Premature Ejaculation with Diabetes & Hypertension

69 year old male patient came with the history of Polyuria Anorexia Generalized weakness since 3-4 months I have advised for HbA1c, FBS, PPBS and Urine Routine (Please refer attached images) Occupation Retired Teacher Prakriti Kapha Pittaja Agni Manda, Constipation on & off Mutra 7-10 time Mala Pravratti 2 time Nindra Samanya Mano Vaha Sthiti Samanya Not having family history of DM BP 140/90 Without any medications Weight 82kg Please help in planning the AYUSH Management, Yoga and Diet Plan for this case....

55 yr woman having a history of diabetes mellitus for about 14 yrs with gross visual loss -FC at 1 foot in each eye Lental opacities in each eye do not allow visibilty of ocular fundus SPOT DIAGNOSIS

*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.

49 year old female with diabetes mellitus brain injury was referred for feeding tube placement. Endoscopy showed a large ulcer. What are the possibilities

84 year old with a lump in the right breast since 1 week. No history of trauma. O/e - 3*3 cm well defined firm lump in upper outer quadrant of right breast. Not fixed to skin or underlying muscle. No enlarged axillary LN. Share your views regarding the mammogram