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Some aspects of the physical environment have also been studied extensively; found that settings that were aesthetically more attractive and had more green space have consistently been related to higher levels of happiness(24-27) pulse pressure therapy buy discount zestril 5 mg online. Perceived access to public transport demi lovato heart attack generic zestril 2.5 mg visa, culture and leisure facilities have been positively related to happiness(24) blood pressure chart based on age buy generic zestril 10mg on-line. Various studies have revealed that students who have high-stress levels are less likely to report high perceived happiness(29) heart attack what everyone else calls fun zestril 10 mg discount. The study suggested that students were least happy about their financial situation, at work, and at school, low perceived happiness reported higher stress levels and lower emotional closeness to others(30). The finding of the present study are in line with the findings of the study reported that adolescents who reported sufficient time spent with family members and the highest level of love and connectedness were happiest(31). Those living in a two-parent family were happiest, followed by those living with a married father or a married mother (in a single parent family). Those living in an unmarried mother family were unhappiest, controlling for household economic status. These findings highlight the important role of a father in a country with a matriarchal family system. Regarding non-family factors, adolescents with the highest school attendance, highest self-esteem, and highest economic status who also regularly participated in extracurricular activities were happiest. Adolescents who were older and who had to do chores regularly tended to be less happy than their peers. The factors identified for happiness among adolescents provide a base for the development of happiness scale. Education, Sociability, Health, Entertainment and Sensation Seeking, by sociability it is meant that adolescents feel happy when they are free to purchase, give surprises to others and they love shopping. For adolescents education also matters, particularly good performance in academics, studying obeying the teachers make them feel happy when they are acknowledged. The young adolescents enjoy food and are also more pleased in hygienic conditions. They also like adventurous activities, traveling, and nature, they like thrilling experiences. The finding of the various researches provides support for an association between social and physical environmental factors and happiness. For example, social environmental factors such as neighborhood 494Indian Journal of Public Health Research & Development, January 2020, Vol. The present work has application in understanding the factors of happiness among adolescents and accordingly their behaviours can be dealt. The measurement of happiness would be helpful in the health sector because happiness can increase physical activity and significantly decrease depression(32). Physical activity makes us look better, feel better, and sleep better by releasing dopamine into the brain. Acknowledgment: the author appreciates all those who participated in the study and helped to facilitate the research process. Source of Funding: None Conflict of Interests: the author declared no conflict of interests. The relationship between life satisfaction and health behavior: a cross-cultural analysis of young adults. An Analysis of Relationship between Happiness and Personality: A Literature Review. A Study of Psychological factor discriminating diabetic and non-diabetic patients. The Quality of Factor Solutions in Exploratory Factor Analysis: the Influence of Sample Size, Communality, and Over determination. Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Moving beyond green: exploring the relationship of environment type and indicators of perceived environmental quality on emotional well-being following group walks. Happiness and health across the lifespan in five major cities: the impact of place and government performance. A study of stress, social support, and perceived happiness among college students.
Alprostadil is supplied in a self-injection pen device prehypertension parameters zestril 10 mg lowest price, which is easy to use arrhythmia word parts discount 10mg zestril mastercard, and supplied with excellent instructions (Figure 45 blood pressure 9058 generic zestril 2.5mg online. Self-injection treatment carries a small risk of priapism (a sustained unwanted erection) pomegranate juice blood pressure medication purchase zestril 5 mg amex. Although an infrequent complication, priapism is an important one, as it must be treated within 6 hours by aspirating blood from the corpus cavernosum. Patients undertaking self-injection must be warned of this potential problem and given instructions on what to do should it occur (Table 45. Transurethral administration of the vasoactive agent would appear largely to overcome this problem. A slender applicator is inserted into the urethra to deposit a pellet containing alprostadil in polyethylene glycol. This gradually dissolves, allowing the prostaglandin to diffuse into the corpus cavernosum. A more recent study reported that most men found transurethral alprostadil less acceptable and efficacious than intracavernosal injection [92], and the long-term usage has been disappointing [93]. They consist of a translucent tube, which is placed over the penis, and an attached vacuum pump (Figure 45. The air is pumped out of the tube, and the negative pressure draws blood into the erectile tissue, producing tumescence. A constriction band (which has previously been placed over the base of the tube) is then slipped off to remain firmly around the base of the penis so as to maintain the erection, and the tube is then removed. The devices require a little practice and some dexterity, but most couples are able to 750 Sexual Function in Men and Women with Diabetes Chapter 45 use them satisfactorily. The side effects are discomfort from the constriction band, failure to ejaculate and a cold penis (reported by the female partner). Many couples find the use of vacuum devices unacceptable, and since the introduction of newer treatments their use has declined; however, they still have a role in men who do not respond or who cannot use other treatments. The surgical options available are: 1 the insertion of penile prostheses; 2 Corrective surgery for associated Peyronie disease or postinjection corporal fibrosis; 3 Venous and arterial surgery. Discussion of vascular and corrective surgery of the penis is best left to a specialist urology textbook, but a general practitioner or diabetes physician needs to know which patients might benefit by referral for insertion of a penile prosthesis. This form of surgery is best reserved for men in whom conventional treatments have failed and who are keen to resume full sexual activity. Counseling of the patient, and whenever possible his partner, is extremely important, particularly about the choice of prosthesis. Patients must be warned regarding postoperative pain or discomfort and the potential for reoperation. Patients will need to restrict physical activity and refrain from intercourse for between 4 and 6 weeks after the operation. They should be warned about the possible complications of infection, erosion and prosthesis failure, and that these problems usually require device removal. It is also very important that the patient and his partner are aware that the erection produced by a prosthesis is different from a normal erection, depending very much on the type of prosthesis chosen. There is uncertainty as to whether men with diabetes are at higher risk of infection than men without diabetes after insertion of a penile prosthesis, but there is a consensus that, should infection occur, it is more serious [98]. Most published series of well-selected groups of men who have undergone penile pros- Figure 45. It is often wise to let the patient take away the literature to read and to consider the matter, with treatment being started at a subsequent visit. As with many disorders encountered in primary care, the general practitioner may choose to manage the problem in a standard consultation with the patient. It is therefore important to consider general health issues and to address lifestyle factors. It is likely that these clinics will mainly treat men who have failed to respond to oral therapies and that they will maintain expertise in the use of other treatments, such as intracavernosal injection therapy and vacuum devices, referring patients when necessary to urologic surgeons for penile prosthesis insertion.
Written informed consent was taken from the subjects and approval was obtained from the Institutional ethical committee blood pressure chart youth discount zestril 5 mg fast delivery. Procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) heart attack neck pain generic 10mg zestril otc. Parameters Measured: Autonomic function tests were employed to evaluate the integrity of both parasympathetic and sympathetic innervations of the heart in all the groups blood pressure bottom number is high order zestril 10mg visa. In previous researches it has been found that both arrhythmia 16 year old purchase zestril 2.5mg online, parasympathetic as well as sympathetic divisions have been found to be affected in the adult obese population as compared to the non- obese adult population. Wu J et al compared autonomic dysfunction in underweight, normal weight, overweight and obese adults. Chronic hypoxemia seems to play a role in sympathetic activation, even in healthy subjects. Furthermore, in several studies we found that irrespective of the stages of the disease, underweight was an independent risk factor for cardiovascular complication and mortality. Limitations of the Study: Our study was constrained by the small size of the sample available. Conflict of Interest: the authors do not have any conflicts of interest to declare. Acknowledgement: the authors acknowledge all the technical help rendered by the lab technicians. Cardiovascular autonomic neuropathy in chronic obstructive pulmonary disease, Respir Med. Cardiovascular autonomic nerve function in patients with hypoxaemic chronic obstructive pulmonary disease. Autonomic nervous system activity in obese subjects before and after caloric restriction. The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies. P Obesity is an independent risk factor for cardiovascular disease: a 26-years follow up of participants in the Framingham Heart Study. Cigarette smoking as a confounder of the relationship between relative weight and long term mortality. B Obesity and Effect of Exercise Program in Reducing Risk of Fall in Elderly People Indian Journal of Public Health Research & Development, January 2020, Vol. Pawar1 Year, 2Assistant Professor, 3Professor, Faculty of Physiotherapy, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India 1Final Abstract Objective: to study the Effect of Exercise Program in reducing risk of fall in elderly subject. Materials and Method: Total 30 elderly subjects(10 males and 20 females) aged above 60 years were having problem with flexibility, balance and high risk of fall were selected for the assessment of their flexibility, gait and balance. Outcome measures used were Morse fall risk assessment tool, Timed up and go test, Functional reach test, Functional gait assessment. Conclusion: the present study provided evidence to conclude that the exercise programme was significantly effective in improving strength, flexibility and balance along with reducing risk of fall in elderly population. Introduction Fall is defined as unintentionally coming to rest on the ground or other level with or without consciousness. Balance in elderly is affected by both diseases as well as age related issues along with problems like cognitive impairment, various medications and environmental changes all appear to contribute to the increase risk of falls. It has various physical, medical, psychological, social and economic consequences. This include disability and deformity,fear of repeated falls,direct costs of medical care associated with injuries and loss of potential income. The environment is perceived to play an significant role in falls experienced by the elderly population. Multiple changes in different systems of body contribute to change in walking pattern in elderly. Body mechanics are altered starting with flexed trunk posture, decreased hip extension in mild to late stance, decreased ankle plantar flexion at power push off and movement control is disturbed like reduced rate of forward momentum, stride length and time variability, and timing issues, and difficulty in transitioning from stance to swing. Reduced hip extension causes blocking of the mechanical accumulation of potential energy in the limb tissue during stance phase with release during swing to fuel the limb forward movement, while also eliminating the hip extension.
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