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I found the answers provided by the Dr. Gourav Potfode to be very helpful. Let see jst start with medicine
It's realy a great experience to visit namoh clinic.doctor is very polite and friendly thank you doctor.
Very good doctor and clinic.Thank you Sir
I am a 21 year old guy and I am finding it very difficult to concentrate on my studies. Whenever I try to focus on my studies I easily get distracted and can't even sit for 5 minutes. I want some help regarding this.
Hi sir my penis is little bit bended even though I had sex with my gf but I think it uncomfortable for me and I did not like it, I remembering me always and I had major stress about it what can I do for it please gave me a solution.
When I ejaculate in my wife all liquid come out from vagina. Is it normal? Or my semen is not going inside and it will create problem in conceiving? I am worried. please help.
I have severe hair fall since 10 to 15 years, hair is very weak, it falls even when combing gently with a very wide toothed comb,
Sir My sugar level is 140/290. I take glimisave M1 tablet twice daily. I take antidepressant for anxiety and depression. My sugar levels causing me indigestion gases pain in legs back and erectile dysfunction .i want to get ayurvedic treatment for sugar and indigestion.
Sir I am addicted to inhale whitener. Before I do not fell any thing like this time. Now from 2/3 days I am feeling that my body is divided in 2 part means every time I fell that in my body there was 2 peoples. When I see any thing constantly in front me every thing become black and only that particular thing is visible by me. And the biggest problem is that I can not sleep in night time when I close my eyes to sleep I fell someone telling me to open or eyes and see any thing but do not close the eye in morning time even I sleep I do not remember please help me.
Did my thyroid profile test and found T3, T4, ft3, and ft4 levels in normal range but tsh levels are high around 9. Taking thyronorm 25 mcg daily one tablet. Also suffers from hail fall, excess weight, dry skin (face skin us oily) and fatigue.
I want to loose my weight and I have low back pain continuously. In April 2017, I get my 4th delivery with lscs. I have hair fall also. Daily I'm soo tired and I feeding my baby boy also he is 4 months now.
My baby have 7 month old and today he have some red spot on her body also she very lazy now a days. Before 10 she had fever and cold.
I am suffering from premature ejaculation for 2 year. My wife is unhappy for this problem. So kindly tell me how to solve this problem permanently.
What will be the effect of masturbating more than 6 times in a month. Will it be harmful when I want my wife to conceive a baby.
Ashwgandha Tablet kya har mausam me le sakte hai Mai energy aur tanav Kam Karne ke liye lena Chahta Hu aur sexual weakness ke liye Mera pet Hameshs gadbad rahta hai kya iske sevan se pet par koi prabhav padta hai Jaise loose motion.
My mom has a problem of gas due to which she does not eat properly and she is also nervous and there is heaviness on her head due to which she is very upset.
Hello mam I am from Hyderabad. I am suffering from varicocele (I get pain on my left side testicles). Which has been causing fertility problem. I have undergone treatment were doctors told that the blood has been clot at my left testicles. Is homeopathy really works and what is the medicine and how to Time it takes to cure.
Penile Doppler in erectile dysfunction:
Penile Doppler (papaverine induced colour duplex Doppler) is an excellent and highly accurate means of assessing patients with erectile dysfunction.
Penile erection is a result of complex interaction between nervous, arterial, venous and sinusoidal systems. Any defect in one of these links can lead to erectile dysfunction.
Psychological factors (mental impulse) causes transmission of parasympathetic impulses to the penis. This causes relaxation of arterioles and corpora cavernosa sinusoids. As the sinusoidal spaces start filling, corporal veno-occlusive mechanism activates, ad fibrous tunica albuginea compresses the emissary veins of corpora, and rigid erection is achieved.
- psychogenic (~10%)
- endocrine disorders
- arteriogenic impotence (~30%)
- peripheral vascular disease
- venogenic impotence (~15%)
- penile venous insufficiency
- combined arteriogenic and venogenic (~10%)
- morphological penile abnormalities
- Peyronie's disease
- ACE inhibitors
- excessive alcohol and smoking
Angiography with selective internal iliac angiography is the gold standard for arteriogenic impotence. However, it is invasive and not recommended for screening or primary diagnosis.
Penile doppler procedure
Procedure should be explained in detail prior to the examination. It is advisable to stop smoking 3 days prior to examination. A proper drug history and cardiac status should be inquired.
High frequency transducer (7.5-9.0 MHz) is used for penile doppler examination. Patient is placed in supine position and penis is positioned in its anatomical position along the anterior abdominal wall. Doppler angle is set at 30-60 degrees.
Pre-injection measurements: inner diameter of cavernosal artery (normal value is 0.3-0.5 mm), baseline peak systolic velocity and end diastolic velocity.
60 mg of papaverine (2 ml ampoule of 30 mg/ml) is injected intracavernosally. 10-15 micrograms of PGE1 can also be injected. Combination of papaverine and phentolamine may also be used.
Corpora cavernosa is localized as two well defined oval compartments with central cavernosal artery on both sides of bulbus spongiosa (urethra is in center of bulbus spongiosa). Insulin syringe is used for injection under sonographic guidance.
Post injection measurements (at 5, 10, 15, 20 minutes): inner diameter of cavernosal artery (normal value is 0.6-1.0 mm), peak systolic velocity, end diastolic velocity, visual tumescence and erection.
Assessment of erection following papaverine injection
- phase 1: sudden increase in both systolic and diastolic flow velocity in cavernosal artery with minimal tumescence
- phase 2: with further increase in intracavernosal pressure, there is a decrease in diastolic flow with a classical 'dicrotic' notch
- phase 3: as the intracavernosal pressure increases, diastolic flow reaches zero with further increase in tumescence
- phase 4: diastolic flow reversal occurs with maximum systolic velocity; this is associated with penile rigidity
- phase 5: decrease in the systolic flow velocity occurs; this is usually 15 minutes post injection which is associated with reduction in tumescence and rigidity
In flaccid state, monophasic flow is seen with absent/minimal diastolic flow. With onset of erection, systolic and diastolic flow both increases. With further increase in pressure, 'dicrotic notch' appears with dip in diastolic flow. End diastolic flow may go down to zero or reversal may be seen. Then monophasic flow is seen with sharp systolic peak, corresponding with visual full erection.
Peak systolic velocity is the best Doppler indicator of arteriogenic impotence. Its value <30 cm/sec during the examination indicates arterial dysfunction. Some people consider <25 cm/sec as definite arterial dysfunction and 25-30 cm/sec as borderline case. Less than 60% increase in cavernosal diameter after papaverine injection is also an indicator of arterial impotence.
End diastolic velocity is the best doppler indicator of venogenic impotence. Its value >5 cm/sec indicates venous dysfunction. A good diastolic reversal virtually rules out venous insufficiency.