antibody response and against the 4 serotypes?
References
1] Luis Villov, Gustavo Horacid. Dayan ; Jose Arrendondo Gurcia; Doris Maribel Revera etal “ Efficacy of a tetravalent Dengue vaccine in Children in Latim Ameria” N engl.j. med 2015; 372; 113-23
2] Professor Pranab Kumar Bhattacharya, Ritwik Bhattacharya, Rupak Bhattacharya Dahlia Mukherjee, UpasanaBhattacharya etal Plaque reduction neutralization test for dengue virus is more sensitive test but expensive Rapid Response Published BMJ 13 December 2009 of article Clinical Review Diagnosis and management of dengue http://www.bmj.com/content/339/bmj.b4338/rapid-responses
3] Professor DR. Pranab Kumar Bhattacharya, Dengue fever in Kolkata, West Bengal India with atypical presentations and its prevention Blogs of Professor(Dr.) Pranab Kumar Bhattacharyya MD(cal.Univ) Pathology; http://totallydrugresistanttbemergesinindia.blogspot.in/2013/04/dengue-f...
Competing interests: No competing interests

 This article "Can we protect the population from Dengue diseases by a recombinant live attenuated tetravalent dengue vaccine?" published in this Blog  ND In BMJ {link provided} is Strictly Copy Righted material to Prof.(Dr.) Pranab Kumar Bhattacharya under his Intellectual Property Right(IPR)  Copy Right Acts  under sections-306/3D/107/1012( a,) (b ) / RDF and Protect Intellectual Property Right ACT of USA-2012. Please do not ever try to infringe to avoid huge  amount  damage suit charge  in several cores INR / or civil suit / or  even criminal proceedings in IPR Courts of India or in any other courts of India Professor Bhattacharya  will deem fit it so . Please do not try or take any sort of  attempts to infringe any thing [ besides reading  or liking or commenting or E mailing  if any if you have ]   or engaging yourself in  kinds  of plagiarism for yours own safety purpose from Plagiarism suit or infringement of Copy Right act suit .  You are not  ever permitted to reproduce any things  from his/ their postings/ published articles/comments/blogs/posts or sharing in his Face book etc or even use for your's fair uses also or dissemination for others knowledge or teaching or public as per IPR acts and laws for ever.These terms are however will not  beapplicable for Professor Dr Pranab Kumar Bhattacharya's  only daughter miss Upasana Bhattacharya , other authors and to  all his family members who can use these articles and postings in this Blog  or his face book  for their beneficiary acts in future or ever in manner they desire to use.

Monday, 21 September 2015

Nobelprize.org

Category:








1. [html] Who Deserves a Nobel Prize?
The Nobel Prizes were created by Alfred Nobel for promoting outstanding achievements ... kindness and his caring nature for humanity." - /Khizar Haider - "I recommend Mr. Rupak Bhattacharya for Nobel Prize in Physics for the year 2015 for Tachyon particles." Dr. ...
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2. [html] Book Tips - Visitors Recommend
Book Tips - Jean-Marie Gustave Le Clézio The Nobel Prize in Literature 2008 ... Rupak Bhattacharya, India Révolutions It moves around the world and takes a wide, historical grip on society and colonialism, and in the middle of all it is intimate and personal ...     
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3. [html] Who Deserves a Nobel Prize?
The Nobel Prizes were created by Alfred Nobel for promoting outstanding achievements ... for Nobel prize for physics is FTL particles, a zero rest mass particle - mr. Rupak Bhattacharya or dr. Allan Guth for Big bang" - /professor Pranab kumar Bhattacharya - "I ...
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4. [html] Greetings to the 2013 Nobel Laureates in Physics
Greetings Immediately after the announcement of the 2013 Nobel Prize in Physics, greetings ... of CERN's project I was very sure that this year you two will get the Nobel prize for your Nobel work. A heartiest congratulation to you and hope for the completion ...
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             5. [html] Greetings
Immediately after the announcement of ... Period 1 "Felicitaciones muchachos, un abrazo desde Venezuela" /pugoz "Congratulations!!" /Nagaraja K K, Mangalore "Congratulations guys,..." /Mohammad Gharavian "Congratulations, another step in the man's knowledge ...
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              6. [html] Greetings to the 2012 Nobel Laureates in Physics
Greetings Immediately after the announcement of the 2012 Nobel Prize in Physics, greetings ... MANISH S. BURELE "Congrats. Soon quantum computers in existance" /M N Haq "
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DocPlexus.in


Erectile Dysfunction
Votes(0)   Answers(16)   Viewed 393 times

A 26 year old unmarried truck driver from North east region of  India complains of premature ejaculation and passing? Turbid urine since three months. He says that there is discharge of a few drops of semen before micturition everytime followed by passage of slightly cloudy urine. Has mild and vague pain in the left flank. No h/o fever, no dysuria. He has reportedly lost 3 kgs of weight in a span of 3 months. Has a single sexual partner, a virgin from college, who is said to be loyal to him. But he had exposure to another lady previously whose credentials are unknown. He has not had coitus since one month. He smokes cigarettes and takes alcohol but not physically or psychologically dependent on them, and no substance abuse. Due to the current problem his sleep and appetite are affected and he is worried. He is not known diabetic or hypertensive and clinical examination is unremarkable. Routine blood and urine examination including VDRl and Urine culture and sensitivity have been ordered.
Need guidelines about this case.
Answers
I feel that this guy, after ruling out any organic or metabolic malady, needs counselling and anti anxiety medication. A combination of Escitalopram 10 mg and 0.5mg Clonazepam at bedtime for 3-4 months along with nutrional supplements will suffice for the time being. Needs REPEATED counselling by an expert and  follow up by an experienced Psychitrist.

Sep 14 2015
Needs tests to confirm STD esp HIV testing since he has multiple sexual partners whatever may be their credentials. If positive needs appropriate therapy plus counselling
This the most common presentation of young men who have multiple artners and that too in the early phases of such liberal activity.
However before labelling the patient, it is wise to exclude organic problems
In view of the possibility of HIV, You need to rule it out also.The investigations ordered by you are not enough. He also needs a semen culture/expressed prostatic secretion culture and sensitivity aa well.
The treatment has to strictly according to the sensitivity report.
If there is infection in the EPS he may need cyclical antibiotics for an extended period of time. He should also use a condom in this period His partner also should be evaluated for 1. Urinary and 2. STDs and treated accordingly.

Sep 15 2015
I agree with above protocol
Premature ejaculation is best treated with Dapoxetine 30mg tablets 2 hrs before intercourse once daily. Psychotherapy and open discussion regarding the issue with the partner is very essential. And regarding semen following micturition try using Dutaseride (urodart) once daily. This will stop the prostatorrhea.
i need to know his urine reports and VDRL reports. Also let me know if he is an alcoholic and i would also request for his Tuberculosis test profile

Sep 14 2015
Dapoxetine is not permanent solution.
Its cost too high.
If use each time from where will arrange lunch and dinner
Rule out any organic cause or associated organic cause and treat them. Otherwise counselling counselling counselling etc.
Please provide the reports which are ordered?
Its DHAT syndrome common in Asia.
Need scientific diagramatic sexual counselling with antianxiety medicine for 10 days

Sep 14 2015
Well said. After a thorough workup dose not uncover any aetiology of course.The fluoxetine and its derivatives like duloxetine and the newer dupoxetine are waste of time and money.
Young Male's erectile dysfunction defined as “the inability to achieve or maintain an erection sufficient for sexual intercourse with or without premature ejaculation problem”—is one of the most common sexual dysfunctions also seen in young or adolescence men besides organic or metabolic cause. Although erectile dysfunction can be primarily psychogenic in origin, most patients have an organic disorder, commonly with some psychogenic overlay.Some men assume that erectile failure is a natural part of the aging process and tolerate it; for others it is devastating. Withdrawal from sexual intimacy because of fear of failure can damage relationships and have a profound effect on overall wellbeing for the couple. Since in this case erectile dysfunction did not  accompanied chronic illnesses, such as diabetes mellitus, heart disease, hypertension, and  or a variety of neurological diseases, the most probable diagnosis may be psychogenic however hormonal levels  particularly testosterone level to be measured along with psychological counselling and anxiolytic medicine. He should be advised  to avoid cigarette and alcohol as it causes endothelial injuries and a cause of ED.
Urine should be examined for spermatozoa to rule out retrograde ejaculation, Semen and urine culture are a must. Order for USG Abdomen to R/O urolithiasis. Advise to practice safe sex.
Please evaluate for metabolic factors in addition to uti evaluation.Considering the life style of truck driver Gonorrhea is very common in them  & appropriate antibiotic must be given at the earliest.
He should consult sex expert with investigation already asked

Sep 14 2015
In india there is no qualified sex expert.
Such pts. Are Reffered to either urologist or psychologist .
And rare timr to psychiatrist

Sep 15 2015
In 1980 American urological association made a statement "90% of sexual /erection problems are due to pscychiatric causes"
In 1990 aua 's position was "90% of the sexual problems/edf are due to organic causes and only 10% psychiatric causes"
In 2000 aua position was " unless proved otherwise all sexual / edf problems are due to organic causes only".
The only person who has the expertise, the investigative tools and the treatment capability - medical or surgical- is a urologist.
When found necessary, the urologist will refer the patient to psychiatrist.
As an axiom- no surgeon would like to hang on to a patient, who does not have a surgically correctable problem - including a urologist . And the urologist rarely tries to treat
a nonurological problem himself.
As a urologist who established and ran a multi-speciality tertiary care andrology center for nearly 10 years, the input of psychiatrist, endocrinologist and a physician was always taken before the treatment plan was decided at our center.!
Dear Doctor,
You must rule out HIV, send urine & semen C&S. Time being after giving for the C&S, you can start with Moxyflox IV then Tab, along with Amikacin.
He needs to be excluded HIV
ED include many thing
Non errction
Delayed erection
Delayed ejaculatation
No orgasm
Loss of libido premature ejaculatation may be symptom of ED but its management will be definitely diffrent or must be refer to psychologist and may requires psychiatric.

Sep 14 2015
Furthr its not mentioned whether satisfactory erection achieved or not.

Sep 14 2015
Further
Most likely the young man is suffering from Prostatitis that needs to be further evaluated and triple regime therapy may solve his problem.SSRIs may help temporarily no doubt.
Thanks for all,
Greetings and sharing with Good Question and very common  problem in Young  and Adolescents in day to day Practice.
My opinion is please  check the levels of Testosterone Hormone,  counselling and treat with  Mild Anti-Psychotics along with Nutritional Supplements would help the patient. At the same time advice to role out Investigation  Pathology like Urine and Semen analysis.
Dear doctor,
Go for Aids serology test.

Sep 19 2015
Karnataka.

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