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Industrial Home loans and Growth Finance

Industrial Home loans and Growth Finance

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***Urinary Incontinence and OAB – Alternative Treatment

I have been a family physician for more than 40 years, and have helped hundreds of women with life-limiting and embarrassing incontinence issues. Most of the time, treatment was frustrating and only partially successful. I have always looked for alternative approaches that were not invasive, surgical or procedural to help with this condition. Even these did not often work successfully.
So, the longer I have worked with Pulsed Electromagnetic Fields (PEMFs) for a vast range of health issues, the more commonly I have encountered responses from patients, particularly females, who have had improvements in their urinary incontinence issues from the use of PEMFs.
Because of these observations, I decided to do a review of the scientific literature on the use of PEMFs for this problem. I was pleasantly surprised to see a reasonably significant number of articles describing research being done on urinary incontinence and overactive bladder. This research is very promising and ranges from the use of high intensity PEMF systems in the professional office setting to the use of much lower intensity PEMF systems in the home setting. My experience has been that high intensity PEMF systems can often get good results in a short time, but often the results don’t last. This is because high-intensity PEMF systems do not always create a physical change in the tissue in the short time in which they are used. This means that they will require multiple courses of treatment over the years. On the other hand, using a home-based, battery-operated PEMF system, worn over the bladder area, many hours a day, possibly even overnight, seems to be very effective, and possibly over the long run even more effective. This is true because of the need to change the physical characteristics of the bladder itself in terms of the inflammation, bladder muscle irritability, and reduce the number of overactive nerve cells contributing to the problem. PEMFs lend themselves extraordinarily well to this complex set of changes that happen in the bladder over time to create an overactive bladder, leading to incontinence.
Better solutions than the current medical solutions (typically medications, procedures or surgeries) are necessary. Electrical stimulation, as noted in a recent study, is not anywhere as effective as PEMF therapy (and nowhere near as comfortable). But, electrostimulation is in the domain of the practitioner and healthcare facility, and that is what they are going to recommend, because that is the only tool they have. We know now as well that pelvic exercises don’t work over time. Certainly pelvic exercises do make any kind of other external stimulation approach work even better. Many women begin to actually recognize contractions of their pelvic muscles after using high-intensity PEMFs. Then, they can go home with a home-based PEMF stimulation system to finish the job. But, using high-intensity PEMFs to begin a course of treatment is not necessary, since home-based PEMF systems will work well over time anyway, and Kegel exercises may not be necessary.
In my review of the science, it’s clear that high intensity PEMFs do improve OAB and urinary incontinence significantly, including positively changing the underlying causes of the incontinence in the bladder tissue itself. At the same time, research is showing that even very low intensity magnetic fields, worn throughout the day for upwards of 2 months at a time also produce improvement. Some of the studies at the lower intensities used 10 Hz and 18.5 Hz, both producing positive results. Higher intensity systems are typically limited to much lower frequencies, or repetition rates, usually less than 10 Hz. But from all of this research, there is still no certainty as to which frequency or intensity works best. From my experience, it’s probably much more important to be using PEMF therapies of whatever kind, on a consistent basis, over the bladder or pelvic area, daily, for an extended period of time. In the long run, this is going to create the physical changes in the bladder that are necessary to reverse the tissue changes causing the bladder overactivity problem. The body has its own pace of healing and we need to acknowledge and respect that.
So, from this review I’m optimistic that we can offer significant relief to millions of women suffering from overactive bladder and urinary incontinence unnecessarily, given the inexpensive, comfortable home-based PEMF solutions available. These are expected to produce much better long-term results than current therapies, with a lot less risk.
As an aside, while most of this review is focused on female urinary incontinence, a number of the studies within included males in their research. Males often had similar results to females in the improvement of their OAB and urinary incontinence. So, ladies, if you have male partners, family members or friends who suffer from incontinence, this technology are likely to benefit them as well.
Over the years of practicing medicine, I have worked with hundreds of women with urinary incontinence. Most of the time these were women who had delivered babies. It’s commonly accepted that women who delivered babies naturally would be expected to have stress urinary incontinence down the road. That was the old thinking. It made sense at the time. However, as we have learned more and more about this common and very stressful problem, we have discovered that it is not as simple as the stretching of the tissues of the birth canal with the birth process. We were all taught that women needed to do pelvic exercises to strengthen the muscles of the pelvis [Kegel exercises] to reduce the symptoms of stress incontinence. Again, that was a very simplistic approach in hindsight. A whole new concept of what is going on with urinary incontinence (UI) has emerged as science has evolved.
Urinary Incontinence: Who is Affected?
At minimum, 11 to 16 million women in the United States cope on a daily basis with symptoms that include sudden strong urges to urinate, difficulty delaying urges to urinate, frequent trips to the bathroom, and in many cases involuntary loss of urine when urgency strikes. They may wear pads or adult diapers for accidents, plan ahead for access to bathrooms, and modify their social and work lives to accommodate their symptoms. Some are very distressed by the symptoms, whether mild shadowfight2hackonlinesz or severe, and others find mechanisms to adapt, reporting little trouble with symptoms or interference with normal routines. Others report their symptoms negatively influence quality of life factors, including: loss of self-esteem, attractiveness, and sexual function. The majority of women believe that some amount of urinary incontinence is inevitable with aging. Women with these symptoms tend to not talk with their health care providers concerning their bladder dysfunction, and providers may not routinely inquire. As a result, a small minority receive treatment.
Between 10-40% of women have UI (possibly even more), and the percentage increases with age. There are 3 basic types of UI: stress, urge, and mixed. Overall, about half have stress incontinence, a smaller proportion have mixed, and the smallest is urge. Since women often have mixed incontinence [MI], the more commonly used term today is overactive bladder [OAB]. OAB with urge incontinence happens in 10% of women 18+ years of age (less than 5% in the age group 18–44 and up to 19% in the 65+ age group).
The severity of the symptoms is critical to determining treatment approaches and the likelihood of success of treatment, and severity increases with age. Significant incontinence is present in 9-13% of women over 55. Remission or improvement in UI is seen particularly in stress incontinence and primarily because women develop coping strategies that decrease the reported frequency of episodes of UI. Not so with OAB, which typically can get worse with time or age.
Traditional Treatments: Outcomes and Costs
Urinary incontinence is an important health problem to the individual sufferer and to health services. Risk factors for UI include age, pregnancy and childbirth, menopause, hysterectomy, obesity, lower urinary tract symptoms, functional or cognitive impairment, occupational risks, family history, genetics, and a host of other factors, including diabetes, use of diuretics, cigarette smoking, dementia, etc.
Treatments include prescription medications or patches, surgeries and procedures (including sacral neuromodulation and botulinum injections), behavioral interventions such as bladder training, and complementary and alternative medicine options such as acupuncture and reflexology.
All these treatments, of course, have varying success rates.
Drug treatment
All drug treatments are effective at improving one or more overactive bladder [OAB] symptoms when compared to placebo. Reductions ranged from 0.9 to 4.6 incontinence episodes per day across all drug treatments and from 0.7 to 4.2 in voids per day. No one drug is clearly better than others. Extended release formulations taken once a day reduce urge urinary incontinence [UUI] by about 2 episodes per day, and total urinations by 2 per day. Immediate release forms taken twice or more a day reduce UUI episodes by 1 per day, and urinations by 2 per day. Of note, placebo reduces UUI by 1 and voids by 1 per day. Even with these small results on symptoms, drug treatments increase quality of life and reduce distress, compared to no treatment.
Surgical treatment
Procedures and surgical treatments include sacral or peripheral neuromodulation, bladder instillation or injection of drugs, bladder distention, and cutting nerves to the bladder. The strength of the evidence for managing OAB with procedural and surgical treatment is weak outcomes of this care.
Stress incontinence is more often managed by surgery due to advances in surgical techniques. While not well proven for its value, most clinicians use invasive urodynamic testing (IUT) to prove stress incontinence before offering surgery. IUT is expensive, embarrassing and uncomfortable for women.
Behavioral treatment
Behavioral interventions include bladder training and more complicated behavioral training (with or without biofeedback), pelvic muscle exercises, vaginal electrical stimulation, and caffeine reduction. Managing OAB with behavioral treatment approaches alone gets moderate to weak short term benefits and weak benefits in the long term. Still, overall, behavioral approaches can reduce episodes of incontinence and daily voids at least somewhat. Complex approaches are close to drug treatment in getting modest improvements, reducing leakages by up to 1.9 per day, and emptying’s per day up to about four. Behavioral approaches do not enhance drug therapy for reducing episodes of incontinence or voiding.
Complementary and alternative treatments
These treatment options include acupuncture, foot reflexology, and hypnotherapy. The evidence for complementary and alternative approaches to managing OAB is weak. Acupuncture may decrease frequency of voiding and symptoms of urgency, with objective evidence from bladder measurements [cystometrics]. Women felt they were improved in the bother associated with incontinence and the quality of life. The results may be similar to the use of drugs. Reflexology needs more evidence know the benefit. Hypnotherapy, or hypnosis, is likely not to be very useful. Given the big role belief plays in OAB treatment, it has been difficult to prove the value of hypnosis.
Costs of Treatments
Total direct health care costs for women with OAB in 2000 were estimated at $6.9 billion, of which $1.1 billion were for drug treatment and $550 million for surgical treatment. Medication costs for OAB with the two most commonly used drugs ranged from $56 to $360 over a twelve month period for newly diagnosed patients. And, these drugs do not cure the problem, only control it. So, these costs will be lifetime.
The research seems to indicate that the evidence is not strong to support the current treatments for OAB. Medications can provide symptom relief which is often not complete, but suffering women see these as better than nothing, and they are convenient. Because benefits of current treatments are only modest, there is a need to consider the value of combinations of types of treatments.
One of the fundamental causes of the relatively poor performance of current treatments may well be due to a previous lack of understanding of the check here fundamental mechanisms involved in UI. As a result of this new information, it appears that one potentially very valuable set of tools for managing incontinence would include magnetic field therapies, particularly PEMFs.
The Latest Science About Causes
Overactive bladder syndrome (OAB) typically includes the lower urinary tract symptoms of frequency, urgency, and varying severities of urgency urinary incontinence. It is specifically defined as “urgency, with or without urge incontinence, usually with frequency and nocturia”.
Nerve growth factor
Other than some of the obvious causes listed above, there is now emerging a better understanding of the tissue changes involved in the bladder to produce OAB. Three hypotheses exist to explain this.
The myogenic hypothesis states that the smooth muscle cells of the overactive bladder are more susceptible to contraction, and smooth muscle bundles contract in groups, allowing for the possibility that physical changes in the muscle fibers allow local activity to spread to the rest of the bladder, making it more susceptible to spontaneous contractions.
The peripheral autonomous hypothesis states that bladder overactivity is due to enhanced coordination of muscle activity by bladder wall nerves. An imbalance of stimulation and relaxation increases autonomous activity, possibly resulting in increased bladder sensation as well as bladder overactivity.
The neurogenic hypothesis states that some nerve fibers are generally quiet during normal bladder voiding. These fibers can form new pathways, and then may be responsible for bladder pain and overactivity, carrying urinary impulses to the spinal cord.
Neurogenic theories suggest that bladder overactivity arises from generalized nerve excitation of the bladder muscle. The main trigger for changes in transmission of nerve signals from the bladder to the central nervous system may be nerve growth factor (NGF), which is elevated in OAB. Blockade of NGF by antibodies against NGF prevents frequent urination, bladder contractions, urination urge activity, and swelling of spinal cord neurons. Based on these findings, NGF plays a critical role in the pathophysiology of OAB.
Inflammation
Although the cause has been divided into neurogenic and non-neurogenic types, there has also been investigation into the role of inflammation in the development of bladder overactivity.
In rats with OAB, injection of COX-2 anti-inflammatories into the bladder reduced inflammatory molecules in bladder tissue and improved bladder contraction. In experimental cystitis, treatment with a peptide that inhibits inflammatory markers reduced inflammation and nerve factors such as NGF, improving symptoms of OAB. Therefore, we can conclude that interaction among other inflammatory disorders in the body, pro-inflammatory molecules, and the peripheral and central nervous system are responsible for the development of OAB.
Alternative Treatments for Urinary Incontinence and OAB
At one level, anti-inflammatory drugs aid in the treatment of OAB symptoms by reducing inflammatory responses. Also, there is evidence to show that OAB may be improved by using various electromagnetic stimulation strategies.
There are 3 basic approaches studied using magnetic fields to stimulate the bladder to reduce the symptoms of OAB and stress incontinence. These include static magnets, direct stimulation of the bladder, and stimulation of the nerves controlling bladder function. Stimulation of the nerves that control bladder function includes stimulation of spinal nerves, the pelvic pudendal nerve and the tibial nerve in the leg. Sacral nerve stimulation involves invasively stimulating the pelvic pudendal nerve and the sacral spinal nerve roots.
Electrical stimulation
Pelvic floor muscle electrical stimulation is an alternative treatment for urinary frequency and urge incontinence with a success rate from between 45% and 91%. There are various approaches for delivering electrical pulses. Use of electrical stimulation is still not commonly accepted, primarily because of discomfort and invasiveness.
Electrical sacral nerve stimulation via an implant for medication resistant OAB treatment has been studied. Sacral nerve stimulation is an increasing alternative gaining some use.
Static magnets
With regard to the use of static magnetic stimulation of the pelvic floor, compared to placebo, the use of 15 static magnets of 800-1200 Gauss, in undergarments to the front, back, and underneath the pelvis for at least 12 hours a day for three months was nba live mobile hacks studied. This study found no evidence that static magnets cure or decrease the symptoms of urinary incontinence.
Magnetic stimulation
Magnetic stimulation is a new technique for stimulating the nervous system noninvasively. It can activate deep neural structures by induced electric currents with much less or no pain.
We have mentioned many times before in other updates that a major aspect of the benefit or value of PEMFs is to reduce inflammation. In addition, there is the expectation that PEMFs should also reduce nerve cell firing (the neurogenic theory). Plus, there is evidence to show that PEMFs can also reduce muscle irritability or spasticity (the myogenic theory). Recent research showed that activating sacral bladder nerve roots by magnetic stimulation suppressed OAB contractions in patients.
Neuromodulation has revolutionized the management of OAB and is now well established as a safe and effective treatment for those who don’t respond to conservative medication treatments. Most of this involves uncomfortable and surgically implanted electrical stimulation. PEMFs have been discovered to have similar actions without the discomfort, cost or harm.
Neuromodulation
Treatment of OAB should progress from the least to most invasive modality, and neuromodulation is a more attractive option owing to it being a minimally invasive approach, tolerable, having positive outcomes, and being reversible.
Multiple neuroanatomical pathways have been described for sacral neuromodulation including the sacral S3 nerve root, pudendal nerve and tibial nerve. The S3 nerve root is currently the main treatment target and has the most long-term data on safety and efficacy to support its use. However, studies on neuromodulation at the pudendal nerve or posterior tibial nerve have been positive and their role in treatment continues to evolve. Most urologists who are experienced in voiding dysfunction can become proficient in each technique. Patient selection, surgical techniques and postoperative management differ slightly between approaches and urologists should familiarize themselves with these differences.
Neuromodulation has been reported to be effective for the treatment of stress and urgency urinary incontinence. The cure and improvement rates of pelvic floor neuromodulation in urinary incontinence are 30-50% and 60-90%, respectively. In clinical practice, vaginal, anal and surface electrodes are used for external, short-term stimulation, and sacral nerve stimulation for internal, chronic (long-term) stimulation. The effectiveness of neuromodulation has been verified in a randomized, placebo-controlled study. However, the superiority to other conservative treatments, such as pelvic floor muscle training has not been confirmed. A long-term effect has also been reported. In conclusion, pelvic floor exercise with adjunctive neuromodulation is the mainstay of conservative management for the treatment of stress incontinence. For urgency and mixed stress plus urgency incontinence, neuromodulation may therefore be the treatment of choice as an alternative to drug therapy. (Yamanishi, 2008)
Percutaneous tibial nerve stimulation (PTNS) has been proposed for the treatment of overactive bladder syndrome (OAB), non-obstructive urinary retention (NOUR), neurogenic bladder, paediatric voiding dysfunction and chronic pelvic pain/painful bladder syndrome (CPP/PBS). (Gaziev) Electrical stimulation of the posterior tibial nerve (PTN) has become an established therapy option for the treatment of OAB that failed medical therapy. An implant is surgically placed near the PTN and activated by an external pulse generator. When you have the PTNS treatment a very fine needle (just like an acupuncture needle) is inserted into the lower leg, slightly above the inside of the ankle. This is the area where the tibial nerve runs. A small pad is stuck to the skin on the bottom of the foot on the same leg. This is a bit like the pads that get stuck on your chest if you have an ECG test. These two electrodes (one needle, one skin-pad) are then connected to the pulse generator which delivers an electrical signal that travels along the tibial nerve up to the sacral nerve plexus in the pelvis. One of the functions of the sacral nerve plexus is to control bladder and pelvic floor function.
When women’s responses to PTNS are compared to standard medication as the only therapy, there are no significant differences in results. Urine leakage associated with a feeling of urgency and loss of stool or gas from the rectum beyond patient’s control became significantly different after treatment in both groups about equally well. (Eftekhar) PTNS was also studied in patients with OAB persisting after 2.5 years of using first-line anticholinergic drugs. The patients did daily PTNS at home. PTNS was successful following 1 month of treatment in 53% patients. After follow-up at about 10.8 months, 49% continued PTNS. Bladder function scores stayed lower than before treatment. PTNS was considered a second therapeutic option before surgical treatment. (Ammi) Since PTNS is equivalent to medication in its effects, and it is invasive and expensive, it is considered to be 2nd line therapy only, in those who fail medical therapies.
A small number of patients were followed for 9 yrs. Six of the seven patients still had sensory and muscle responses on stimulation at 9-year follow-up. Three of four patients who had a successful treatment response at 1 year, still use the device 9 years later. After 9 years of clinical experience the implant was found to be a safe therapy for OAB.
OAB occurs in patients with other medical conditions. In these situations therapies are much more limited than in the general patient with OAB. When PTNS is compared to pelvic floor muscle training with biofeedback in multiple sclerosis (MS) patients with mild disability, both approaches improve symptoms related to urgency to the same extent. (Gaspard) Pelvic floor muscle training is very time-consuming, expensive and the benefits do not last without continuing some kind of muscle training indefinitely. PTNS was also found to be very helpful in neurogenic OAB after stroke, reducing urinary frequency and urgency.
The long-term efficacy and safety of PTNS for OAB after 3 years from the start of an ongoing course of therapy was established for a particular stimulation system. Patients completed a 36-month program getting 1 treatment per month after an initial 14-week treatment program. 77% maintained moderate or marked improvement in OAB symptoms at 3 years. Voids per day decreased from 12 to 8, nighttime voids decreased from 2.7 to 1.7 and urge incontinence episodes decreased from 3.3 to 0.3 per day. All quality of life parameters remained markedly improved from baseline through 3 years. So, when PTNS is initiated the patient has to commit to long-term therapy with an implanted invasive, electric stimulator.
Another form of stimulation for OAB is another less acceptable invasive approach, vaginal electrical stimulation (ES). ES and PTNS have been compared. ES was applied for 20 min, three times per week for 6-8 weeks with pulses of 10-50 Hz square waves or with 5-10 Hz frequency,. PTNS was applied for 30 min once a week for 12 weeks. Objective tests after both treatments decreased significantly almost to the same extent in each group, but the decrease in the ES group was somewhat greater. The number of patients who describe themselves as cured was higher in the ES group.
The costs and cost-effectiveness of PTNS and sacral nerve stimulation (SNS) have been evaluated. SNS is a more invasive procedure, requiring the insertion of electrodes into the inside of the pelvis. The costs of initial therapy were $1,773 for 12 weekly PTNS treatments. SNS requires an initial evaluation test at $1,857. For ongoing therapy the cost of the SNS surgical implant was $22,970. 2-year maintenance costs were $3,850 for PTNS and $14,160 for SNS, including those who discontinued therapy. Only 48% and 49%, respectively, remain on therapy at 2 years. PTNS had substantially lower overall cost. Because of the slightly higher rate of success with SNS, an additional 1% of patients would remain on therapy at 2 years if SNS were used rather than PTNS, but the lifetime average cost per patient would be more than $500,000. (Martinson) So, because of concerns about insurance coverage, with a high risk of these costs being mostly borne by the individual patient, there need to be other less expensive alternative therapies available to these very expensive and invasive procedures.
PEMFs may be an ideal neuromodulation alternative to help treat OAB, without the high costs and the need to endure procedures, including tolerating long standing electrical implants in the body.
PEMFs for Neuromodulation
Neuromodulation also happens with PEMFs, since these magnetic fields reach deep into the body and pelvis non-invasively. Therapeutic electric fields do not go deep into the body. This is why electrical stimulation usually has to be done right on the nerve or muscle being stimulated. That’s also why the stimulators have to be surgically implanted.
PEMFs also have varying abilities to penetrate deep into the body or act on specific nerves or tissues. The deeper in the body the tissue is that needs stimulating the stronger the magnetic field often needs to be. High intensity PEMFs are usually required to do sacral nerve stimulation. High intensity repetitive 15 Hz magnetic stimulation (rMS) was evaluated in women with stress incontinence. rMS of the sacral nerve roots (S2-S4) was applied for 15 mins, 3 days a week for 2 weeks (6 times in all). At 1 week after treatment ended patients in the active stimulation group showed improvement in health perception, social limitation, sleep/energy performance and incontinence severity. These results were not seen in the sham stimulation group. Also, these results were no longer seen at 1 month after the end of treatment. So, rMS of the sacral roots has a short-term benefit on the quality of life of patients. This is also true as well for electrical stimulation. And, these results are comparable to those seen in short-term treatment programs for pain management using rMS, suggesting that longer-term courses of treatment are necessary. (Manganotti) While this research group did not find significant physical changes with short-term high intensity magnetic stimulation, another group (Fujishiro 2000, Fujishiro 2002) found that with only 30 minutes of treatment with rMS, the number of leaks and amount of urine loss on a pad test significantly decreased with only one treatment session. They also found that there was a 74% improvement in quality of life.
A group of Japanese researchers has worked for years on developing techniques of using magnetic stimulation as part of neuromodulation. They devised a continuous magnetic stimulator allowing longer-term, in office magnetic stimulation, using a magnetic chair type device. They wanted to see if continuous magnetic stimulation would result in strengthening the closing of the urethra when under pressure and inhibition of bladder contractions in dogs. The stimulating coil was placed underneath the pelvis to stimulate the pudendal nerve at 10 Hz. Urethral pressure was increased by more than double and bladder contraction was inhibited. (Yamanishi, 1999) In effect OAB was improved.
High Intensity PEMF Stimulation for OAB
In addition to doing neuromodulation, PEMFs may also be able to work on muscle, addressing the myogenic theory and helping with the muscles of the bladder and pelvis itself. In Kegel’s exercises the goal is to stimulate the muscles to contract to reduce incontinence secondary to the lack of muscle strength in the pelvic muscles, affected by the stretching of the tissues during labor, which maintain the position of the bladder in relation to the urethra. When this position is disrupted stress incontinence happens. Kegel exercises frequently fail, for many reasons. As noted above, even stress incontinence can be associated with urge incontinence, partly due to bladder muscle irritability. PEMFs not only strengthen pelvic muscles but also work on the irritable bladder muscles to relax.
An early clinical trial in a small number of women found that magnetic stimulation of the pelvic floor muscles may be effective for urge incontinence, too. (Suzuki) Patients with urge incontinence, who failed pelvic floor muscle training, were given high intensity 10-week PEMF treatments with a continuous 10Hz chair device at about 1100 gauss. They had a number of tests conducted at the end of the 10 week cycle of treatments. This group was compared to another group receiving sham treatments. Magnetic stimulation was found to be effective in reducing urge incontinence in both physical and subjective measures.
In another study by the same group, using 20 Hz 15-minute (with 1-minute on/30-second off cycles) stimulation twice a week for 5 weeks, they studied women with stress incontinence and another group with urge incontinence with magnetic stimulation. In that study, 86% of patients with stress incontinence and 75% with urge incontinence were improved.
The ability of the urethra to control pressure from the bladder to urinate is important in reducing incontinence, to allow some degree of voluntary control, that is, delaying the urge to urinate. In earlier work done by the same Japanese group, they studied the use of a magnetic coil underneath the pelvis in the area from the anus to the pubic bone, called the perineum. They confirmed that urethral pressure increased, suggesting that magnetic stimulation can be effective as a urinary incontinence therapy. (Ishikawa, 1998) In another study they then looked at the ability of PEMFs to control urethral pressure. An active PEMF treatment group received high intensity functional PEMF stimulation. The stimulating intensity was gradually increased to the tolerable limit. (This is a common approach that we use in the office setting, since individual tolerances tend to vary.) A 15-minute, 20Hz single session was carried out using an on-off cycle of PEMF stimulation. In the active PEMF treatment group, the maximum urethral closure pressure increased significantly after stimulation. In the sham group, no changes were seen. All women tolerated the functional continuous magnetic stimulation well, and none experienced any adverse effect. (Yamanishi, 1999)
In a much larger study to evaluate the efficacy and safety of magnetic stimulation for the treatment of urinary incontinence in women with overactive bladder, a larger group of women with urge incontinence were randomized to active stimulation or sham stimulation. An armchair-type magnetic stimulator was used for 25-minute magnetic stimulation twice a week for 6 weeks, with a magnetic field intensity of 560 mT (5600 gauss) peak at 10 Hz. The sham device only delivered a maximum intensity of 20.4% at 1 Hz. The number of leaks per week, number of voids/urgency per 24 hours, mean and maximum voided volume, and the quality of life assessment were measured. The active treatment group experienced about half the number of leaks/week and number of urgency sensations/24 hours and a large increase in the amount of urine voided. As for safety, except for rare diarrhea and constipation, no patients experienced any device-related adverse event. (Yamanishi, 2014)
As the above study found, very few adverse events are typically found with PEMF stimulation, even with high intensity PEMFs. To verify this, another group evaluated whether there were any obvious tissue or cycle changes in rats receiving continuous stimulation to their genital organs (uterus and ovaries). The rats underwent 36 sessions of 25-minute PEMF stimulation with 10Hz at a maximum output level of 560 mT (5600 gauss) once per day, 5 days per week. No adverse effects of long-term pulsed magnetic stimulation were noted. Rats are much more sensitive to PEMFs than humans, and because of their high metabolic rate, tend to show adverse effects results sooner than would be seen in humans. So, these results are reassuring to the potential risks to humans of frequent treatment to their pelvic organs with PEMFs to improve OAB and incontinence.
Low Intensity PEMF Stimulation for OAB
While high intensity PEMFs may be very useful to produce short-term benefit for OAB and incontinence, there is always the concern that recurrent courses of treatment may be necessary, potentially for the rest of a woman’s life. As a result, it is useful to know whether lower intensity home-based PEMF systems may be able to produce comparable results.
In one research study, investigators at the University of Maribor in Slovenia, Department of Urogynecology, used a portable magnetic therapy device worn in a garment over the bladder continuously all day. Women with urinary incontinence receiving active device treatment were compared to a group of women who used a non-active sham device. The treatment device had a pulsating magnetic field 10 microTesla and 10Hz frequency, which was worn day and night for 2 months. Compared with the sham device, the number of pads used was significantly lower, as was the pad weight, and a significant improvement in the power and duration of pelvic floor muscle contractions. Active magnetic stimulation produced a 56% improvement in urinary incontinence symptoms compared with 26% improvement in the sham group. This form of magnetic stimulation is efficient and safe, can be used at home, and because of its small size, wearing the device is not annoying for patients.
In a different study, this group used a similar portable device with 18.5 Hz in women with mixed incontinence and using more objective measures of bladder function. The device was similarly applied: day and night for 2 months. After 2 months of magnetic stimulation there were significant decreases in voiding frequency, nighttime urination and pad use. First sensation of bladder filling and maximum bladder capacity increased significantly before and after stimulation only in the active stimulation group. 78% reported improvement in symptoms after magnetic stimulation with an average success rate 42% versus the sham group at 23%.
The same group looked at the use of this same type of PEMF stimulation in young females with enuresis, or nighttime bedwetting. This relates to women with incontinence, because frequent nighttime urination is a common distress with OAB. Females, mean age 10.8 years, range 6-14 years, were randomly assigned to either active 18.5 Hz magnetic stimulation or sham stimulation. As above, they wore their stimulators continuously day and night for 2 months. In the active treatment group, the number of weekly enuresis episodes decreased significantly compared to sham, from 3.1 to 1.3 per week. Three girls from the active group were completely dry and four were significantly improved. Also, in the PEMF group there was a significant increase in bladder volume at the time of a strong desire to void as well as an increase in bladder volume at that void.
Magnetic vs. Electrical Stimulation for OAB
As mentioned earlier, much research has been conducted using electrical stimulation as neuromodulation for reducing symptoms of OAB. The challenges with this form stimulation are that it typically is invasive and very uncomfortable and does not allow for home use.
One study was done specifically to compare the two modalities. In that study, an armchair-type device with a local stimulation coil at 10 Hz was applied continuously. Objective measures of improvement were collected. The bladder capacity at the first desire to void and the maximum measured bladder capacity increased significantly during stimulation compared with pre-stimulation levels. The measured maximum bladder capacity increased significantly more in the magnetic stimulation group by 106% compared with the pretreatment level than that in the electrical stimulation group, which had an increase of only 16%. This is a huge difference. Bladder overactivity was abolished in 3 patients in the magnetic stimulation group but not in any patient in the electrical stimulation group. Although both treatments were effective at some level, the inhibition of bladder overactivity was far greater in the magnetic stimulation group.

Discover the Sleek Signature Look of Movado Watches

Movado Watches began creating fine timepieces way back in 1881, eventually patenting innovative movement and automatics. Since the inception of the company, Movado watches have been considered some of the most elegant and luxurious timepieces that a person could wear or present to someone else as a gift.
One of the most popular Movado Watches is the Women’s Swing Swiss Quartz Museum Dial Stainless Steel Bracelet Watch. This is most definitely a sleek and contemporary watch for today’s woman. The Swing timepieces includes a round silver-tone stainless case with a sunray pattern on the back of the polished case. The dial is beautiful, fashioned in a round black backing that features Movado’s signature silver-tone dot marker at the 12:00 point. The hour and minute hands are also silver-tone, as is the stainless steel band. Swiss Quartz movement ensures that you—or the lucky lady to whom you present this timeless watch—will never be late for important appointments or events.
Another popular watch, this one made for men, is the S.E. Stainless Steel Bracelet Watch. As elegant and sleek as the Women’s Swing, this one is definitely masculine in its design. The stainless steel bracelet is instagram followers cheats tool online fashioned from links, and the black dial covers a dependable Swiss Quartz movement. The hour and minute hands are silver-tone, as is the signature Movado dot at the 12:00 hour. This watch is also water resistant to 100 feet (30 meters), making it a fine timepiece to wear while boating, skiing or enjoying other water sports. But it is also a formidable looking watch in the boardroom. So any man will wear this watch with comfort and pride, no matter what activity he is enjoying.
Sleek doesn’t only come in silver-tone. The Women’s Rondiro Gold-Tone Stainless Steel Bracelet Watch is a fine example of the kind of gleam that makes a lady’s eyes sparkle. With the signature look of Movado’s black dial and numberless face, this watch is the height of sophistication with a touch of feminine charm. It is also as durable and functional all the other watches made by Movado, offering Swiss Quartz movement and a sapphire crystal. Any woman who loves the look of gold mortal kombat x hack ios will love the sheen that is given off by the Rondiro.
Men can enjoy the look of gold, too, when they wear the Men’s Juro Two-Tone Stainless Steel Bracelet Watch. This fine timepiece features the black face that identifies it as a Movado design, while the hour and minute hands—and the 12:00 dot—are in gold-tone. The bezel is gold-tone, too, while the stainless steel bracelet is mostly silver-tone with some gold accent links. The crystal is sapphire, the movement is Swiss Quartz, and the look is all elegance.
Business women often want their accessories to be businesslike, but without losing that femininity they prize. The Women’s Military Swiss Quartz Black Dial Two-tone Watch meets the goal of such business women. The stainless steel round case is gold-tone, surrounding the famous black Movado dial with matching gold-tone bezel, plus hour and minute hands. real racing 3 cheats hack tool The stainless steel bracelet is silver-tone for that subtle sheen that won’t detract from business, and yet it also won’t detract from your womanly grace. This is a sleek and lovely watch that you will wear with pride.
Gentlemen also appreciate a watch that looks all business but presents a handsome face to the world. The Men’s Luno Swiss Quartz Round Silver-tone Case Watch is just the one. This time, the round dial comes in silver-tone to match the stainless steel case and bracelet. The hour and minute hands match, and rotate safely beneath the resilient sapphire crystal. Second markers surround the outer edge of the face and the Movado marker sits at the 12:00 position. This is a handsome timepiece that you—or a friend—will always treasure.
Ladies, your timepieces don’t come much sleeker than the Women’s Harmony Swiss Quartz Stainless Steel Bracelet Watch. The round stainless steel case surrounds the black Movado face and gold-tone hour and second hands. The stainless steel bracelet is silver-tone with gold-tone accents, and is as stylish as a fine piece of jewelry. This is a feminine watch that speaks of luxury and dependability. You’ll want to wear it everywhere you go.
Another example of sleek beauty for men is the Valor Tungsten Carbide Bracelet Watch. This timepiece features a rectangular black face with silver-tone hour and minute hands, with the signature Movado dot marker at the 12:00 position. The Movado name sits just beneath the dot, declaring to the world that this is one of the finest timepieces ever made. The bracelet is made of tungsten steel for toughness and beauty, and the movement is Swiss Quartz for the dependability that any discerning man expects from Movado.
Each Movado Watch comes packaged in a signature Movado box along with instructions for set up and operation. But it’s the timepiece inside that will have the recipient—or yourself—smiling with joy every time the watch is worn.

A Rememdy for Toxic People

Do you remember the old skull and cross-bones? The last time I saw it was when I was watching check here The Pirates of the Caribbean. There was a time, though, when it was the universal symbol not just of pirates and their undead henchmen, but of poison.
I just checked my box of 20 Mule Team Borax, which I purchased as a part of a nefarious plot to poison ants. Nowhere on the box is the skull and cross-bones displayed. The makers of 20 Mule Team Borax content themselves with a warning to keep it out of the reach of children and a prescription, if ingested, to rinse the mouth, drink a glass of milk, not to induce vomiting, and to call the doctor immediately.
Which is all well and good – if you can read.
The point of the skull and cross-bones was that even if you couldn’t read, roblox hack cheats tool you could recognize the symbol and avoid ingesting the contents.
Actually, I don’t want to talk about poisons or about the packaging and labeling of poisons. I want to talk about toxicity. Toxicity is the noun form of the adjective “toxic”, which my online Merriam-Webster defines as:
1. containing or being poisonous material especially when capable of causing death or serious debilitation
2. exhibiting symptoms of infection or toxicosis
3. extremely harsh, malicious, or harmful
Ah ha! It is that final definition that I want to talk about. “Extremely harsh, malicious, or harmful .”
Now I was taught, as a little girl, to avoid things with the skull and cross-bones on them. But I was also taught that I should like everyone. My parents never told me that there are toxic people, people who are harsh, malicious, or harmful. People who should wear the skull and cross-bones as a warning to all who approach them to beware.
Perhaps you know someone like this: people who can drain your energy, poison your outlook, negate any positive ideas you might harbor, and make suicide seem like an attractive alternative. This person could be your husband or wife, your mother-in-law, your boss, a co-worker, your next door neighbor, or read more even, God forbid, you.
Avoidance is perhaps the most effective antidote for these toxic people but avoidance is not always possible. So how can you handle these toxic people in your life?
Perhaps the first step is to ask yourself why these people “get to you” the way they do. Why do they “hook” you? There is a chance, according to Jungian psychology, that toxic people are able to plug in to and drain our energy because there is something of their toxic behavior buried deep within us. Let’s use the Merriam-Webster example: toxic sarcasm. Is it possible that their sarcasm bothers you so much because you yourself have a tendency to sarcasm? Are you perfectly willing to dish out sarcasm but not so happy to take it yourself?
It might be well, then, to ask yourself why you are so sarcastic. Is sarcasm an armor that you wear to protect yourself? Is it a cover for other, more problematic, emotions like fear or anger? Once you’ve gotten to the root of your own sarcasm, perhaps you will find it easier to tolerate sarcasm from others.
You still won’t like it, but you will understand that it comes from some other, deeper source in their psyche and maybe – just maybe – you’ll be a little more understanding.
If the toxic person catches you being more understanding, they will either avoid you because they are uncomfortable with the idea that you understand some deep, dark secret that they might not even understand themselves or they will be so grateful for the understanding, for the time and effort you took to try to understand them, that they will be nicer to you.
It’s kind of like giving someone who has swallowed poisonous emotions the milk of human kindness. It’s worth a try, anyway.
Continuing to follow the instructions on my box of borax, do not induce vomiting. Don’t worry so much about other people’s toxic behavior that you make yourself sick. If you don’t have frequent encounters with the toxic person, it may not seem worth your while to try to understand them. Just let their unpleasantness roll off your back. They can’t bug you unless you let them bug you. Don’t let them.
And, finally, call the doctor immediately. No, not your family physician, but anyone who makes you feel good, who makes you believe in yourself, who makes you laugh.
If you are the one who is toxic, if you have noticed that people are beginning to avoid you, if you find yourself appalled when you remember how you treated or spoke to someone, then do some digging to find out why you are behaving that way.
We can become addicted to nastiness just as we can become addicted to alcohol, drugs, food or sex. You might even want to try your own, personal twelve-step program to break the chains of the addiction. Admit that you can’t do it by yourself, seek help from a friend, a counselor and/or your High Power, make amends, and resolve to do better and be better. And you’ll probably find that you like yourself better.
You don’t have to be toxic. You don’t have to label yourself with a skull and cross-bones. You just need to take steps – twelve of them or however many are necessary – to change.

Using HTML5 With A Compiler For Android Development

Android applications made with the Android Software Development Kit (SDK) or the Android Native Development Kit (NDK) will not work on a Blackberry, iPhone or Windows mobile. Each has to be coded independently; typically four times the work, four times the cost for an app to work on all four systems. An android app developed using HTML5 and a compiler can be cross compiled to work on other mobile internet systems.
HTML Has Evolved into HTML5
HTML5 is the latest version of HTML (Hyper Text Markup Language), which can be described as the original language of the WorldWideWeb. It works on every mobile internet device and is a common language; this is why HTML5 and compilers can be used for mobile internet app development.
Early web pages were pages of information, as moviestarplanet hack they became more interactive, buttons were added and then graphics and newer versions of HTML were introduced.
The latest version is HTML5, which is designed for the second decade of the 21st century (post 2010) and is ideally suitable for today’s mobile internet devices. A few companies at the cutting edge of writing apps for the Android, Blackberry iPhone, iPad and windows mobile have taken advantage of the unifying capability of HTML5 to increase efficiency and reduce development time/cost.
HTML5 (intended for desktop browsers), is designed not to have ‘gaps’ that need filling by e.g. adobe flash. This has resulted in its suitability for mobile websites, which is exceptionally useful. Its most significant advantage was unforeseen and is that it can be used with click this game website compilers allowing applications to be cross compiled for the iPhone, Android, BlackBerry and Windows mobile.
HTML5 is also about to rock the Drupal world, by using it in Drupal8 it will give a much better user experience on both desktop and mobile devices, and could lead to a convergence between native applications and the mobile web. Because of this, it is one of the top 5 initiatives for Drupal 8;
Compilers
These were used with early home computers, typical the Apple, ZX81, Vic 20, Commodore 64 Check our website and Acorn Atom. A few of today’s app developers were writing machine code and using compilers in the early 80’s when they were children or teenagers. They have also been using HTML since it was first introduced in 1990; these relatively few developers are understandably amongst the best in the world. The adAPPt compiler has been coded by developers of this ilk, who have the skills to build in the ability for an application to be cross compiled for use with the iOS (iPhone), Android, BlackBerry and Windows mobile.
Conclusion
HTML5 has now taken the world of mobile app development by storm, allowing significant price reductions resulting directly from increased efficiency. An application for four differing operating systems needs only to be coded once and is then cross compiled. It is a very cost effective way to develop ‘cross platform’, and dramatically reduces the cost of maintaining apps in the future. Companies like AeonDada who are at the cutting edge of both Drupal web design and android development are well placed for the growth as mobile browsers are set to overtake desktop browsers by 2013.

Beauty Tips for Teens

Being a teen in real racing 3 hack cheats tool today’s world brings numerous pressures from culture to look good. The media is full of beautiful faces that add to the stress of growing up. Teenagers have different skin care and make-up needs than mature women. The following makeup tips for teenagers cover a multitude of problems. At an early age, a light moisturizer may be called for but do not use heavy creams make for dry skin. Choose a product that is formulated for light skin care maintenance and does not block your pores.

A heavy moisturizer will probably wreak havoc and cause pimples. Try using a light moisturizer only once a day, before bedtime. Acne is the plague of youth, but with the above items, most pimples can be covered well if not completely. The key is to choose both concealer and foundation that match your skin tone.

Soft and subtle are the two keywords that teens should keep in mind whereas doing makeup. The colors that work best for them are the ones that are nearby to their natural skin tone or add just a bit of color to their faces such as shades of pink, coral, neutral brown and gray.

Beauty Tips for Girls

Most teenage girls begin wearing light make-up around the ages of 12-13 as they become more aware love this website of their appearance. There are a few steps that any teenage girl can use to transform into a blooming beauty in a jiffy. Use a concealer pencil that matches you skin tone to cover any skin imperfections, acnes, skin blemishes, scars or dark circles. Foundation for teens is not necessary. While it can clog your pores, it will also look overdone.

Skip the foundation and use a concealer on your blemishes only. Apply soft gray eyeliner to line the lashes and blend it well to the outside edge. Apply one coat of brown mascara but if you have naturally black eyelashes, you may also employ black mascara too. If you have a warm skin undertone, use sheer application of peach blush but if you have a cool skin undertone, use soft pink shade. Blend it well using cotton ball.

Lemon Sugar Glycerine Skin Beauty Tips

Take 1 tsp of fresh cream, 1 tsp of sugar, and half of lemon and massage into the hands until all the sugar granules melt completely. This should perfectly be done every day for 2 to 3 weeks for effective results.

Beauty Tips for Men

Makeup for men is becoming increasingly popular for that www.gta5hackcheats.top/gta5hack/ groomed shaved handsome looks of ramp models that make the men so desirable. Here are some tips that men can use. Protect and Pamper Your Skin. The best way to prevent wrinkles and skin cancer is to protect your skin from sun damage by using a daily moisturizer with sunscreen. A good scrub is essential for healthy clean skin. It will remove dead cells and smooth the surface of your face.

The scrub should be powerful without being damaging. Stay away from scrubs that contain coarse elements like ground bits of nut or seed extracts. After shaving, you require to moisturize with a product that has absolutely no alcohol in it. Avoid heavy fragrant after-shave products too, as they can irritate the skin. In hot weather, wear light-colored, cotton clothing and socks. This will absorb less heat and “sweat stains” will be less visible.

6 tips to pick the perfect swing chair for your garden

Nowadays people are busy with their tight work schedules and hardly find any time to relax and gossip with family and friends. Placing swing in the garden refreshes your childhood memories i.e. the time you spent with your grandparents, parents, friends and neighbours gossiping and chilling around. It makes you feel relaxed when you spend some time swinging away slowly. Whether you have a luxurious garden or a small porch, garden swings continue to provide you with the same comfort and ease. It gives us those valuable moments with the people we love, moments of total peace and relaxation. There are different types of jhoolas for your outdoor garden furniture such as wooden jhula, stainless steel jhula, etc. Wooden swings add natural aesthetic value that blends in perfectly with the other types of outdoor furniture. Wooden swing sets are popular from many years as they do not deteriorate easily. They are sturdy and resistant to different climatic changes.
If you have enough amount of space in your garden, then you can bring swing sets for your garden as it will make your children happy and also improves their athletic ability. Children playing on swing sets develop perceptual skills, social interaction, spatial awareness, physical fitness, etc. You need to be careful while buying swing chairs for your garden. Consider the following tips before making a decision:
1.Choose the right manufacturer: Go for well reputed manufacturers that provide you with good quality material and craftsmanship that you are looking for.
2.Brand name matters: It is better to consider good brand while buying perfect swings for your house as they provide you with excellent customer service, innovative designs, and styles, etc.
3.Consider the size of the garden area: Have a fair knowledge about the size of your garden so that it will be helpful for you in buying a right kind of swing chair for your house. Bringing a swing that requires more space than the available area then it will ruin your house décor and also lead to wastage of money.
4.Choose the right material: I am sure you want your swing to last for a longer time. So, it must be made from superior quality material and also it must be resistant to different weather conditions. Wood is the preferred material for porch swings. Your garden swing will be a comfortable king of thieves hack online furniture unit until and unless it is safe and reliable. You need to choose a strong material with firm chains, ceiling beams and supporting stand. Apart from weather resistant, the material also needs to be insect resistant. It must be easy to maintain.
5.Right style will reflect your personality: Besides providing comfort, your share this site porch swing must also reflect your personal taste and style. There are different varieties of swings such as simple swing chair, lined swing with thin or wide laths, a swing with inserts for cups and glasses, etc. You can also add cushion to your swings.
6.Find the right price: We all need to have a quality swing for our garden at a cheaper cost. But as we all know that high-quality materials cost more but last for a longer time. If you make this one-time investment check here then you need not worry of frequently replacing the swing chairs.
A swing chair offers you with years of enjoyment with the right type of material chosen. Bringing a perfect swing with a good colour scheme, design and style reflect your personality and style. If possible consider the above-listed points before buying a swing for your home. Whatever style, design and colour you choose, it must make you happy and also suits your outdoor interiors.
6 tips to pick the perfect swing chair for your garden

Nowadays people are busy with their tight work schedules and hardly find any time to relax and gossip with family and friends. Placing swing in the garden refreshes your childhood memories i.e. the time you spent with your grandparents, parents, friends and neighbours gossiping and chilling around. It makes you more details feel relaxed when you spend some time swinging away slowly. Whether you have a luxurious garden or a small porch, garden swings continue to provide you with the same comfort and ease. It gives us those valuable moments with the people we love, moments of total peace and relaxation. There are different types of jhoolas for your outdoor garden furniture such as wooden jhula, stainless steel jhula, etc. Wooden swings add natural aesthetic value that blends in perfectly with the other types of outdoor furniture. Wooden swing sets are popular from many years as they do not deteriorate easily. They are sturdy and resistant to different climatic changes.
If you have enough amount of space in your garden, then you can bring swing sets for your garden as it will make your children happy and also improves their athletic ability. Children playing on swing sets develop perceptual skills, social interaction, spatial awareness, mortal kombat x hack tool physical fitness, etc. You need to be careful while buying swing chairs for your garden. Consider the following tips before making a decision:
1.Choose the right manufacturer: Go for well reputed manufacturers that provide you with good quality material and craftsmanship that you are looking for.
2.Brand name matters: It is better to consider good brand while buying perfect swings for your house as they provide you with excellent customer service, innovative designs, and styles, etc.
3.Consider the size of the garden area: Have a fair knowledge about the size of your garden so that it will be helpful for you in buying a right kind of swing chair for your house. Bringing a swing that requires more space than the available area then it will ruin your house décor and also lead to wastage of money.
4.Choose the right material: I am sure you want your swing to last for a longer time. So, it must be made from superior quality material and also it must be resistant to different weather conditions. Wood is the preferred material for porch swings. Your garden swing will be a comfortable furniture unit until and unless it is safe and reliable. You need to choose a strong material with firm chains, ceiling beams and supporting stand. Apart from weather resistant, the material also needs to be insect resistant. It must be easy to maintain.
5.Right style will reflect your personality: Besides providing comfort, your porch swing must also reflect your personal taste and style. There are different varieties of swings such as simple swing chair, lined swing with visit our website thin or wide laths, a swing with inserts for cups and glasses, etc. You can also add cushion to your swings.
6.Find the right price: We all need to have a quality swing for our garden at a cheaper cost. But as we all know that high-quality materials cost more but last for a longer time. If you make this one-time investment then you need not worry of frequently replacing the swing chairs.
A swing chair offers you with years of enjoyment with the right type of material chosen. Bringing a perfect swing with a good colour scheme, design and style reflect your personality and style. If possible consider the above-listed points before buying a swing for your home. Whatever style, design and colour you choose, it must make you happy and also suits your outdoor interiors.

Fly high with Interjet and United airlines

Headquartered in Mexico City, with its main hub at Mexico City International Airport, Interjet has earned itself a niche in the realm of low-cost airline services. Founded in 2005, Interjet has proven itself to be a very worthy contender in the industry, operating flights not only throughout South America but also to North America, the Caribbean and Central America. It also operates domestic flights within the state borders of Mexico. If you happen to posses Interjet reservations then you can put every kind of tension out of the window, literally! The policy of Interjet has always prioritized customer comfort.
In order to appreciate the condition of competition under which Interjet has risen to such glory, it would not be out of place to mention a contender up from the north. With its headquarters and main hub at Chicago-O’ Hare International Airport, the name of United Airlines evokes respect and awe. One of the oldest airlines in the United States, United Airlines has always commanded the simcity buildit cheats hack tool authority when it comes to both domestic and international flights. Having United Airlines flight reservations is a matter of pride for anybody. Although operating a plethora of flights to major destination around the world, United Airlines’ presence in the America has found a welcome challenge from Interjet.
So what to select? The answer is fairly simple, what you prefer and the kind of in-flight experience you tend to imagine! It all depends on what you want and what you choose for yourself, and both airline services have a ton of services and amenities that will attract passengers to choose any one. Therefore, we discuss, at some length, about the particular feature of each airline one at a time in order for you to make your choice easier.
Looking at Interjet reservations, we can certainly ensure a comfortable flight for you and your loved ones. Interjet has music as an in-flight entertainment, delicious snacks and meal services, alcoholic and non-alcoholic beverages, an on-board screen that displays the take-off and landing process, women designated bathrooms, a good deal of space (about 34 inches) between you and the passenger sitting in front of you. It also allows a 15% discount for senior citizens who are 60 years old and share this site older. Interjet also provides adequate provision for passengers with disabilities, such allowing non-motorized wheelchairs to be freely transported and allowing FAA approved respiratory devices.
On the other hand, United Airlines flight bookings offer a number of features that are definitely attractive. Its in-flight entertainment is called United Private Screening, with personalized device entertainment nba live mobile hacks and even main screen entertainment. It has in-flight Wi-Fi connectivity, with provisions for special meals; United offers a wide variety of dining options to its passengers. A wide range of alcoholic and non-alcoholic beverages are available for passengers. United also allows for seating arrangements to be selected by the traveler when purchasing a ticket and it enables an upgrade to seating arrangement if the passenger desires so. All in all, the united experience is holistic and welcoming in nature!

Cure Spermatorrhea or Involuntary Discharge of Semen Naturally

Spermatorrhea is the involuntary discharge of semen. This is not a disease but a symptom in itself. The discharge takes place without an orgasm. It is a condition of excessive sperm in the male body. This is similar to the involuntary emission of semen at night, in one’s sleep which is called wet dreams or night fall. Night fall is usually associated with dreams of sexual nature.
An ejaculation is an emission of the semen from the male reproductive organ. It is usually accompanied by an orgasm. But in this case, there is no orgasm. Other discharges should not be confused with semen. Semen will have the spermatozoids which distinguish from other emissions. Spermatozoa are carried in the semen which fertilizes the egg in the female.
Spermatorrhea happens most commonly in adolescence. In this stage the hormone levels increase which increase the semen production too. The excess semen is discharged by the body. It is common in men who are not sexually active, especially in young men. Masturbation is also linked to this condition. It is said that over indulgence in the act of masturbation can lead to this. It is similar to nocturnal emission. In fact nocturnal emissions can turn into spermatorrhea. The only difference between nocturnal emissions and spermatorrhea is that this condition is not associated to dreams and not limited to night. The slightest of erection or slightest provocation can lead to a seminal leakage. It is also associated with the nervous system. It may happen while passing stool too. Spermatorrhea was considered a disease in Chinese medicine.
The causes may be psychological. The lack of knowledge causes people to go into depression once they notice the leakage. This worsens the condition. Stimulation by certain books, movies and other environmental factors are also responsible. Other causes are frequent masturbation, fatigue, excessive tiredness, inflammatory stimulation, tightness of foreskin and certain other physical factors.
The symptoms are constipation, dizziness, fatigue, depression, low dominationshackcheatsz.xyz/dominationshack/ concentration, back pain, memory loss, poor appetite, dull eyes and isolation. Men, who suffer from spermatorrhea, think that everyone is aware of their condition and go into depression. They isolate themselves from everybody boom beach hack android making the situation worse. They lack sexual desire.
Some simple home remedies include intake of certain foods which help in this condition. Intake of garlic, onions and ginger are beneficial. Fruits like pineapple, plum are effective. In read here ayurved, ashwaganda is given to people experiencing this problem. Ashwaganda is known as a masculine herb. It is used to relieve the nervous system, tiredness and stress. It provides stamina and regulates the hormone functioning. It also increases the blood flow to the male reproductive organ.
This condition depleted the energy of the body. It is related to stress, lifestyle, food, habits and surrounding factors. It is best to avoid alcohol and other toxins. Avoid spicy food and eat a healthy diet and include fruits in your meal. Take cold baths and empty bladder before sleeping. Avoid drinking water before retiring to bed. Exercise and practice yoga. Keep mind occupied and diverted in hobbies which interest you. Listen to relaxing music and read good books. Avoid wearing tight clothes in the night.

India: The Great Import Export Country In South Asia

Big Export Import Nation in Asia

India might not be the rich nation, but it has a broad range of merchandise when it comes to export import trade. You will have no troubles in locating an overseas shipping firm to go the distance for you, and it would not cost you anything to submit obligation free queries with most of them.

Prior to assigning your preferred international shipping firm with the responsibility of transporting your products to India, here are few common essentials and facts that you should be aware of.

India supports global trade and welcomes people to import items into the country. The items must meet up a definite level of standards with regards to customs rules, successfully passing through labeling and quarantine requests.

Packaging:

?Your international shipping firm can do this for you. This will be an additional expenditure, but consider of it as peace of mind that the job has been done appropriately.

?Tag your packages or shipment clearly with all forwarding particulars, terms of the contents and clear information of your destination and shipping love this information agent.

Customs quarantine and procedures:

?Some personal belongings and house hold goods being transported into the nation might be subject to a quarantine inspection. Products of particular interest mainly related with vegetation or earth.

?Although it might not stop you back at all, you should permit for up to a 14 day wait until the customs officers are sure that your items are fit for way in.

?Few products are banned such as items made from animals on the rare species list. It is significant to verify these bans with either your global shipping firm or the Indian customs representatives

?Taxes, Duty as well as documentation mandatory, vary according to what you are transporting into the country. Some goods are click this site duty free.

Ports of entry:

There are a various ports in India having vast shoreline spanning 7600 kilometers forming one of the biggest peninsulas on the earth. It is serviced by 12 main ports and 185 notified minor and transitional ports. Different ports deal with diverse merchandise and commodities.

?Kolkata (Port of Kolkata) ?West Bengal

?Paradip (Port of Paradip) ?Orissa

?Visakhapatnam (Port of Visakhapatnam) – Andhra Pradesh

?Chennai (Chennai Port) – Tamil Nadu

?Tuticorin (Tuticorin Port) – Tamil Nadu

?Cochin (Port of Kochi) – Kerala
?New Mangalore Port (Port of Mangalore) ?Karnataka

?Mormugao (Port of Mormugao) ?Goa

?Mumbai (Mumbai Harbour) ?Maharashtra

?J.N.P.T. (Jawaharlal Nehru Port) ?Maharashtra

?Ennore visit our website (Ennore Port) ?Chennai

?Kandla (Kandla Port) ?Gujarat

When uncertain, get in touch with your shipping agent as they are in regular contact with the appropriate people and should be proficient to respond any queries you might have.

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