Pheochromocytomas

Panchakarma- Five Teatments -1 Pancha Karma is the cornerstone to Ayurvedic management of disease. Pancha Karma is the process which gets to the root cause of the problem and corrects the essential balance of 'Tridosha' in body. Pancha Karma is not only good for alleviating disease but is also a useful tool in maintaining excellent health. Ayurveda advises undergoing Pancha Karma at the seasonal changes to clean the body, improve the digestion and to improve the metabolic processes. Panchakarma is a Sanskrit word that means "five actions" or "five treatments ". This age-old science of purifying the body is an ancient branch of Ayurveda, The Treatment in Ayurveda consists of two main types. One is Shaman Chikitsa, used to subdue the vitiated Doshas, due to which any ailments may be produced. It is administered by using various medicinal herbo-mineral preparations. However, if the Doshas are vitiated beyond a particular level, they give rise to various endotoxins, which have a tendency to be accumulated in the minute channels. These are beyond the level of pacification and hence need to be eliminated or removed from the body. In such cases, the second type of treatment, which is Shodhan Chikitsa or cleansing therapy, is indicated. Since it consists of the five types of main therapies, it is known as the Panchakarma Chikitsa. Panchakarma has been given a special place in all the ancient Ayurvedic texts. Aacharya Charak, the author of the most important ancient text on internal medicine, has described a wide use of Panchakarma therapy for almost all the major diseases. Two separate sections, Kalpa Sthanam, and Siddhi Sthanam in Charak Samhita describe the details of special decoctions and other preparations used for Panchakarma therapy. Panchakarma includes three parts namely: Poorva Karma (Preparatory Methods)which includes : Paachan (Digestion) Snehan (Internal and external oleation) Swedan (Fomentation) Pradhan Karma (Main methods)which includes : Vaman (Induced vomiting) Virechan (Induced purgation) Basti (Medicated enema) Nasya (Nasal medicine) Rakta Mokshan (Artificial bloodletting) Pashchat Karma (Post-Therapeutic Measures)which includes: Sansarjan Krama (Specific dietetics), DhumaPana (smoking of medicinal cigars) and some rules to follow specific activities. Purvakarma : Pre-purification Measures Before the actual operation of purification begins, there is a need to prepare the body in prescribed methods to encourage the body to let go of the toxins. The two procedures are 'snehan' and 'swedan'. Snehan is the oil massage. Oil is applied to the entire body with a particular type of massage which helps the toxins to move towards the gastro-intestinal tract. Oil massage also makes the superficial and deep tissues soft and supple. Snehan is given daily for three to seven days, as indicated. Swedan is sudation or sweating and is given every day immediately following the snehan. An herbal concoction may be added to the steam to further loosen the toxins from the individual. Swedan liquefies the toxins and increases the movement of toxins into the gastro-intestinal tract. After three to seven days of snehan and swedan, the doshas become well "ripened". A particular panchakarma method is then given according to the individual's constitution and disorder, prakruti and vikruti, respectively. Panchakarma - Five Basic Shodhans: Cleansing Methods 1) Vaman : therapeutic vomiting or emesis 2) Virechan : purgation 3) Basti : enema 4) Nasya : elimination of toxins through the nose 5) Rakta moksha : detoxification of the blood Vaman: Emesis Therapy When there is congestion in the lungs causing repeated attacks of bronchitis, colds, cough or asthma, the Ayurvedic treatment is therapeutic vomiting, vaman, to eliminate the kapha causing the excess mucus. First, after the snehan and swedan, three to four glasses of licorice or salt water is administered, then vomiting is stimulated by rubbing the tongue which triggers the vomiting center through the gag reflex. One may alternatively take two to three glasses of salt water which will also aggravate kapha and then rub the tongue to induce vomiting. Once the mucus is released the patient will feel instantly relieved. It is likely that congestion, wheezing and breathlessness will disappear and that the sinuses will become clear. Therapeutic vomiting is also indicated in chronic asthma, diabetes, chronic cold, lymphatic congestion, chronic indigestion and edema. Emetic Substances: madan-emetic nut, madhuka-yastimadhu-licorice, neem-bitter leaf, bimbi, kutaj-kurchi- conessi bark, murva-clematis, triloba-devdaru-deodar, Cedrus deodara, Salt, NaCl, ela-cardamom, nux vomica. Indications for Vaman : used for all kapha type disorders good for pitta headache, dizziness, and nausea will help to release blocked emotions respiratory congestion bronchitis chronic cold sinus congestion kaphagenic asthma Contra-Indications for Vaman : below the age of 12 or over age 65 menstruation pre-menstrual period (one week prior) pregnancy emaciation delicate or sensitive person with too much fear, grief or anxiety hypoglycemia vata prakruti vata diseases heart diseases during vata season acute fever diarrhea obesity Virechan : Purgation Therapy When excess bile, pitta, is secreted and accumulated in the gall bladder, liver and small intestine, it tends to result in rashes, skin inflammation, acne, chronic attacks of fever, biliary vomiting, nausea and jaundice. Ayurvedic literature suggests in these conditions the administration of therapeutic purgation or a therapeutic laxative. Virechan is facilitated with senna leaves, flax seeds, psyllium husks or triphala in a combination that is appropriate for the individual person. Virechan Substances: Senna, prune, bran, flaxseed husk, dandelion root, psyllium seed, cow's milk, salt, castor oil, raisins, mango juice, triphala. Indications for Virechan: allergic rash skin inflammation acne, dermatitis, eczema chronic fever ascites biliary vomiting jaundice urinary disorder enlargement of the spleen internal worms burning sensation in the eyes inflammation of the eyes conjunctivitis gout Contra-Indications for Virechan: low agni acute fever diarrhea severe constipation bleeding from rectum or lung cavities foreign body in the stomach after enema emaciation or weakness prolapsed rectum alcoholism dehydration childhood old age ulcerative colitisAyurveda-Panchakarma Basti & Nasya -2 Basti: Enema Therapy Vata's predominant site is the colon. Ayurvedic basti involves the introduction into the rectum of herbal concoctions of sesame oil, and certain herbal preparations in a liquid medium. Basti, is the most effective treatment of vata disorders, although many enemas over a prescribed period of time are usually required. It relieves constipation, distention, chronic fever, cold, sexual disorders, kidney stones, heart pain, backache, sciatica and other pains in the joints. Many other vata disorders such as arthritis, rheumatism, gout, muscle spasms and headaches may also be treated with basti. Vata is a very active principle in pathogenesis. If we can control vata through the use of basti, we have gone a long way in going to the root cause of the vast majority of diseases. Vata is the main etiological factor in the manifestation of diseases. It is the motive force behind the elimination and retention of feces, urine, bile and other excreta. There are eight main types of basti, according to traditional texts, each with their own indications and contra-indications as listed below. 1. Anuvasana (oil enema) is used in pure vata disorders and when a person is having excess hunger or dryness related to vata imbalances. 2. Niruha-Asthapana (decoction enema) is used, among other conditions, for evacuation of vata, nervous diseases, gastro-intestinal vata conditions, gout, certain fever conditions, unconsciousness, certain urinary conditions, appetite, pain, hyperacidity and heart diseases. 3. Uttara Basti (through the urethra with men or vagina with women) is used for selected semen and ovulation disorders and for some problems involving painful urination or bladder infections. This is not to be used for someone with diabetes. 4. Matra Basti (daily oil enema) is used by someone emaciated by overwork or too much exercise, too much heavy lifting, walking too long of a distance, too much sexual activity or someone with chronic vata disorders. It does not need to be accompanied by any strict dietary restriction or daily routine and can be administered, in the appropriate cases, in all seasons. It gives strength, promotes weight and helps elimination of waste products. 5. Karma Basti (schedule of 30 bastis), 6. Kala Basti (schedule of 15 bastis; 10 oil + 5 decoction) 7. Yoga Basti (schedule of 8 bastis; 5 oil + 3 decoction). 8. Bruhana Basti (nutritional enema) is used for providing deep nutrition in select conditions. Traditionally, highly nutritive substances have been used, such as warm milk, meat broth, bone marrow soup and herbs like shatavari or ashwagandha. General Indications for Basti: constipation low back ache gout rheumatism sciatica arthritis nervous disorders vata headache emaciation muscular atrophy General Contra-Indications for Basti (include but are not limited to the following): Enema therapy should not be used if the patient is suffering from diarrhea, bleeding of the rectum, chronic indigestion, breathlessness, diabetes, fever, emaciation, severe anemia, pulmonary tuberculosis, old age or for children below the age of seven years. for oil enemas: diabetes, obesity, indigestion, low agni, enlarged liver or spleen, unconsciousness, tuberculosis and cough. for decoction enemas: debility, hiccough, hemorrhoids, inflammation of anus, piles, diarrhea, pregnancy, ascites, diabetes and some conditions involving painful or difficult breathing. for nutritional enemas: diabetes, obesity, lymphatic obstruction, ascites. for urethra or vaginal enemas: diabetes Nasya: Nasal Administration The nose is the doorway to the brain and it is also the doorway to consciousness. The nasal administration of medication is called nasya. An excess of bodily humors accumulated in the sinus, throat, nose or head areas is eliminated by means of the nearest possible opening, the nose. Prana, life force as nerve energy, enters the body through the breath taken in through the nose. Prana is in the brain and maintains sensory and motor functions. Prana also governs mental activities, memory, concentration and intellectual activities. Deranged prana creates defective functioning of all these activities and produces headaches, convulsions, loss of memory and reduced sensory perception. Thus nasal administration, nasya is indicated for prana disorders, sinus congestion, migraine headaches, convulsions and certain eye and ear problems. There are six main types of nasya, as listed below. 1. Pradhamana (virechan) Nasya (cleansing nasya) uses dry powders (rather than oils) that are blown into the nose with a tube. Pradhamana nasya is mainly used for kapha types of diseases involving headaches, heaviness in the head, cold, nasal congestion, sticky eyes, hoarseness of voice due to sticky kapha, sinusitis, cervical lymph adenitis, tumors, worms, some skin diseases, epilepsy, drowsiness, Parkinsonism, inflammation of the nasal mucosa, attachment, greed and lust. Traditionally, powders such as brahmi are used. 2. Bruhana Nasya (nutrition nasya) uses ghee, oils, salt, shatavari ghee, ashwagandha ghee and medicated milk and is used mainly for vata disorders. It is said to benefit conditions resulting from vata imbalances such as vata-type headaches, migraine headache, dryness of voice, dry nose, nervousness, anxiety, fear, dizziness, emptiness, negativity, heaviness of eyelids, bursitis, stiffness in the neck, dry sinuses and loss of sense of smell. 3. Shaman Nasya (sedative nasya) is used according to which dosha is aggravated but mainly for pitta-type disorders such as thinning of hair, conjunctivitis and ringing in the ears. Generally certain herbal medicated decoctions, teas and medicated oils are used. 4. Navana Nasya (decoction nasya) is used in vata-pitta or kapha-pitta disorders and is made from decoctions and oils together. 5. Marshya Nasya (ghee or oil nasya) 6. Prati Marshya (daily oil nasya) This helps to open deep tissues and can be done every day and at any time to release stress. Substances Used in Nasya: brahmi, ginger, ghee oils, decoctions, onion, garlic, Piper longum, black pepper, curry pepper, rose, jasmine, mogra flowers and henna. Indications for Nasya: stress emotional imbalances stiffness in the neck & shoulders dryness of the nose sinus congestion hoarseness migraine headache convulsions Contra-Indications for Nasya: sinus infections pregnancy menstruation after sex, bathing, eating or drinking of alcohol should not be used below 7 years or over 80 years of age Click here to read more about 'Nasyakarma' Raktamoksha : Traditional Ayurvedic Method for Purification and Cleansing of the Blood Toxins present in the gastro-intestinal tract are absorbed into the blood and circulated throughout the body. This condition is called toxemia, which is the basic cause of repeated infections, hypertension and certain other circulatory conditions. This includes repeated attacks of skin disorders such as urticaria, rashes, herpes, eczema, acne, leukoderma, chronic itching or hives. In such conditions, along with internal medication, elimination of the toxins and purification of the blood is necessary. Raktamoksha is also indicated for cases of enlarged liver, spleen and gout. Extracting a small amount of blood from a vein relieves the tension created by the pittagenic toxins in the blood. Bloodletting also stimulates the spleen to produce antitoxic substances which helps to stimulate the immune system. Toxins are neutralized enabling radical cures in many blood born disorders. Bloodletting is contraindicated in cases of anemia, edema, extreme weakness, diabetes and in children and elderly persons. Indications for Raktamoksha: urticaria rash acne eczema scabies leukoderma chronic itching hives enlarged liver or spleen gout Contra-Indications for Raktamoksha: anemia edema weakness young children old age during pregnancy during menstruation Read more about Various Diseases and Indicated Panchakarma procedures for them > @

17 Best Benefits and Uses Of Leeks (Hara Pyaz) For Skin, Hair and Health stylecraze.com Oct 18, 2017 12:00 PM  Ranking high on the nutritional chart, leeks are a popular remedy for several ailments. They are highly nourishing, inexpensive and plentiful. Used in various forms, from soup to beurek, leeks can add aroma, flavor and richness to almost any recipe. Its syrup, seeds and juice also have a distinct place in the pharmaceutical and cosmetic industries. With the unique combination of flavonoids and sulfur-containing nutrients, leeks make an important component in your diet. Scientifically known as Allium porrum, leeks belong to the family of onion, garlic, shallots and scallions.Leeks are packed with essential vitamins, minerals, antioxidants and dietary fiber. It is widely consumed in many parts of Europe, America and Asia. Though they are available throughout the year, they are at their best during the early part of the spring season. Nutritional Value Of Leeks: Leeks contain an impressive amount of flavonoids, particularly kaempherol, and considerable amounts of sulfur. In addition, they are quite rich in vitamins, minerals and dietary fiber, and low in calories. Their nutritional chart is explained below. Leeks (A. ampeloprasum var. porrum), Nutrient value per 100 g(Source: USDA National Nutrient data base)PrincipleNutrient valuePercentage of RDAEnergy61 Kcal2%Carbohydrates14.15 g11%Protein1.50 g3%Total Fat0.30 g1%Cholesterol0 mg0%Dietary Fiber1.8 g5%VitaminsFolates64 µg16%Niacin0.400 mg2.5%Pantothenic acid0.140 mg3%Pyridoxine0.233 mg18%Riboflavin0.030 mg2%Thiamin0.060 mg5%Vitamin A1667 IU55%Vitamin C12 mg20%Vitamin E0.92 mg6%Vitamin K47 µg39%ElectrolytesSodium20 mg1%Potassium180 mg4%MineralsCalcium59 mg6 %Copper0.120 mg13%Iron2.10 mg26%Magnesium28 mg7%Manganese0.481 mg2%Phosphorus35 mg5%Selenium1 µg2%Zinc1.2 mg11%Phyto-nutrientsCarotene-ß1000 µg—Crypto-xanthin-ß0 µg—Lutein-zeaxanthin1900 µg—Carbohydrates: Carbohydrates are one of the most abundant macronutrients in leeks. A medium-sized leek provides about 10-12 gms of carbohydrates. Out of these, 3 gms are sugars and the rest is complex, slow-digesting carbohydrate. Leeks are also a good source of fiber which is a non-digestible form of carbohydrate. This fiber aids in digestion and helps prevent certain cancers and heart diseases.Vitamins: Leeks contain plenty of folates and vitamin C. Raw leeks provide twice as much of these vitamins as the same amount of cooked leeks. They are also excellent sources of vitamins K and B6. The folate found in leeks is partly present in the bioactive form of 5-methyltetrahydrofolate (5-MTHF).Minerals: Leeks are rich in minerals like potassium, calcium and phosphorus. Potassium is vital for nerve function and energy production whereas calcium and phosphorus help strengthen your teeth and bones. Leeks also contain iron which is vital for hemoglobin synthesis and enzymatic reactions related to energy production.Protein: Leeks are relatively low in protein. 100 grams of leek, including the shaft and lower leaves, provides just about 1 gm of protein.Fat: Leeks are extremely low in fat with a medium-sized leek providing less than half a gram of fat. Moreover, the few fats it contains are mostly polyunsaturated fats which are beneficial for your heart and reduce the risk of cardiovascular diseases. Benefits Of Leeks: Leeks are rich in dietary fiber, folic acid, calcium, potassium and vitamin C. They are easily digestible as compared to onions. Now, let’s look at the leeks benefits. Skin Benefits Of Leeks: Being a good source of vitamin C and A along with several antioxidants, this vegetable is great for your skin. Their several skin benefits are as follows: 1. Detoxifies Your Skin: Leeks are a natural diuretic and detoxify your skin by trapping harmful substances and flushing them out of your body. They perfect cleanse your body, making your skin look radiant. 2. Sun Protection: The green leaves of leek contain 100 times more beta-carotene and twice as much vitamin C as in the white parts. This combination of vitamins A, C and E as well as other powerful antioxidants in leeks protects your skin against damage by free radicals and harmful ultraviolet rays of the sun. Hair Benefits Of Leeks: Leeks are a good source of minerals like manganese, iron, vitamin C and folates. Consumption of leeks adds health to your hair. 3. Promotes Hair Growth: Leeks are an important source of iron which helps the hair follicles to grow. They are also rich in vitamin C that promotes the absorption of iron by the body. Deficiency of iron can cause anemia which is one of the causes for hair loss. Health Benefits Of Leeks: Packed with abundant essential vitamins, minerals and antioxidants, leeks offer a variety of health benefits. They are explained here below: 4. Protects Blood Vessels: Leeks contain a flavonoid, kaempherol, which protects the linings of the blood vessels against free radicals. Kaempherol stimulates the production of nitric oxide which acts as a natural dilator and relaxant of the blood vessels. It allows the blood vessels to rest and decreases the risk of hypertension. Leeks contain a generous amount of vitamin K which benefits every tissue in your body. Low levels of vitamin K can induce bleeding and adversely affect blood circulation. 5. Bone Health: High content of vitamin K in leeks activates osteocalcin, a protein that is vital for bone health. A cup of leeks provides about 42 microgram of vitamin K which is 47 and 34 percent of the daily recommended amount for women and men respectively. 6. Good For The Heart: High levels of homocysteine in the blood can increase the risk of cardiovascular diseases such as coronary artery disease and atherosclerosis. Leeks contain a bioactive form of folate called 5-methyltetrahydrofolate, which has been shown to lower the concentration of homocysteine in the blood. Kaempherol present in leeks also improves heart health by reducing the production of nitric oxide. 7. Reduces the Risk Of Chronic Inflammatory Diseases: Chronic inflammation is detrimental for heart health. Vitamin K has anti-inflammatory properties that can fight against chronic inflammatory diseases such as diabetes, obesity and rheumatoid arthritis. Abundance of vitamin K in leeks prevents chronic inflammatory diseases and unwanted calcification of the arteries. Besides vitamin K, vitamin B6 in leeks also provides anti-inflammatory benefits. 8. Aids Digestion: A prebiotic, leekshelp in digestion, and stimulates and strengthens the stomach, kidneys and gut. Fibrous vegetables like leeks enable you to eat slowly, hence properly digest your food. This prevents overeating and makes you feel full. 9. May Prevent Cancer: Leeks are a good source of allyl sulfides which can inhibit pathways associated with the formation of malignant tumors. Like other members of the allium family, they may play an important role in preventing certain types of cancer. They can also reduce the risk of prostate, colon and ovarian cancer. 10. Promotes Weight Loss: Leeks help in weight loss and fight obesity as they are low in calories and fat-free. Leeks are a natural appetite suppressant. Their high fiber content suppresses your hunger by providing a feeling of fullness. Both soluble and insoluble fibers present in leeks regulate intestinal activity and reduce bloating. It can also be added to your recipes to get that extra flavor without adding calories, proving beneficial for those who want to slim down. 11. Improves Vision: Leeks are a good source of lutein and zeaxanthin. These compounds are vital for healthy eyesight. They protect your eye tissues from the harmful oxidation of DNA and cell membranes, by filtering out harmful light rays while they enter your eyes. The consumption of leeks in adequate amounts protects your eyes from cataracts and age-related macular degeneration. 12. Beneficial During Pregnancy: Leeks are rich in vitamin B9, also known as folate (folic acid). Folates form an important part of the diet of pregnant women. They are essential for the production of new DNA which is needed for formation of new cells. Folates also promote healthy neural tube formation, adequate birth weight and proper development of the face, heart, spine and brain. 13. Maintains Healthy Cholesterol: Fiber plays an important role in reducing cholesterol levels by promoting easy bowel movements. It also helps to flush out the extra cholesterol from the body and reduces the production of cholesterol in the liver. Leeks have antiseptic properties that help the body fight infection. Thus, they help lower LDL cholesterol and increase HDL cholesterol. Here is another good post on home remedies for reducing cholesterol. 14. Acts As An Antioxidant: Leeks are valuable sources of antioxidants such as polyphenols. These antioxidants help fight against free radicals, preventing ageing and many chronic diseases. A serving of 100 grams fresh leeks provides about 3 mg gallic acid equivalents (GAE). 15. Aphrodisiac: Leeks along with onions, garlic and celery are knownfor centuries, for their aphrodisiac effects.Make a juice with leeks and celery, and you will be surprised to see the difference. 16. Balsamic Action: Due to the presence of volatile oils, leek juice has a balsamic action on the respiratory tract. Thus, it can relieve the symptoms associated with flu, cold and hay fever. 17. Nervous System: Magnesium, phosphorous and folate are important nutrients needed for healthy functioning of the nervous system. Leeks being rich in these vitamins and minerals help improve concentration, memory and the brain’s ability to process information. Quick And Easy Ways Of Including Leeks In Your Daily Diet: Cut it into thin slices and addto a variety of salads.Make leek juice from the stalk, bulb, and leaves.Prepare soups, pottages, broths, omelettes and sauces.The stalks can be steamed and sautéed along with other vegetables in stir-fry recipes. Boost Your Health With Leeks Today! To get the maximum benefits of eating leeks, here’s a quick recipe you can try at home. Here is the link to the recipe of an appetizing potato and leek soup: [youtube http://www.youtube.com/watch?v=vwjxCIC9vDI] What’s Required? To make this soup, you need leeks, potatoes, butter, olive oil, white pepper powder, salt, cream and bay leaf. How To Prepare? Chop 1-2 leeks(including the stalk and leaves) into thin slices and then wash them thoroughly to clear soil and dirt.Also, cut 2-3 medium sized potatoes into small cubes.Heat some butter and olive oil in a pan and put the cut leeks into it.Add some salt as per your taste.When the leeks become soft, add the potatoes and turn them around for a minute.Then, add some home-made chicken or vegetable stock (proportionately) to it.You can add one bay leaf and a half teaspoon of white pepper powder to the soup.Once the soup comes to a boil, turn it down to a gentle simmer and then cover it with a lid.Let it simmer for about 45 min until the potatoes become tender.Then, blend the mixture and add a little bit of cream to enhance the taste. Your yummilicious, healthy soup is ready to serve! Try this great appetizer for extracting the best health benefits from leeks. Leeks are wonderful in taste and rich with amazing health benefits. Include them in your recipes to enhance taste and boost the nutritional value. Leave a comment below to share your experiences and views with us. Report a problem 42dislike

12 yr old with axillary freckling , cafe au lait spots . Diagnosis & management ?

*Impotency - Homeopathic Medicines* It is also called Erectyle Dysfunction. Defination - It is abnormal physical or psychological state of a male characterized by inability to engage in sexual intercourse because of failure to have or maintain an erection. *Causes* These include both emotional and physical disorders. An estimated 50 percent of men ages 40 to 70 experience some ED at one time or another. The risk of impotence increases with age. *1. Endocrine Diseases* Diabetes is an example of an endocrine disease that can cause a person to experience impotence. Diabetes affects the body’s ability to utilize the hormone insulin. One of the side effects associated with chronic diabetes is nerve damage. This affects penis sensations. Other complications associated with diabetes are impaired blood flow and hormone levels. *2. Neurological and Nerve Disorders* Several neurologic conditions can increase the risk for impotence. Nerve conditions affect the brain’s ability to communicate with the reproductive system. This can prevent a person from achieving an erection. Neurological disorders associated with impotence include: * Alzheimer’s disease * Parkinson’s disease * brain or spinal tumors * multiple sclerosis * stroke * temporal lobe epilepsy *3. Taking Medications* Taking certain medications can affect blood flow, which can lead to ED Examples of medications known to cause impotence include: * alpha-adrenergic blockers, including tamsulosin (Flomax) * beta-blockers, such as carvedilol (Coreg) and metoprolol (Lopressor) * cancer chemotherapy medications, such as cimetidine (Tagamet) * central nervous system depressants, such as alprazolam (Xanax), diazepam (Valium), and codeine (found in various brand name drugs) * central nervous system stimulants, such as cocaine or amphetamines * diuretics, such as furosemide (Lasix) and spironolactone (Aldactone) * selective serotonin reuptake inhibitors or SSRIs (Prozac, Paxil) * synthetic hormones, such as leuprolide (Eligard) *4. Cardiac-Related Conditions* Conditions that affect the heart and its ability to pump blood well can cause impotence. Without enough blood flow to the penis, a person can’t achieve an erection. Atherosclerosis, a condition that causes the blood vessels to become clogged, can cause impotence. High cholesterol and high blood pressure (hypertension) are also associated with increased risks for impotence. *5. Lifestyle Factors and Emotional Disorders* To achieve an erection, a person must first go through what’s known as an excitement phase. This phase can be an emotional response. If a person has an emotional disorder, this affects their ability to become sexually excited. Depression and anxiety are associated with increased risk for impotence. Performance anxiety can be another cause of impotence. If a person wasn’t able to achieve an erection in the past, he may fear he won’t be able to achieve an erection in the future. Abuse of drugs like cocaine and amphetamines can also cause impotence. Alcohol abuse and alcoholism can affect a person’s ability to achieve or maintain an erection as well. Impotence or Erectile Dysfunction is a condition in which there is a problem in getting or maintaining an erection sufficient for sexual intercourse. Here I am giving few medicines which are most effective may be prescribed according to symptoms. *Agnus Castus 30* 1. There is no penile erection during the sexual act. 2. The penis remain relaxed and flaccid during sex. 3. Penis cold. 4. No desire for sex and decreased physical strength. 5. Erectle dysfunction with history of gonorrhoea. 6. There is sadness and depression. 7. It relieves the sadness, enhancing the desire to have sex and achieving erections. *Caladium 30* 1. No erection but great sexual desire. 2. No erection after an embrace. 4. The penis remains in a relaxed condition and there is no erection. 5. There is a sexual weakness due to mental depression. 6. The erectyle dysfunction is due to tobacco addiction. There is tobacco addiction. *Selenium 200* 1. The erection is too weak and slow. 2. The complete inability to have an erection. 3. The erection is insufficient and remains for a very short period. 4. The pt has sexual desire but they lack of erectyle power. 5 Irritability and excessive weakness after the sexual. 6. Involuntary emission of seminal discharge during sleep. 7. A few may also complain of dribbling of semen while passing stool or urine. *Lycopodium 1M* 1. It is good for both young and pls people. 2. Erectile Dysfunction resulting from excessive masturbation in young person. 3. In elderly people, erectylw dysfunction is after of more indulgence in sexual activity. 4. The desire for sexual act is present but the erection is not adequate. At times, 5. There is premature ejaculation. 6. In old age imperfect erection with prostate enlargement.. *Avena Sativa Q* 1. It can be used as a tonic for enhancing the sexual power of males. 2. This medicine helps in to remove extreme exhaustion and deficient erections. 3. Erectile Dysfunction after overindulgence in sexual activity or masturbation. *Lecithin 3x* Increase the exual desire and also increases the strength of penile erection by supplying more blood to it. *Nux Vomica 200* 1. When the patient has lived a high life with lots of indulgences like wine, women, tobacco and other stimulants, 2. The patient is short tempered and an aggressive. 3. He may have remained under a lot of stress related to his business and trying to achieve whatever he set his sights on. *Tribulus Terrestris ( Iksugandha ) Q* 1. There is presence of urinary troubles along with Erectile Dysfunction. 2. The sexual organs are weak and pain is experienced while passing urine. *Nuphar Luteum 6* 1. Erectile Dysfunction with no sexual desire and relaxed genitalia. Erectile Dysfunction with zero desire for sex. 2. Seminal discharges during passing stool or urine. *Yohimbinum Q* 1. This medicine acts as a agent to increase sexual desire. 2. It is also the best remedy for Neurasthenic Impotency, like lack of interest in sexual activity, deficient erection, extreme weakness, irritability and sadness. *Acid Phos 30* 1. Erectyle dysfunction with diabetes mellitus 2. The sex power is very weak. 3. The genitals are relaxed. 4. Seminal emissions while the pt is asleep. 5. The pt suffers from extreme physical debility and mental exhaustion.. *Moschus 30* *Cuprum Met 30* Impotent due to diabetes. *Agnus Castus and Nuphar Luteum* *Agnus Castus* is the best medicine to increase the the desire to have sex who have complete impotency and a marked aversion to sex *Nuphar Luteum* is used for exactly the same condition as in *Agnus Castus*. But the additional symptom over *Agnus Castus* to increase the sexual desire is the involuntary semen discharge while passing stool or urine or while sleeping.

A middle aged woman developed this stage within 4days.Non diabetic.No other relevent history.Kindly diagnose and advice further management.