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If you’ve ever witnessed someone suffer a stroke, you understand the humbling nature of this disease. It can reduce the mightiest human being to an immobile, helpless creature. Impairment of crucial functions like speech, walking, and control of bowel and bladder can wrench control from the body in a moment. Even perpetually youthful TV personality Dick Clark was struck down by stroke at age 75, despite the outward appearance of perfect health. Clark’s stroke resulted in a six-week hospital stay and, judging from fragmented reports, significant disability. Stroke can be like a devastating fire that strikes without warning, leaving only smoldering rubble. Stroke can so ravage basic bodily functions that often all you can hope for is to regain a portion through rehabilitation. The disease process that underlies stroke requires decades—30 or 40 years—to develop. With that much lead time, why aren’t we better able to detect or stop this crippling disease? The truth is that we are able to predict many, if not most, strokes. Advances in imaging technology allow detection of atherosclerotic plaque that cause stroke years before it becomes a threat. Progress in deciphering the causes of stroke has also leapt forward. Unfortunately, your neighborhood physician still focuses on diagnosing the crisis rather than anticipating it. Physicians prefer to deal with catastrophes and are just not that interested in prevention. Most physicians ask: “Is it time to operate or not?” The medical community obsesses over procedures like carotid endarterectomy (surgical removal of plaque) or carotid stents. Even when a person is afforded the warnings of a “mini-stroke”, or transient ischemic attack (TIA), little more is done once it’s determined that surgery is not necessary—even though this person has high risk for future stroke (50% over 10 years). Let’s flip-flop this approach to stroke. Procedures represent a failure of prevention! Where do strokes come from? Stroke develops when some portion of the brain is deprived of blood. This usually results from a tiny bit of debris that dislodges from an atherosclerotic plaque along the walls of an artery (the same sort that accumulates in coronaries causing heart attack). The sources of debris have been a subject of controversy, but new imaging technologies have settled the question. Any blood vessel that leads from the heart to the brain can be a source. The two carotid arteries on both sides of your neck are a frequent source, as these arteries are prone to develop plaque. (Our discussion will be confined to what are called thromboembolic, or ischemic, strokes, i.e, strokes that occur from plaque that fragments, sending debris to the brain, and will not include the far less common hemorrhagic strokes due to rupture of small vessels in the brain, nor will we discuss atrial fibrillation and other heart causes of stroke. The thromboembolic strokes we discuss cause around 88% of all strokes.) Over the last 10 years, the aorta has been recognized as another important source of stroke. The aorta is the main artery of the body whose branches go to the head, arms, and legs. Atherosclerotic plaque is a live tissue that, through poor diet, inactivity, high cholesterol, overweight, etc., grows and becomes progressively more unstable. At some point, plaque fragments. Little bits break away, traveling to the brain. Fractured plaque also exposes its deeper structures to flowing blood, triggering blood clot formation, which in turn can also fragment and go to the brain. Atherosclerotic plaque is a prerequisite for the most common causes of stroke. If the majority of strokes originate from plaque, why not measure plaque to determine if you’re at risk for stroke? How can we easily, safely, and accurately measure plaque in the carotid arteries and aorta? And if plaque can be measured, can it be shrunk or inactivated to reduce or eliminate risk for stroke? How can plaque be measured? Just 20 years ago, the only practical method of identifying plaque in the carotids or aorta was through angiography, requiring catheters inserted into the body to inject x-ray dye. Angiography was impractical as a screening measure. CT scanning and magnetic resonance imaging (MRI) are emerging as exciting methods of imaging both carotids and aorta. Unfortunately, most centers and physicians are much more focused on the diagnostic uses of these technologies for people who have already suffered stroke or other catastrophe, and application of these devices for preventive uses is still evolving. One exception is when aortic calcification or aortic enlargement is incidentally noted on the increasingly popular CT heart scans; this is an important finding that can signal presence of aortic plaque. The one test that is widely available and can be performed in just about any center is carotid ultrasound. It’s simple, painless, and precise. Two basic observations can be made: 1. Plaque detection—Atherosclerotic plaque can be clearly visualized. If plaque blocks more than 70% of the diameter of the vessel, or if there are “soft” (unstable) elements in plaque, then stroke risk may be high enough to justify surgery or stents. However, if there are plaques that are less severe, substantial risk for stroke may still be present that can be reduced with preventive measures. 2. Carotid intimal-medial thickness—This is a measure of the thickness of the lining of the carotid artery in areas not involved by plaque, but often precedes the development of mature plaque. Carotid intimal-medial thickness also provides an index of body-wide potential for atherosclerotic plaque that can place you at risk for stroke. The aorta, for instance, cannot be well imaged by surface ultrasound but can still be a source for stroke. Increased carotid intimal-medial thickness and carotid plaque are closely associated with likelihood of aortic plaque. The Rotterdam Study of 4000 participants demonstrated that if carotid intimal-medial thickness is greater than normal (1.0 mm), then you can be at risk for stroke (and heart attack), even if no carotid plaques are detected. Carotid ultrasound is the one test you should consider that provides the most information with least effort. Ultrasound is harmless, painless, and can be obtained just about anywhere. Even if your doctor disagrees with your request for a carotid ultrasound, an increasing number of mobile services are popping up nationwide that make this test available for around $100. One important point: many scanners and interpreters will only report whether plaque is present or not. While this is important information, you should request that the carotid-intimal medial thickness be made as well. Not all centers can make this simple measure (because of software requirements), but it doesn’t hurt to try. Any amount of carotid plaque is reason to follow a preventive program, even if the plaque is insufficient to justify surgery. Can plaque be reduced? Can we shrink plaque in carotid arteries and aorta and thereby reduce, perhaps eliminate, these sources of stroke? That question is gaining momentum as effective therapies become available that pack real punch for reducing plaque. Study after study has now documented that plaque can be reduced and, with it, risk for stroke. Reduction in plaque of 10–20% is possible within a year or two. Let’s consider the most potent influences on carotid and aortic plaque growth that need to be considered in a plaque-reducing program. (I assume that you are a non-smoker—if you are a smoker, you first need to concentrate on quitting.) Hypertension Considerable experience documents the power of blood pressure-lowering for prevention of stroke. The most recently updated guidelines, the JNC–VII, recommends a blood pressure of 407 mg/dl heightens stroke risk six-fold. C-reactive protein (CRP) This measure of inflammation is proving to be a useful marker for identifying people at risk for stroke, with increased risk beginning at a level of 0.5 mg/l. High CRP also predicts more rapidly growing carotid plaque. Homocysteine Homocysteine is an important marker of increased likelihood of both carotid and aortic plaque, as well as stroke. In 1997, the European Concerted Action Project reported more than a doubling of stroke when homocysteine levels exceeded 12 mol/l. As homocysteine increases to 20 μmol/l, risk for stroke and heart attack increases an amazing 10-fold over that at a level of 9 μmol/l. Asymmetric dimethylarginine (ADMA) ADMA is recently discovered amino acid whose blood levels can skyrocket up to 10-fold in the presence of hypertension, metabolic syndrome, diabetes, high cholesterol and triglycerides, obesity, and high homocysteine levels. ADMA blocks the action of the amino acid, l-arginine. This mimicry reduces the availability of nitric oxide, a powerful dilator and protector of arteries. ADMA levels in the top 10% predict a six-fold heightened risk for future stroke, and ADMA levels in people with strokes are double that in other people. A carotid ultrasound study in 116 subjects showed that higher blood levels of ADMA are associated with more severe carotid plaque. Because of ADMA’s shared role across a variety of abnormal conditions, correction or blocking the action of ADMA has been suggested as a unique therapeutic tool to reduce stroke risk. Cholesterol Data suggest that lowering cholesterol with statin cholesterol-lowering drugs slows carotid plaque growth and reduce stroke risk approximately 22%. An interesting study from the Cardiovascular Institute at Mt. Sinai School of Medicine in New York using the precise measuring ability of MRI of the carotids and thoracic aorta showed an impressive 20% regression of plaque area with simvastatin (Zocor®) taken for two years. Although guidelines for cholesterol treatment recommend reduction of LDL cholesterol to 100 mg/dl in high-risk persons, a report from the Walter Reed Army Medical Center in Washington, DC, showed that carotid plaque was more effectively reduced when LDL cholesterol of 70 mg/dl or lower was achieved with statin cholesterol drugs. Lower LDL cholesterol may, therefore, be better. Treatment Strategies to Reduce Carotid and Aortic Plaque The essential question: How do we reduce carotid and aortic plaque? If we make this the focus of our efforts, many pieces begin to fall into place. If you’ve had any measure of carotid or aortic plaque such as a carotid ultrasound or aortic calcification on a CT heart scan, you know that you’re at increased risk for stroke. You also have a baseline for future comparison to gauge whether your program is working or not. Because most people have not one but several causes of carotid and aortic plaque, there is no one single treatment that effectively eliminates risk for stroke. Instead, most people require a comprehensive program of healthy diet, exercise, supplements, and medication when indicated. Here, we focus on the nutritional supplements that can be critical components of your plaque-reduction program. Fish oil Fish oil is a cornerstone of your stroke prevention program. Epidemiological observations suggest a strong relationship of fish intake and reduction of stroke risk. Carotid ultrasound studies demonstrate less carotid plaque with greater intakes of fish. A cleverly designed University of Southampton study made the fascinating observation that fish oil transforms the structure of carotid plaque. 150 people with severe carotid plaque scheduled for carotid endarterectomy (surgical removal of the plaque) were given fish oil, sunflower oil, or no treatment over several months while waiting for their procedure. (Delays in the British health system permitted this unique design.) Plaque was removed at surgery and examined. Participants taking fish oil had reduced inflammation in plaque and thicker tissue covering the fatty core, markers of more stable plaque. Those taking sunflower oil or no treatment had unstable plaques with greater inflammation and thinner, less sturdy covering tissue. This suggests that fish oil stabilizes carotid plaque, making it less likely to rupture and fragment. A standard capsule of fish oil (containing 300 mg of EPA + DHA) contains the same amount of omega-3s as a 3 oz serving of cod or halibut; three capsules (900 mg DHA + EPA) contain the equivalent of a serving of farm-raised salmon. The dose that seems to provide greatest protection from stroke, lowers triglycerides (that form abnormal lipoproteins; see above), and reduces fibrinogen, is four capsules per day (1200 mg EPA + DHA). Coenzyme Q10 (CoQ10) Although there are no data specifically addressing whether CoQ10 reduces plaque, it is a marvelously effective way to reduce blood pressure, one of the crucial factors causing carotid and aortic plaque growth. A pooled analysis of eight studies showed that, on average, CoQ10 in daily doses of 50–200 mg reduced systolic blood pressure by 16 mm Hg, diastolic pressure by 10 mm Hg. Data suggest that CoQ10 can reverse abnormal heart muscle thickening (hypertrophy), another manifestation of high blood pressure, strongly suggesting that CoQ10 has benefits beyond just reducing pressure. Supplements to correct the metabolic syndrome Weight loss is, without question, the most immediate and direct path to correction of this dangerous pre-diabetic condition. A drop of even 10–20 lbs yields improvements across the board: increased sensitivity to insulin, increased HDL, and reductions in triglycerides, CRP, fibrinogen, small LDL particles, and blood pressure. Diet and exercise are fundamental components of an effort to lose weight; low carbohydrate or reduced glycemic index diets (e.g., South Beach or Mediterranean) rich in fibers are clearly effective. Several supplements can amplify weight-reduction efforts and be useful adjuncts to your lifestyle program. Among them: White bean extract White bean extract blocks intestinal absorption of carbohydrates by 66%. 1500 mg twice a day with meals yields, on average, 3–7 lbs of weight loss in the first month of use. The only side-effect is excessive gas, due to unabsorbed starches. Glucomannan This unique fiber taken prior to meals absorbs many times its weight in water and thereby fills your stomach. You consequently take in less food. Most people lose around four lbs per month using 1500 mg prior to each meal. Interestingly, glucomannan also blunts the rise in blood sugar after meals, an effect that, by itself, may lead to weight loss. Be sure to take with plenty of water. DHEA This adrenal hormone is key to maintaining physical stamina, mood, muscle mass in men, and libido in women. A recent randomized, placebo-controlled study at Washington University in 56 subjects showed a 13% decline in abdominal fat (fat that drives resistance to insulin) measured by MRI with 50 mg of DHEA per day at bedtime, along with improved sugar control and lower insulin levels. Pectin, beta-glucan Pectin is the soluble fiber in citrus rinds, green vegetables, and apples, also available as a supplement. Beta-glucan is the soluble fiber of oats and is also available as a supplement. Both are wonderful fibers that provide feelings of fullness, lower cholesterol, slow release of sugars, and can yield modest weight reduction. A USC study in 573 subjects using carotid ultrasound showed that greater intake of healthy fibers like pectin and beta-glucan is associated with less carotid plaque growth. Folic acid, vitamins B6 and B12 Dr. Daniel Hackam at the Stroke Prevention and Atherosclerosis Research Centre in Ontario conducted a study using carotid ultrasound in 101 participants treated with folic acid 2.5 mg, vitamin B6 25 mg, and B12 250 mcg per day. Treatment resulted in plaque reduction, especially when homocysteine levels exceeded 14μmol/l at the start, compared to untreated participants who experienced substantial plaque growth. An attempt to clarify the role of homocysteine treatment was made through a National Institute of Health-sponsored study of stroke prevention. 3680 participants with a prior history of stroke were enrolled and given either a “low-dose” (20 mcg folic acid, 0.2 mg B6, 6 mcg B12) or a “high-dose” (2.5 mg folic acid, 25 mg B6, 400 mcg B12) regimen. Although starting homocysteine levels showed a graded association with stroke risk (higher homocysteine levels predicted greater stroke risk), the treatment groups experienced, on average, only a 2 μmol drop in homocysteine levels and no reduction in stroke risk over two years. The study investigators as well as critics have suggested that the study failed due to an insufficient treatment period and that the doses were too low. (The doses we use in our plaque reduction program are folic acid 2.5–5.0 mg, B6 50–100 mg, B12 1000–2500 mcg.) L-arginine L-arginine can be used to overpower the adverse effects of ADMA. L-arginine is emerging as an important carotid plaque-reversing tool. Early reports in animals showed that l-arginine completely halted growth of aortic plaque, and did so more effectively than lovastatin (a cholesterol-lowering drug). In humans, L-arginine reduces blood pressure, abnormal constriction of carotid and coronary arteries, blocks entry of inflammatory cells into plaque, increases sensitivity to insulin, and heightens exercise capacity. Following coronary angioplasty or stent placement, l-arginine results in up to 36% reduction in plaque growth. The average American takes in 5400 mg of l-arginine through food every day. Supplementing with doses of 3000–12,000 mg per day has proven useful to correct many of these phenomena. (We use a dose of 6000 mg of l-arginine powder, twice a day on an empty stomach, dissolved in water, for our plaque regression program.) Does this result in a reduction of stroke risk? The emerging data suggest that l-arginine is likely to exert a powerful plaque-reducing and stroke-preventing benefit, but we await more clinical trial data. Conclusion Reducing stroke risk by reversing carotid and aortic plaque is becoming an everyday reality, with better tools becoming available. To know whether you’re at risk, the best and most available imaging tool is carotid ultrasound, aiming to identify intimal-medial thickness >1.0 mm, or carotid plaque. Any degree of calcification of the aorta, such as on a CT heart scan, is another useful measure of risk. Treatment to reduce risk is multi-faceted but is based on examining all your sources of risk, including metabolic syndrome, small LDL, lipoprotein(a), and C-reactive protein. Fish oil is the one absolutely crucial ingredient in any stroke prevention program. Other supplements can be used in a targeted fashion, depending on the causes identified for your carotid or aortic plaque. Ideally, repeat scanning of your carotids should be done sometime after your program has begun to assess whether you’ve successfully achieved reversal of plaque growth. pennis enlargement pump penis enlarement video penis enlargment pills review guide to penis elargement easy enlargement free penis surgery way top rated penis enhancement pills herbal pnis enlargement penis enlargment doctor

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If, like the majority of men in later life, you begin to experience problems with urinating then there is a good chance that you are suffering from a swollen or enlarged prostate. This condition, which is also known as BPH (benign prostatic hyperplasia or benign prostatic hypertrophy), will affect about half of the male population by the age of 60 and rise to about ninety percent of all men by the time they reach 80 years of age. Many men suffering from BPH will experience little if any enlarged prostate symptoms, but others will develop a range of symptoms associated with urinating including the need to strain in order to urinate, a weak or slow flow which starts and stops, a feeling that they have not emptied their bladder following urination, the need to urinate frequently and often with urgency and frequent awakening during the night to urinate. In the early stages of BPH these symptoms are caused by the enlarging prostate pressing on the urethra and restricting the flow of urine from the bladder. At this point the bladder is able to counter this to a certain extend by simply contracting more strongly to force urine through the constricted urethra. As time goes by however, and the enlargement of the prostrate continues, a point will be reached at which the bladder cannot force all of its contents through the urethra and the bladder can no longer empty completely. The restriction of the urethra and the inability to regularly flush out the bladder can also give rise to repeated urinary tract infections leading to a burning sensation or pain when urinating. Stones may also form in the bladder and this can lead to a complete blockage of the urethra and an inability to urinate at all. This is known as acute urinary retention and should be treated as a medical emergency. As a general rule the presence of enlarged prostate symptoms does not in itself mean that treatment is required and many men will simply live with these symptoms as long as they are not bothered by them too much. This said, enlarged prostate symptoms can also indicate the presence of other problems, or indeed mask other problems, and it is always advisable to consult your doctor and get an accurate diagnosis before deciding to let things be. free natural penis elargement cheap penis enargement pills penis enlagement without pills surgical penile enlargement easy enlargment free penile surgery way free penis enlargement pill vimax do penis enlargement pills really work vimax natural penis enlargement pills penis enlargment picture

Ever been confused by all the overwhelming information and different strategies to cure premature ejaculation? Let me show you the top 5 misleading suggestions I've uncovered on the web. Many common 'solutions' to prevent premature ejaculation are completely counterproductive. Anyone who is familiar with my writing or my work as a sexual healer will understand what I mean. To successfully treat premature ejaculation or increase sexual stamina it is important to experience a sexual moment deeply and completely. Many of the premature ejaculation remedies available today come from the opposite perspective. Let's run through a few of these techniques that take you further away from sexual fulfillment and satisfaction. 1. Numbing Creams / Sprays / Extra condoms Numb says it all. What's the point of sex if you're not really feeling it. Your partner doesn't want a human vibrator. Trust me, there's a time for toys and there's a time for a real live man. I don't want mine with extra layers of latex and dead nerve endings thankyou very much. When I have a man inside me I want to know he is feeling it! Plus, I've heard that that those numbing potions can affect the woman during sex. Imagine that, two people going through the motions without feeling it! 2. Distracting Yourself A lot of folklore about male sexual performance revolves around the idea of delaying orgasm by distracting yourself. Thinking about your mother-in-law or sports, biting your cheek etc are all methods I have heard of or read about at some time or another. Turning off your arousal temporarily is not the same as mastering it. And again, if you only able to have sex by thinking about boring or distasteful things, how much fun is it going to be? This is a bad habit to get into. You don't want to train yourself to get bored and distracted when you are in the middle of hot lovin'. No woman is ever going to be interested in a man who can't focus on the matter at hand. Especially if she figures out you are thinking about your mother-in-law!! 3. Masturbation This is an interesting one. Remember that scene in 'Something About Mary' where he 'clears the pipes' before his big date to avoid seeming desperate. I have read that it is a good thing before sex to have a pre-emptive orgasm in order to delay the main event. I'd like to examine this a bit closer to see where this isn't helpful and maybe highlight when it is. Anxiety and stress about the impending sexual experience, thinking about the possibility of embarrassing yourself by coming too soon and focusing on the negatives of your sexual performance WHILE you masturbate is extremely unhelpful. Building a regime of this can be very damaging. It will have the effect of eroticising and reinforcing these aspects. You will associate orgasm even more with the stress and performance anxiety that is already a problem. However masturbating as part of a relaxed regime of self-pleasure and self-love can be very helpful. As long as your masturbation is not tied to your sexual performance it can be an enriching part of your sex life. In particular using self-pleasure to more fully explore your sexual arousal levels, orgasms, and control is the first step to deepening your awareness of sex. 4. Muscle Control Some techniques are like shaolin kung-fu disciplines that prescribe pelvic floor exercises. The theory is that with enough muscle strength and control you can prevent ejaculation escaping. By catching it with intense muscle contractions! Pretty spectacular stuff hey? In reality it's a bit like shutting the gate after the horse has bolted. Wouldn't you rather devote your time to exercises that help you understand your arousal levels so you can control the orgasm beforehand, and not just the fluid after the fact. And by the way, from what I gather it's extremely difficult to achieve anyway. 5. Alcohol / Drugs Relying on alcohol or drugs before you initiate a sexual encounter is a definite no no. Alcohol ultimately depresses your nervous system. And so depresses your ability to feel and maintain an erection. It is certainly the last thing you want to rely on for great sex. It may seem that you might loosen up your inhibitions temporarily. From the point of view of sexual stamina, forget it! And drugs - recreational or therapeutic. Some may give the illusion of increased sexual performance. But ultimately it is your level of awareness, your level of consciousness, your level of presence as a man that makes all the difference. I don't want you to think I'm a complete prude. This stuff isn't terrible in and of itself. I like the odd glass of champagne as much as the next girl. But my point is this. Using any or all of these techniques as the basis of your premature ejaculation cure will fail. It could actually make the situation worse. Relying on these things will lead you further from your true goal of sexual mastery and control of your orgasms. The only way to become a master of your sexuality is to go deeper into your sexual experiences, not further away. Learn about your body and orgasmic arousal by focusing on them. Don't shut your sexuality down in the quest for the 'appearance' of sexual mastery. A man with a numb penis, thinking about sports, thrusting for an hour, is about as far from a master as you can get. Love, Mukee Okan Copyright 2005 Mukee Okan vimax free penis enlargement video penis enlarement video herbal pennis enlargement pills vimax enlargement free penis pills sample penis enlargment drug penis elargement drug penis enlarement pills review penile enlargment herb penis enlargment picture

1) “Why do Eskimos and husky dogs do not eat polar bear liver?” Because it contains huge amounts of Vitamin A. One gram of polar bear liver contains 12 times the daily required amount of Vitamin A (1 mg). And what happens if you overdose on Vitamin A? Here is a not-too-pleasant list: skin problems (itching, peeling off), drowsiness and sleepiness, splitting headaches, spleen and liver enlargement, painful swelling of tissues next to the bones, loss of appetite. Vitamin A overdose during the first three months of pregnancy can cause congenital abnormalities. 2) “Why did Linus Pauling took 40,000 mg of Vitamin C a day?” Linus Pauling, the only scientist who won 2 Nobel prizes in history (Chemistry 1954 and Peace in 1962), was a big-time believer in Vitamin C. Pauling himself took massive amounts of it daily to prevent common cold. He started taking 12,000 mg a day and took it all the way up to 40,000 mg. He claimed he delayed the onset of his prostate cancer by twenty years by taking such unheard of quantities of Vitamin C before he died at 93. The modern medical research could not prove that Vitamin C protects against common cold or cancer. However, Vitamin C is of course essential for healthy gums, fighting gingivitis, healthy vision, among its many other benefits. Vitamin C deficiency causes scurvy. 3) “What does Vitamin Choline do?” Perhaps you’ve never heard of Vitamin Choline, which is a member of the Vitamin B family. It’s other name is “Amanitine” and is found in Lecithin. Some doctors recommend Choline for alcoholics or diabetics. It is used to fight Alzheimer’s disease, angina, atherosclerosis, fatty liver, senility, high blood pressure, thrombosis, and strokes. Choline is found in bananas, green leafy vegetables, legumes, beef, nuts, wheat germ, shellfish, whole grain cereals. The literature does not cite any serious side effects. ---------------------------------------------------- (312 words, Copyright May 2006 Ugur Akinci) by Ugur Akinci, Ph.D. Creative Copywriter and Technical Communicator writer111@gmail.com www.writer111.com penile enlargement exercise penis enlagement fact herbal penis enlargement pill vimax buy penis enlargement pills buy penis enargement pills real penis enlagement free natural penis enlarement penile enlargment operation penis enlargment picture

A slow and steady revolution is sweeping the market for erectile dysfunction drugs – Cialis. Most people may not even be aware of it. Lilly ICOS, the pharmaceutical alliance, which launched the blockbuster drug Cialis, announced that the drug has achieved 1 billion dollars in global sales since launching in Europe less than two years back. In fact Cialis has become the top Erectile Dysfunction treatment in France, since January 2005, based on the latst market data, easily overtaking Viagra, the first brand to be launched in this market. It is also doing very well in United Kingdom, Italy, Germany, United States, Canada, Australia, Mexico and Brazil. So much so that a Lilly ICOS press release contained these words from Rich Pilnik, President of Lilly's EMEA region "We are very pleased with the performance of Cialis and the steady development of the brand since its launch two years ago. Millions of men suffer from ED and the growth of the market demonstrates that patients are speaking to their healthcare providers about ED and seeking treatment options." Not only has Cialis been able to expand the market but it has also eaten heavily in the market share of Viagra from Pfizer, the first drug to be launched in this market and Levitra from Glaxo-Bayer-Schering Plough. In fact Cialis was the second PDE5 inhibitor drug to become available in Europe. It is currently promoted in approximately 100 countries including the United States, Australia, Brazil, Mexico, Canada and across Europe and Asia for Erectile Dysfunction. According to Paul Clark, Chairman and Chief Executive Officer of ICOS Corporation. "Passing the $1 billion mark is an important milestone for Lilly ICOS and a great accomplishment for the Cialis team. Since 2003, men with erectile dysfunction have had a choice of oral treatments for their condition - a condition which may impact on relationships and daily life." Beyond all the hype and the jubilation is the sheer superiority of Cialis over all the other drugs available in this indication. To understand the benefits of Cialis, we need to firstly understand this complex condition. Erectile Dysfunction or Impotence is defined as the inability to ensure and maintain an erection sufficient for sexual intercourse. ED affects an estimated 180 million men worldwide . 90 percent of ED cases are related to a physical or medical condition, such as diabetes, cardiovascular diseases, and prostate cancer treatment, while 10 percent are due to psychological causes . In many cases, however, both psychological and physical factors contribute to the condition. Where physical factor play an important role PDE-5( Phosphodiaterase) inhibitors have a significant role to play. These include drugs like Sildenafil (Viagra) and Vardenafil(Levitra). But none are as good as Tadalafil(Cialis). Why? Firstly let’s understand how PDE-5 inhibitors work. They work by inhibiting the enzyme phosphodiasterase-5 which is responsible for degrading another enzyme called cGMP(cyclic Guanosine Mono Phosphate) which through a series of reactions is responsible for the synthesis of nitric oxide. Nitric oxide is an important vasodilator responsible for dilation of the blood vessels that supply blood to the penis. Thus, there is an increase in the blood supplied to the penis and this increased blood engorges the penis and leads the formation of an erection through hydraulic pressure. All PDE-5 inhibitors work in the same way but because they are different molecules, they also have different properties. The body quickly eliminates both Sildenafil and Vardenafil. Therefore their action lasts for only 4 hours, while Tadalafil(Cialis) is absorbed and eliminated slowly therefore it remains in the body for a longer period of time. Therefore its duration of action is 9 times that of other drugs - 36 hours. This ensures that Cialis will act over a whopping 36 hours and any patient on Cialis does not need to have hurried sex , but sex at his or his partner’s leisurely pace. That is why Cialis has been nicknamed as “Le Weekend Pill” in France. It allows the man to relax with his partner and have spontaneous sex. Also other drugs like Viagra act on the enzyme PDE-6, which is found in the eyes, leading to bluish discolouration of vision, which will not occur with Cialis. Cialis can be taken with a 100% fat meal and there will be no change in it’s action. The same is not true for Sildenafil or Vardenafil, which are affected by food. All this makes Cialis currently the best drug for erectile dyfunction. What further adds to it’s appeal are programmes like “The Cialis Promise” from Lilly ICOS which guarantees free trial with a rival drug in case Cialis does not work. With this kind of confidence oozing from Lilly ICOS, there is reason to believe in the promise of Cialis. Cialis is available at any neighbour chemist on providing a doctor’s prescription or one can buy Cialis online. An online prescription is generated on filling a short form and on payment through credit card, one can be rest assured of getting Cialis discreetly. What more cheap generic Cialis is also available online. This will further reduce your medical bills. The low cost is like an icing to the Cialis cake or pudding for that matter . But, as is said, the proof of the pudding lies in the eating - So go for Cialis.