Botulinum Toxin Injection for the Treatment of Premature Ejaculation
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1) Botulinum toxin A (Btx-A) injection into the bulbospongiosus muscle (BSM) was found to significantly lengthen the latency time to ejaculation in rats compared to placebo, suggesting Btx-A may be an effective treatment for premature ejaculation (PE) in humans. 2) A clinical trial was proposed to study Btx-A injection for lifelong PE but was declined by Allergan due to concerns about supporting an unlicensed use of their product. 3) Further research is still needed but Btx-A injection shows promise as a treatment for PE that may avoid the side effects of current options like topical anesthetics or antidepressants.
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THE ART OF NON SURGICAL SKIN REJUVENATION. MULTIPLE APPROACHES
The sudden explosion in recent years of nonsurgical
rejuvenative techniques is patient-driven. The modern
patient, man or woman, desires quick, safe and pre-
dictable nonsurgical techniques that will confer some
form of facial rejuvenation and at the same time allow
them to get back to work or their social lives with a
minimum of downtime. By that is meant a modicum
of bruising and swelling for 2–3 days (i.e., over a week-
end) and not the 2–4 weeks of downtime and scars
that often accompany open surgical techniques.
Whilst nonsurgical techniques are not a substitute
for traditional rejuvenative surgery, the combination
of several nonsurgical tools and procedures has be-
come a powerful adjunct to or a temporizing substi-
tute for open surgery.
Dermal filler sminar
Based on longevity: Temporary, Semipermanent, Permanent,
Based on site of placement
Dermal
Subdermal
Supraperiosteal
Based on origin of filler material
Heterografts:
(a) Bovine collagen-(1) zyderm 1 and 2
(2)zyplast
(3)restoplast
(4)artecoll
(b) Hyaluronic acid derivative implant-(1) restylane
(2) perlane
(3) hylaform
(4)dermalive
(5)reviderm intra
(c) Porcine collagen- (1) permacol
(2) fibrel
Allografts : human derived collagen
(a) dermalogen
(b) alloderm
(c) cosmoderm
Autograft: (a) autologous fat
(b) autologous collagen
Synthetic material: (a) polytetrafluoroethylene
(b) silicone
(c) biopolymer 3
(d) bioplastique
Botulinum toxin in dermatology ppt
This document provides a historical overview and detailed information on botulinum toxin (BTX), including:
- Its discovery in the early 19th century by Justinus Kerner who identified botulism from sausage poisoning.
- Isolation of the Clostridium botulinum bacterium in 1895 and use of botulinum toxin to treat human disease beginning in 1980.
- FDA approval of Botox Cosmetic in 2002 for frown lines and additional approvals through 2004.
- Mechanism of action whereby BTX blocks acetylcholine release at neuromuscular junctions.
- Commercial preparations of botulinum toxin serotype A and approved therapeutic uses in medical conditions and for cosmetic purposes.
Acne vulgaris - COSMETIC
Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units
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This document outlines the following information for this unit:
Learning Outcomes
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Indicative Content
BOTOX - Botulinum toxin in aesthesis
Botulinum toxin is produced by Clostridium botulinum bacteria. It works by blocking the release of acetylcholine at neuromuscular junctions, preventing muscle contraction. It has been used since the 1980s to treat medical conditions involving muscle overactivity like strabismus and dystonia. In the 1990s, its use was explored for cosmetic purposes to reduce facial wrinkles. The FDA approved its use for frown lines in 2002 and excessive underarm sweating in 2004. It is injected into specific facial muscles to weaken them and smooth wrinkles. Common sites include the glabella, forehead, crow's feet, bunny lines, marionette lines and platysmal bands. Potential complications include
Botox and Dermal Fillers - Impressiosmedispa
This document provides information about Botox and dermal fillers for cosmetic treatments. As we age, collagen and elastin in the skin decrease, causing fine lines and wrinkles to form as the skin loses volume and hyaluronic acid. Botox temporarily relaxes muscles to smooth wrinkles while dermal fillers containing hyaluronic acid or calcium lift and restore volume. Botox effects last 3-5 months while fillers last 6-18 months. The document also gives details on treatments available at a medical spa in Fairfax, Virginia using natural fillers and Botox injections to prevent expression lines.
Chemical Peel.pptx
Chemical peels are a method of skin resurfacing that uses irritant chemicals to accelerate skin exfoliation and renewal. There are different types and depths of chemical peels depending on the agent used and its concentration. Superficial peels treat the epidermis using mild acids like glycolic, salicylic, or lactic acid. Medium peels reach the papillary dermis using stronger acids like higher concentrations of TCA. Deeper peels penetrate the reticular dermis and carry higher risks. Proper patient assessment, preparation, application technique and post-care are required for safe and effective chemical peels.
Recommended
THE ART OF NON SURGICAL SKIN REJUVENATION. MULTIPLE APPROACHES
The sudden explosion in recent years of nonsurgical
rejuvenative techniques is patient-driven. The modern
patient, man or woman, desires quick, safe and pre-
dictable nonsurgical techniques that will confer some
form of facial rejuvenation and at the same time allow
them to get back to work or their social lives with a
minimum of downtime. By that is meant a modicum
of bruising and swelling for 2–3 days (i.e., over a week-
end) and not the 2–4 weeks of downtime and scars
that often accompany open surgical techniques.
Whilst nonsurgical techniques are not a substitute
for traditional rejuvenative surgery, the combination
of several nonsurgical tools and procedures has be-
come a powerful adjunct to or a temporizing substi-
tute for open surgery.
Dermal filler sminar
Based on longevity: Temporary, Semipermanent, Permanent,
Based on site of placement
Dermal
Subdermal
Supraperiosteal
Based on origin of filler material
Heterografts:
(a) Bovine collagen-(1) zyderm 1 and 2
(2)zyplast
(3)restoplast
(4)artecoll
(b) Hyaluronic acid derivative implant-(1) restylane
(2) perlane
(3) hylaform
(4)dermalive
(5)reviderm intra
(c) Porcine collagen- (1) permacol
(2) fibrel
Allografts : human derived collagen
(a) dermalogen
(b) alloderm
(c) cosmoderm
Autograft: (a) autologous fat
(b) autologous collagen
Synthetic material: (a) polytetrafluoroethylene
(b) silicone
(c) biopolymer 3
(d) bioplastique
Botulinum toxin in dermatology ppt
This document provides a historical overview and detailed information on botulinum toxin (BTX), including:
- Its discovery in the early 19th century by Justinus Kerner who identified botulism from sausage poisoning.
- Isolation of the Clostridium botulinum bacterium in 1895 and use of botulinum toxin to treat human disease beginning in 1980.
- FDA approval of Botox Cosmetic in 2002 for frown lines and additional approvals through 2004.
- Mechanism of action whereby BTX blocks acetylcholine release at neuromuscular junctions.
- Commercial preparations of botulinum toxin serotype A and approved therapeutic uses in medical conditions and for cosmetic purposes.
Acne vulgaris - COSMETIC
Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units
Unit 7: Principles of Dermal Filler Use in Aesthetic Medicine
This document outlines the following information for this unit:
Learning Outcomes
Assessment Criteria and Assessment Method
Indicative Content
BOTOX - Botulinum toxin in aesthesis
Botulinum toxin is produced by Clostridium botulinum bacteria. It works by blocking the release of acetylcholine at neuromuscular junctions, preventing muscle contraction. It has been used since the 1980s to treat medical conditions involving muscle overactivity like strabismus and dystonia. In the 1990s, its use was explored for cosmetic purposes to reduce facial wrinkles. The FDA approved its use for frown lines in 2002 and excessive underarm sweating in 2004. It is injected into specific facial muscles to weaken them and smooth wrinkles. Common sites include the glabella, forehead, crow's feet, bunny lines, marionette lines and platysmal bands. Potential complications include
Botox and Dermal Fillers - Impressiosmedispa
This document provides information about Botox and dermal fillers for cosmetic treatments. As we age, collagen and elastin in the skin decrease, causing fine lines and wrinkles to form as the skin loses volume and hyaluronic acid. Botox temporarily relaxes muscles to smooth wrinkles while dermal fillers containing hyaluronic acid or calcium lift and restore volume. Botox effects last 3-5 months while fillers last 6-18 months. The document also gives details on treatments available at a medical spa in Fairfax, Virginia using natural fillers and Botox injections to prevent expression lines.
Chemical Peel.pptx
Chemical peels are a method of skin resurfacing that uses irritant chemicals to accelerate skin exfoliation and renewal. There are different types and depths of chemical peels depending on the agent used and its concentration. Superficial peels treat the epidermis using mild acids like glycolic, salicylic, or lactic acid. Medium peels reach the papillary dermis using stronger acids like higher concentrations of TCA. Deeper peels penetrate the reticular dermis and carry higher risks. Proper patient assessment, preparation, application technique and post-care are required for safe and effective chemical peels.
Acne scar treatment
Acne scarring can be classified as icepick, boxcar, or rolling scars based on their width, depth, and architecture. Treatment options include topical agents, superficial and medium-depth peels, dermabrasion, fillers, fat transfer, needling, fractional photothermolysis, and surgical techniques like excision, grafting, and subcision. Superficial peels improve boxcar scars but may require multiple sessions. Dermabrasion is effective for acne scars but requires proper patient selection and technique. Fillers and fat transfer work best for atrophic depressed scars. Needling induces collagen without damage to induce healing. Surgical techniques are best for deep
Topical Prepartions in dermatology
Topical medications are applied directly to the skin and are designed to achieve high drug concentrations in the skin with minimal systemic exposure. Some key points:
1) The skin is the largest organ of the body and topical absorption depends on the formulation and site of application, with the scrotum and forehead having the highest absorption.
2) Topical formulations include liquids, semisolids, and solids designed for different applications depending on the condition of the skin.
3) When prescribing topical medications, clinicians should specify the concentration, vehicle, application frequency, and quantity to maximize effectiveness and avoid side effects or overuse.
Botulinum toxin
Botulinum toxin is a neurotoxin produced by Clostridium botulinum bacteria. It is commonly known as Botox or Dysport. While initially investigated for medical uses in the 1890s-1960s, it was not approved for use in humans in the United States until 1973 or in Spain until 2004. Botulinum toxin is now frequently used for facial remodelling by paralyzing muscles that cause wrinkles, and has other applications such as treating migraines and excessive sweating.
PDO Thread Lift
Pdo thread lift
PDO Thread Lift is a popular non-surgical skin lifting treatment carried out by many doctors
Thread lifting is a procedure that works to tackle sags and folds. The procedure is becoming more popular than ever before as demand grows for skin care where less is more.
Cutis PDO thread lift is a procedure that involves the insertion of a blunt-tip cannula with a very fine absorbable polydioxanone threads into the skin or the subcutaneous fat of the specific areas to be treated.For more information, you can book an appointment at
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Dermal fillers
Derma fillers are gel like substances that are injected beneath the skin to restore lost volume,smooth lines and soften creases, or enhance facial contours.They can be used as "volumizers" plumping and lifting cheeks,chins,jawlines and temples, filling out thin lips.Mostly Hylarudonic acid fillers like Juvederm are used.The procedure takes around 30-45 minutes and patients can see results in about 10 days-2weeks.
Derma Fillers are done at Dr Sachdeva's Dental clinic and Facial aesthetic centre in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Painless hair removal
If you're not happy with shaving, tweezing, or waxing to remove unwanted hair, laser hair removal may be an option worth considering.
It beams highly concentrated light into hair follicles. Pigment in the follicles absorb the light. That destroys the hair.
Dr Sachdeva’s Dental ,Aesthetic And Implant Institute is one of the leading clinics in Delhi offering laser hair removal . So hurry up and book an appointment with us Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Acne
This document summarizes guidelines for treating acne vulgaris. It begins by reviewing the pathogenesis and types of acne. It then outlines a treatment approach including topical retinoids, antibiotics, and oral medications like isotretinoin. Specific recommendations are provided for treating comedonal, papulopustular, and nodulocystic acne. Education on proper application and expected timelines is also covered.
Face lift without surgery
facelift without surgery can be done by
Botox
ultherapy
laser
threadlifts
LED
laser skin resurfacing
fillers
All these are age defying non surgical facelift alternatives
No risk of surgery is involved.These treatments encourages increased collagen production or remodelling of existing collagen.Supportive underlying tissues of the skin contract,resulting in tighter,more uplifted appearance of the skin.
Dr Sachdeva's Dental clinic and Facial aesthetic centre is one of the leading clinics performing facelift without surgery in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Chemical peels
Chemical peels are used to improve and smooth the texture of skin by removing the outermost layer of skin.They can reduce freckles, age spots, dark patches and can give you a nourished and healthy skin.
Various peels can be used according to your requirements like glycolic acid, salicylic acid, lactic acid or carbolic acid.You will need to avoid sun for around 1 month and a little swelling might occur post treatment.They are ideal treatments for people with fair skin but shows good results even in people with dark skin.
Chemical peeling is done at Dr Sachdeva's Dental clinic and Facial aesthetic centre in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
How to Treat Hyperpigmentation
The key to effectively treating hyperpigmentation is finding the right product for your sensetive skin. Visit askderm.com to find products that will leave you feling like new!
Cog | Face Lift Surgery
As age advances, Connective Tissue becomes thinner, collagen and elastin breakdown and results into wrinkles.
PDO is Thread Lift Therapy, where thread will form an integral support structure for tissue of face due to Collagen Synthesis.
MONO; COG: Crew Threads are three types of PDO thread.
COG Thread are designed to anchor more firmly within the skin as it consist of barbs.
COGS provide immediate face lifting effect, helps in producing brighter skin tone and rejuvenate the skin.
Call us regarding Facial aesthetic :-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
Follow us here:-
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Learn more:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
Botox:use in facial plastics
Botulinum toxin A is used for both cosmetic and dermatological indications to temporarily improve the appearance of wrinkles and lines. It works by blocking the release of acetylcholine at the neuromuscular junction, preventing muscle contraction. Common areas treated include the glabellar region, forehead, crow's feet, and bunny lines. Proper injection technique and dosage tailored to the individual are important to achieve the desired aesthetic results while avoiding complications.
Minimally Invasive Techniques In Facial Rejuvenation
In this presentation Naheed R. Abbasi, MD, MPH, FAAD, Summit Medical Group Department of Dermatology, shares how an understanding of the skin helps to identify technologies most likely to be effective in improving pigment, lines, volume loss and skin laxity. Dr. Abbasi explains numerous minimally invasive technologies available that pose minimal risk and produce little downtime and how surgery can be avoided or postponed through less invasive techniques.
Woundhealing drneerajjain
The document discusses wound healing and its three phases: inflammatory, proliferative, and remodeling. It defines wound healing and the two processes of tissue regeneration and scar formation. The inflammatory phase involves hemostasis, recruitment of inflammatory cells, and late events like lymphocyte and mast cell entry. The proliferative phase involves granulation tissue formation, angiogenesis, contraction, and epithelialization. Remodeling involves the formation of new collagen to increase tensile strength over months. Factors influencing healing and potential complications are also outlined.
Management of Acne
Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units
Acne can present as noninflammatory lesions, inflammatory lesions, or a mixture of both,
affecting mostly the FACE but also the back and chest.
surgical management of acne scars
This document discusses various dermatosurgical procedures for acne scars. It begins by explaining the pathogenesis of acne scars, including inflammation, granulation tissue formation, and matrix remodeling. It then classifies acne scars and discusses various surgical procedures like microneedling, subcision, punch techniques, TCA cross, and dermal grafting to treat different scar types. The document provides details on how to perform each procedure and considerations for pre-operative assessment and post-operative care. It concludes by discussing resurfacing techniques like chemical peels, dermabrasion, lasers, and fractional photothermolysis to further treat acne scarring.
Botulinum toxin use in dermatology
Botulinum toxin is produced by Clostridium botulinum bacteria. It inhibits the release of acetylcholine at neuromuscular junctions, causing flaccid paralysis. There are 7 serotypes of botulinum toxin, with types A and B approved for medical use. Botulinum toxin is used cosmetically to weaken muscles that cause wrinkles, including frown lines, crow's feet, and forehead lines. It is injected into specific muscles under the skin following consultation and testing to determine appropriate dosing. Potential side effects include localized bruising, drooping eyelids, and muscle weakness.
Protocolo y Fichas de Evaluación (1).pdf
El documento presenta un protocolo para realizar peelings salicílicos para el tratamiento del acné. Describe las etapas del procedimiento incluyendo la evaluación de la piel, limpieza facial, aplicación del ácido salicílico al 10%, soluciones posteriores para desinflamar y regenerar la piel, así como la hidratación y protección posterior. Los peelings de ácido salicílico son efectivos para todos los tipos de acné al eliminar células muertas y descongestionar los poros.
The era of non surgical beautification
Aesthetic treatments allow people to look better, feel fresher and attain a new found confidence in their lives. “Tightness, freshness and liveliness are the elements that we always see on a young face.
Non-surgical facial rejuvenation is a phrase that describes cosmetic treatment that addresses all the aspects of the ageing process without surgical methods.
Dr Sachdeva’s Facial Aesthtic Institute is unique as it caters to the whole spectrum of anti-ageing, from prevention to surgical treatment. These unique procedures help in exfoliating, toning, tightening and moisturizing the skin. These are enough in early stages to keep the skin from ageing, while dietary advice and regular detox nourishes the skin from inside.
So hurry up and come book an appointment with us at Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Threadlift pp anti aging
The document discusses Fine Thread Contour (F.T.C.), a cosmetic technique that lifts and tightens sagging skin using bio-absorbable and antimicrobial filament threads. F.T.C. stimulates collagen production to instantly lift the face and body contours, resulting in a more youthful complexion. It has minimal downtime, little pain, and is safe and effective for wrinkles, lifting, firming, shaping, and tightening various areas of the face and body. The technique involves inserting thin threads into the dermis to trigger wound healing and collagen production without surgery or permanent threads.
Role of pelvic floor in male sexual dysfunction
The document discusses the role of the male pelvic floor (MPF) in male sexual dysfunction. It begins with an introduction on the prevalence of male sexual dysfunctions like erectile dysfunction (ED), ejaculatory dysfunction (EjD), and chronic pelvic pain/chronic prostatitis (CP/CPPS). It then covers the anatomy and physiology of the MPF, explaining its role in urination, erection, and ejaculation. Subsequent sections discuss how MPF dysfunction may contribute to ED, EjD/orgasmic dysfunction, and CP/CPPS. The document concludes that MPF therapy shows promise in treating some male sexual dysfunctions and more research is still needed.
Ejaculatory disorders
This document discusses ejaculatory disorders and provides definitions and classifications of different types. It focuses on delayed ejaculation (DE), defining it as either a marked delay in ejaculation or absence of ejaculation in 75-100% of sexual encounters for at least 6 months, causing distress. DE can be psychogenic, due to anatomical issues, congenital problems, neurological conditions, infections, endocrine abnormalities, or medications. Masturbation habits may also play a role in some cases of DE.
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Acne scar treatment
Acne scarring can be classified as icepick, boxcar, or rolling scars based on their width, depth, and architecture. Treatment options include topical agents, superficial and medium-depth peels, dermabrasion, fillers, fat transfer, needling, fractional photothermolysis, and surgical techniques like excision, grafting, and subcision. Superficial peels improve boxcar scars but may require multiple sessions. Dermabrasion is effective for acne scars but requires proper patient selection and technique. Fillers and fat transfer work best for atrophic depressed scars. Needling induces collagen without damage to induce healing. Surgical techniques are best for deep
Topical Prepartions in dermatology
Topical medications are applied directly to the skin and are designed to achieve high drug concentrations in the skin with minimal systemic exposure. Some key points:
1) The skin is the largest organ of the body and topical absorption depends on the formulation and site of application, with the scrotum and forehead having the highest absorption.
2) Topical formulations include liquids, semisolids, and solids designed for different applications depending on the condition of the skin.
3) When prescribing topical medications, clinicians should specify the concentration, vehicle, application frequency, and quantity to maximize effectiveness and avoid side effects or overuse.
Botulinum toxin
Botulinum toxin is a neurotoxin produced by Clostridium botulinum bacteria. It is commonly known as Botox or Dysport. While initially investigated for medical uses in the 1890s-1960s, it was not approved for use in humans in the United States until 1973 or in Spain until 2004. Botulinum toxin is now frequently used for facial remodelling by paralyzing muscles that cause wrinkles, and has other applications such as treating migraines and excessive sweating.
PDO Thread Lift
Pdo thread lift
PDO Thread Lift is a popular non-surgical skin lifting treatment carried out by many doctors
Thread lifting is a procedure that works to tackle sags and folds. The procedure is becoming more popular than ever before as demand grows for skin care where less is more.
Cutis PDO thread lift is a procedure that involves the insertion of a blunt-tip cannula with a very fine absorbable polydioxanone threads into the skin or the subcutaneous fat of the specific areas to be treated.For more information, you can book an appointment at
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Dermal fillers
Derma fillers are gel like substances that are injected beneath the skin to restore lost volume,smooth lines and soften creases, or enhance facial contours.They can be used as "volumizers" plumping and lifting cheeks,chins,jawlines and temples, filling out thin lips.Mostly Hylarudonic acid fillers like Juvederm are used.The procedure takes around 30-45 minutes and patients can see results in about 10 days-2weeks.
Derma Fillers are done at Dr Sachdeva's Dental clinic and Facial aesthetic centre in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Painless hair removal
If you're not happy with shaving, tweezing, or waxing to remove unwanted hair, laser hair removal may be an option worth considering.
It beams highly concentrated light into hair follicles. Pigment in the follicles absorb the light. That destroys the hair.
Dr Sachdeva’s Dental ,Aesthetic And Implant Institute is one of the leading clinics in Delhi offering laser hair removal . So hurry up and book an appointment with us Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Acne
This document summarizes guidelines for treating acne vulgaris. It begins by reviewing the pathogenesis and types of acne. It then outlines a treatment approach including topical retinoids, antibiotics, and oral medications like isotretinoin. Specific recommendations are provided for treating comedonal, papulopustular, and nodulocystic acne. Education on proper application and expected timelines is also covered.
Face lift without surgery
facelift without surgery can be done by
Botox
ultherapy
laser
threadlifts
LED
laser skin resurfacing
fillers
All these are age defying non surgical facelift alternatives
No risk of surgery is involved.These treatments encourages increased collagen production or remodelling of existing collagen.Supportive underlying tissues of the skin contract,resulting in tighter,more uplifted appearance of the skin.
Dr Sachdeva's Dental clinic and Facial aesthetic centre is one of the leading clinics performing facelift without surgery in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Chemical peels
Chemical peels are used to improve and smooth the texture of skin by removing the outermost layer of skin.They can reduce freckles, age spots, dark patches and can give you a nourished and healthy skin.
Various peels can be used according to your requirements like glycolic acid, salicylic acid, lactic acid or carbolic acid.You will need to avoid sun for around 1 month and a little swelling might occur post treatment.They are ideal treatments for people with fair skin but shows good results even in people with dark skin.
Chemical peeling is done at Dr Sachdeva's Dental clinic and Facial aesthetic centre in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
How to Treat Hyperpigmentation
The key to effectively treating hyperpigmentation is finding the right product for your sensetive skin. Visit askderm.com to find products that will leave you feling like new!
Cog | Face Lift Surgery
As age advances, Connective Tissue becomes thinner, collagen and elastin breakdown and results into wrinkles.
PDO is Thread Lift Therapy, where thread will form an integral support structure for tissue of face due to Collagen Synthesis.
MONO; COG: Crew Threads are three types of PDO thread.
COG Thread are designed to anchor more firmly within the skin as it consist of barbs.
COGS provide immediate face lifting effect, helps in producing brighter skin tone and rejuvenate the skin.
Call us regarding Facial aesthetic :-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
Follow us here:-
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
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• Linkedin link: https://goo.gl/PrPgpB
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Learn more:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
Botox:use in facial plastics
Botulinum toxin A is used for both cosmetic and dermatological indications to temporarily improve the appearance of wrinkles and lines. It works by blocking the release of acetylcholine at the neuromuscular junction, preventing muscle contraction. Common areas treated include the glabellar region, forehead, crow's feet, and bunny lines. Proper injection technique and dosage tailored to the individual are important to achieve the desired aesthetic results while avoiding complications.
Minimally Invasive Techniques In Facial Rejuvenation
In this presentation Naheed R. Abbasi, MD, MPH, FAAD, Summit Medical Group Department of Dermatology, shares how an understanding of the skin helps to identify technologies most likely to be effective in improving pigment, lines, volume loss and skin laxity. Dr. Abbasi explains numerous minimally invasive technologies available that pose minimal risk and produce little downtime and how surgery can be avoided or postponed through less invasive techniques.
Woundhealing drneerajjain
The document discusses wound healing and its three phases: inflammatory, proliferative, and remodeling. It defines wound healing and the two processes of tissue regeneration and scar formation. The inflammatory phase involves hemostasis, recruitment of inflammatory cells, and late events like lymphocyte and mast cell entry. The proliferative phase involves granulation tissue formation, angiogenesis, contraction, and epithelialization. Remodeling involves the formation of new collagen to increase tensile strength over months. Factors influencing healing and potential complications are also outlined.
Management of Acne
Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units
Acne can present as noninflammatory lesions, inflammatory lesions, or a mixture of both,
affecting mostly the FACE but also the back and chest.
surgical management of acne scars
This document discusses various dermatosurgical procedures for acne scars. It begins by explaining the pathogenesis of acne scars, including inflammation, granulation tissue formation, and matrix remodeling. It then classifies acne scars and discusses various surgical procedures like microneedling, subcision, punch techniques, TCA cross, and dermal grafting to treat different scar types. The document provides details on how to perform each procedure and considerations for pre-operative assessment and post-operative care. It concludes by discussing resurfacing techniques like chemical peels, dermabrasion, lasers, and fractional photothermolysis to further treat acne scarring.
Botulinum toxin use in dermatology
Botulinum toxin is produced by Clostridium botulinum bacteria. It inhibits the release of acetylcholine at neuromuscular junctions, causing flaccid paralysis. There are 7 serotypes of botulinum toxin, with types A and B approved for medical use. Botulinum toxin is used cosmetically to weaken muscles that cause wrinkles, including frown lines, crow's feet, and forehead lines. It is injected into specific muscles under the skin following consultation and testing to determine appropriate dosing. Potential side effects include localized bruising, drooping eyelids, and muscle weakness.
Protocolo y Fichas de Evaluación (1).pdf
El documento presenta un protocolo para realizar peelings salicílicos para el tratamiento del acné. Describe las etapas del procedimiento incluyendo la evaluación de la piel, limpieza facial, aplicación del ácido salicílico al 10%, soluciones posteriores para desinflamar y regenerar la piel, así como la hidratación y protección posterior. Los peelings de ácido salicílico son efectivos para todos los tipos de acné al eliminar células muertas y descongestionar los poros.
The era of non surgical beautification
Aesthetic treatments allow people to look better, feel fresher and attain a new found confidence in their lives. “Tightness, freshness and liveliness are the elements that we always see on a young face.
Non-surgical facial rejuvenation is a phrase that describes cosmetic treatment that addresses all the aspects of the ageing process without surgical methods.
Dr Sachdeva’s Facial Aesthtic Institute is unique as it caters to the whole spectrum of anti-ageing, from prevention to surgical treatment. These unique procedures help in exfoliating, toning, tightening and moisturizing the skin. These are enough in early stages to keep the skin from ageing, while dietary advice and regular detox nourishes the skin from inside.
So hurry up and come book an appointment with us at Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Threadlift pp anti aging
The document discusses Fine Thread Contour (F.T.C.), a cosmetic technique that lifts and tightens sagging skin using bio-absorbable and antimicrobial filament threads. F.T.C. stimulates collagen production to instantly lift the face and body contours, resulting in a more youthful complexion. It has minimal downtime, little pain, and is safe and effective for wrinkles, lifting, firming, shaping, and tightening various areas of the face and body. The technique involves inserting thin threads into the dermis to trigger wound healing and collagen production without surgery or permanent threads.
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Minimally Invasive Techniques In Facial Rejuvenation
Minimally Invasive Techniques In Facial Rejuvenation
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Ejaculatory disorders
This document discusses ejaculatory disorders and provides definitions and classifications of different types. It focuses on delayed ejaculation (DE), defining it as either a marked delay in ejaculation or absence of ejaculation in 75-100% of sexual encounters for at least 6 months, causing distress. DE can be psychogenic, due to anatomical issues, congenital problems, neurological conditions, infections, endocrine abnormalities, or medications. Masturbation habits may also play a role in some cases of DE.
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Botox Injection is a commercially successful non-surgical cosmetic procedure, to gets rid of the deep wrinkles in the skin between eyebrows, of the forehead, of the corner of eyes. Effective for 3 - 4 months, and the procedure is repetitive in nature.
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Botulinum toxin is produced by Clostridium botulinum bacteria and is the most potent biological toxin. It has been used commercially for decades to treat medical conditions by blocking neurotransmitter release. Its use in ophthalmology began in the 1980s for strabismus and blepharospasm. It works by inhibiting acetylcholine release at neuromuscular junctions, causing temporary muscle paralysis. Common uses include blepharospasm, strabismus, dry eyes, elevated intraocular pressure, and nystagmus. Side effects are usually minor and temporary.
Botox® cosmetic show
Best facial cosmetic surgeons Best facial plastic surgeon Browlift Charlotte endoscopic brow lift Charlotte’s top facial plastic surgeon Facial plastic surgeons Facial plastic surgery Face lifts Facial mini-tuck Lip enhancement Lip augmentation Nose job Nose job cost Nose surgery Rhinoplasty Rhinoplasty Expert Rhinoplasty and teens Revision rhinoplasty Teen Rhinoplasty, Charlotte Teen Rhinoplasty, North Carolina Teen Rhinoplasty Expert Top rhinoplasty surgeons Best Charlotte rhinoplasty surgeons Most experienced rhinoplasty surgeons
SEM History - version 2017
Harry Schooley who taught History at SEM from 1967-2010 shares the History of the school with the freshmen history class.
Nonsurgical Facial Rejuvenation: Botox and Facial Fillers
An overview of injectable techniques of nonsurgical facial rejuvenation, focusing on Botox Cosmetic and Juvederm. Includes extensive before and after photographs.
Botulinum toxin in urology2
Botulinum toxin has been used in urology since the late 1980s. It works by blocking acetylcholine release at the neuromuscular junction, relaxing overactive bladder muscles. The document discusses botulinum toxin's mechanism of action, indications for overactive bladder, neurogenic conditions, pelvic pain, prostate issues, and pediatric incontinence. Potential side effects are typically minor and temporary, with the effects lasting 6-16 months before repeat treatment is needed.
Radio isotopes in surgery
This document discusses nuclear medicine, which uses radioactive tracers and imaging to diagnose and treat diseases. It describes how radionuclides emit radiation that can be detected externally to create images of internal organs and tissues. Some common medical uses are thyroid scans to evaluate nodules, bone scans to detect fractures or metastases, and myocardial perfusion scans to assess coronary artery disease. The document also outlines therapeutic applications like treating hyperthyroidism with radioactive iodine and precautions needed after such treatments.
Botox
El botox es una toxina botulínica descubierta en los años 70 y usada inicialmente para tratar el estrabismo. Bloquea la acción de la acetilcolina y relaja los músculos al frenar el impulso nervioso. Se usa principalmente para tratar arrugas faciales de expresión y tiene un margen de seguridad alto dado que se necesitan 2000 unidades para efectos tóxicos y solo 30-70 unidades para tratamientos cosméticos. Los efectos duran entre 4 a 5 meses y no se recomienda repetir el tratamiento antes de 3.
Botulinum toxin
Botulinum toxin is produced by Clostridium botulinum bacteria. It works by blocking the release of acetylcholine at neuromuscular junctions, preventing muscle contraction. There are several types of botulinum toxin, with type A (BTX-A) being the most widely used therapeutic agent. BTX-A is used to treat muscle spasticity and dystonia by temporarily weakening muscles via chemodenervation. Its applications in orthopedics include improving gait and limb function, preventing deformities, and reducing spasticity-related pain. Proper administration techniques like electrical stimulation are important for targeting specific muscles. Side effects are usually mild and local but precision is needed to avoid weakness
Nuclear medicine in nerphology
Nuclear imaging techniques can evaluate renal function and detect abnormalities. Radiotracers that are filtered, secreted, or retained by the kidneys provide information. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) are measured to assess kidney function. Obstructions are identified by delayed tracer excretion. Diuretic renography distinguishes dilated but unobstructed systems from true stenoses. Techniques require specialized cameras but provide functional details and separate evaluation of each kidney without invasive procedures.
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Premature ejaculation is a common male sexual dysfunction characterized by the inability to delay ejaculation and can cause distress. It is classified as lifelong or acquired and has prevalence rates ranging from 2-33% depending on age and region. While the exact etiology is unknown, potential contributing factors include anxiety, penile hypersensitivity, serotonin receptor dysfunction, and multifactorial biological and psychosocial influences. Diagnosis involves assessing ejaculation latency, distress levels, and ruling out other conditions. Treatment options include behavioral techniques, pharmacotherapy like SSRIs, and counseling with success rates over 85% depending on commitment to therapy. Prognosis is generally good but relapse can occur without ongoing management.
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Invited lecture by Dr Sujoy Dasgupta in the Webinar on "Sexual Dysfunction" organized by the BOGS (Bengal Obstetric and Gynaecological Society) and the Sexual Medicine Committee of FOGSI (federation of Obstetric and Gynaecological Societies of India) held in September, 2021
Premature ejaculation
Premature ejaculation is a common male sexual dysfunction characterized by the inability to delay ejaculation and can cause distress. It is classified as lifelong or acquired and has prevalence rates ranging from 2-33% depending on age and region. While the exact etiology is unknown, potential contributing factors include anxiety, penile hypersensitivity, serotonin receptor dysfunction. Treatment involves behavioral techniques like start-stop and squeeze methods as well as pharmacotherapy with SSRIs or topical anesthetics. Prognosis is generally good with most men achieving success with behavioral therapy alone or combined with medication, though some may require lifelong treatment or experience relapse.
5.Pr_.Droupy.LIFE2015.DAY2_.Session6.3.pdf
This document summarizes a presentation on ejaculatory dysfunction. It discusses the physiology of ejaculation, including the two phases of emission and expulsion. It then reviews various types of ejaculatory dysfunctions including anejaculation, retrograde ejaculation, delayed ejaculation, and premature ejaculation. The document discusses brain and spinal control of ejaculation and etiologies of dysfunction including surgery, drugs, spinal cord injury, and other causes. Management strategies for drug-induced sexual dysfunction and erectile dysfunction in spinal cord injury patients are also presented.
Dapoxetin
Dapoxetine is a selective serotonin reuptake inhibitor developed for the treatment of premature ejaculation. It has a rapid onset and short half-life allowing it to be taken on demand a few hours prior to intercourse. Phase 2 clinical trials found that dapoxetine doses of 30-60 mg significantly increased intravaginal ejaculatory latency time compared to placebo. Phase 3 trials involving over 4,000 men further demonstrated dapoxetine's efficacy and safety in the treatment of premature ejaculation. Dapoxetine is the first drug approved for on-demand treatment of premature ejaculation.
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Dr Clarence Lei Chang Moh
MMA Sabah
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This document provides an overview of premature ejaculation (PE). It begins by listing the moderators and their departments. It then discusses the definition of PE, prevalence rates, causes including genetic, neurological and other factors. Evaluation involves measuring intravaginal ejaculatory latency time (IELT). Treatments discussed include both medical options like SSRIs, tramadol, topical anesthetics as well as behavioral therapies and surgical options. PE is portrayed as a multifactorial condition with contributions from biological, psychological and relationship factors.
Male Sexual Dysfunction: Evaluation and Management by Dr Shahjada Selim
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Ejaculation involves three phases - emission, bladder neck contraction, and expulsion. Premature ejaculation (PE) is defined as ejaculation occurring within about 1 minute of penetration that the man has little control over, causing distress. The pathophysiology of PE is not fully understood but may involve genetic, psychological, hormonal, penile sensitivity, and prostatic factors. PE is diagnosed based on history and can be evaluated using tools like the Premature Ejaculation Diagnostic Tool. Treatment includes behavioral therapies like stop-start and squeeze techniques as well as pharmacotherapies.
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The document discusses sexual health issues for men undergoing cancer treatment. It notes that the World Health Organization defines sexual health as the integration of physical, emotional, intellectual and social aspects of sexual being. It then lists some of the most common sexual problems men with cancer face, such as lack of desire, erection issues, and pain during sex. It provides information on how cancer treatments like chemotherapy, radiation and surgery can impact sexual functioning and fertility. It also discusses options for addressing issues like erectile dysfunction through medications, devices, therapy or surgery.
Mechanical Devices for the Treatment of Premature Ejaculation
This document summarizes current treatments for premature ejaculation and discusses new treatment devices. It describes how botulinum toxin injections into the bulbospongiosus muscle have been shown to increase ejaculatory latency time in rats. A clinical trial also found botulinum toxin injections increased average intercourse duration in men. A new neuromuscular electrical stimulation device is being developed to contract the bulbospongiosus muscle during intercourse via electrical pulses, with the goal of immediately inhibiting ejaculation without drugs or surgery. Early feasibility studies found this device was able to delay ejaculation without adverse effects. Regulatory approval is planned in 2019. Transcutaneous posterior tibial nerve stimulation is also being studied as a potential non
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Postprostatectomy sexual dysfunction is restoring erections enough?
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ejaculatory disorders are always bothering. premature, delayed ejaculation, or anejaculation are all challenging both in diagnosis or treatment
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1. Define an electrocardiogram (ECG) and electrocardiography
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3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
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Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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- 1. A NOVEL APPROACH IN THE TREATMENT OF LIFELONG PREMATURE EJACULATION BOTULINUM TOXIN A INJECTION Ege C. Serefoglu, M.D.
- 2. Botulinum Toxin A Injection for PE • Physiology of Ejaculation • Premature Ejaculation (PE) • Ætiology • Treatment • Btx-A injection for PE
- 3. Physiology of Ejaculation • Constituted by 2 phases – Emmision: Ejection of the semen into the posterior urethra Contraction of testes, epididymes, VD, SV, prostate – Expulsion: Ejection of sperm from urethra REFLEX response to the presence of semen in BU Rhythmic contractions of perineal muscles (BS/IC)
- 5. Premature Ejaculation ◦ Cited as “the most common male sexual dysfunction” ◦ Affects 20 - 30% of sexually active men ◦ Diminished self-esteem, anxiety, embarrassment ◦ Partner dissatisfaction, interpersonal difficulty Porst et al. 2007;Symonds et al, 2003; Patrick et al. 2005
- 6. Porst et al. 2007 0 10 20 30 40 50 18-24 25-34 35-44 45-54 55-64 65-70Age group (yrs) Prevalence(%) PE The Premature Ejaculation Prevalence and Attitudes: Multi-National Survey 18% 23% 23% 24% 25% 20%
- 7. What is different in men with PE? PE “Normal” male sexual response Steep Excitement phase Short Plateau phase Rapid ejaculation and associated orgasm “PE” male sexual response Master & Johnson, 1970
- 8. Ætiology: Organic Theories • Penile hypersensitivity • Central 5-HT receptor sensitivity • Hyperexcitable ejaculatory reflex Colpi et al. 1996; Waldinger, et al. 1998; Waldinger 2002-2004
- 9. Ætiology: Organic Theories • Penile hypersensitivity – Reach ejaculatory threshold more rapidly – Lower ejaculatory threshold • Central 5-HT receptor sensitivity • Hyperexcitable ejaculatory reflex Colpi et al. 1996; Waldinger, et al. 1998; Waldinger 2002-2004
- 10. Ætiology: Organic Theories • Penile hypersensitivity • Central 5-HT receptor sensitivity –Lower 5-HT neurotransmission in PE –5-HT2C receptor hyposensitivity –5-HT1A receptor hypersensitivity –Genetic predisposition • Hyperexcitable ejaculatory reflex Colpi et al. 1996; Waldinger, et al. 1998; Waldinger 2002-2004
- 11. Ætiology: Organic Theories • Penile hypersensitivity • Central 5-HT receptor sensitivity • Hyperexcitable ejaculatory reflex – Faster emission and/or expulsion phase – Faster bulbocavernosus reflex Colpi et al. 1996; Waldinger, et al. 1998; Waldinger 2002-2004
- 12. Treatment • Penile hypersensitivity Topical anaesthetics* » interference with the spontaneity of having sex » Penile and vaginal hyposthesia / skin reactions • Central 5-HT receptor sensitivity Anti-depressants* – sexual dysfunctions, insomnia, fatigue, nausea, constipation – Poorly accepted by patients and partners • Hyperexcitable ejaculatory reflex Btx-A (?) – No side effects / No pills - creams / Spontenous sex * Unlicensed application
- 15. From: Allergan Medical Affairs Department [IR-MedicalAffairsResearch@Allergan.com] Sent: Monday, August 01, 2011 7:43 PM To: Hellstrom, Wayne J Subject: Decline Trial - Email - Trial ID#IIT-000344 RE: Trial ID: 000344 Title: Efficacy of Botulinum Toxin Type A for the Treatment of Life-Long Premature Ejaculation; A Randomized, Double-Blind, Placebo-Controlled Phase III Trial Dear Wayne Hellstrom, Thank you for your proposal entitled "Efficacy of Botulinum Toxin Type A for the Treatment of Life-Long Premature Ejaculation; A Randomized, Double-Blind, Placebo- Controlled Phase III Trial". We have reviewed your proposal and determined, unfortunately, that we are unable to support this trial. Should you have any further questions regarding this proposal, please contact me. Again, thank you for submitting your proposal to Allergan. Sincerely, Urology Therapeutic Area Manager
- 17. Effects of Btx-A Injection on Male Rat Ejaculatory Behavior • Long-Evans rats (33 males) • ~2 weeks to adapt to the light–dark cycle 1) Placebo: Saline injection (0.1 ml) 2) Low Dose: Botulinum toxin-A (0.5 U in 0.1 ml) 3) High Dose: Botulinum toxin-A (1 U in 0.1 ml)
- 21. Chan et al, 2010
- 22. BEFORE AFTER
- 23. The Effects of Btx-A Injection on Male Rat Ejaculatory Behavior 402,3 453,8 361,6 590,2 302,8 668 0 100 200 300 400 500 600 700 800 900 Pre-Inj Post-Inj Pre-Inj Post-Inj Pre-Inj Post-Inj Time(sec.) p=0.53 P=0.04* P=0.013* PLACEBO LOW-DOSE HIGH-DOSE * Paired-sample T-test
- 24. Conclusion • Btx-A injection into the BSM is a safe and effective treatment which can lengthen the latency time to ejaculate in rats, without suppressing sexual behavior. • Further studies are required to evaluate the therapeutic concept of this drug in PE patients.