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By D. Ugrasal. State University of New York College at Cortland.

Specific Effects of Drugs in Interrogation Situations Advantages and limitations of a number of different types of pharmacologic agents as adjuncts to interrogation can be examined by reviewing clinical and experimental data from the works of psychiatrists order kamagra oral jelly 100mg on line, neurologists buy kamagra oral jelly 100mg without prescription, psychologists, physiologists, and pharmacologists. Barbiturates tend to increase contact and communication, decrease attention, decrease anxiety, decrease psychotic manifestations, and make the mood more appropriate and warmer. When combined with interview techniques that aim at arousing emotions, strong emotional reactions may be catalyzed for psychotherapeutic purposes. Barbiturates have been found helpful in detecting whether an individual is feigning knowledge of the English language and in getting mute catatonic schizophrenics and hysterical aphasics to talk. They are of no avail, however, in remedying the speech defects of true aphasics, even transiently. The use of barbiturates has helped to get more reliable estimates of intelligence and personality through psychological tests, particularly in emotionally upset individuals. The use of various stimulant and antidepressive drugs has been explored, for diagnostic and therapeutic purposes in psychiatric practice, but not to any extent for interrogation. Amphetamine, pipradrol, methylphenidylacetate have in common the capacity to produce an outpouring of ideas, emotions, and memories. An injection of amphetamine following an intravenous barbiturate is said to provoke a striking onrush of talking and activity from psychiatric patients. Without adequately controlling his study, one author claims that methamphetamine produces such a strong urge to talk that the criminal who feigns amnesia or withholds vital information cannot control himself and thus gives himself away. Iproniazid, an antidepressive drug which is relatively slow and sometimes dramatic in its thera- -131- peutic effect, should be considered for experimentation. This drug, and similar, less toxic analogs which are being developed, might be considered for use in special instances. For example, informants suffering from chronic depression, whether due primarily to emotional factors, situational stress, or physical debilitation, might become very responsive after using a medication of this type. As a class, the stimulants probably present the most obvious exploitative potential for an interrogator. The use of such drugs by an interrogator would tend to produce a state of anxiety or terror in most subjects, and promote perceptual distortions and psychotic disorientation. Their use could constitute a definite threat to most medically unsophisticated subjects, i. When the subject is not under the influence of such drugs, vital information might be extracted as a price for ceasing further medication. An enlightened informant would not have to feel threatened, for the effect of these hallucinogenic agents is transient in normal individuals. The information given during the psychotic drug state would be difficult to assess, for it may be unrealistic and bizarre. The introduction of new drugs like tranquilizers that sedate but do not impair intellectual functioning in moderate dosage (e. There is a possibility that these tranquilizers might be of use with selected informants who are highly agitated and disturbed, and who might give information they prefer to withhold in return for the tranquility they experience with such a sedative. Under the influence of this drug, the less emotionally upset informant might find that he can better master his anxieties and keep his resolve to remain silent. The ability of the subject to give information is not notably affected by a mainte- -132- nance dosage. The motivational effects of obtaining drug supplies, while extreme, are not of a different order for most subjects than those which the interrogator could produce by other more rapid means. The exploitation of addiction probably constitutes a threat to persons previously addicted, or to those who become addicted in the captivity situation as a sequel to other aspects of their treatment, rather than through the deliberate creation of addiction for exploitative purposes. Another use to which interrogators might put drugs and placebos would involve their ability to absolve the subject of responsibility for his acts. The popular meaning of being "drugged" or "doped" implies that an individual in this state has lost control over his actions and that society will not hold him responsible for them. When the transmittal of information is likely to induce guilt in the source, the interviewer can forestall some of this reaction by the administration of a placebo or drug. In some cases, this will be all that is require4l to remove the barrier to information transmittal. What are the over-all conclusions that can be drawn from this review and critical analysis of the use of pharmacologic agents in obtaining information? Are pharmacologic agents of any value to the interrogator in eliciting vital information? The answer is that drugs can operate as positive catalysts to productive interrogation. Combined with the many other stresses in captivity that an individual may be obliged to undergo, drugs can add to the factors aimed at weakening the resistance of the potential informant.

Parenteral artemether or artesunate purchase kamagra oral jelly 100mg, whose use is restricted purchase 100 mg kamagra oral jelly fast delivery, are efectve alternatves to quinine for the treatment of severe falciparum malaria and are preferred in areas where decreased efcacy of quinine has been documented. To ensure radical cure following parenteral treat- ment with artemether or oral treatment with artesunate, a full therapeutc dose of mefoquine should be given. A fxed-dose oral formulaton of artemether with lumefantrine has recently become available and is recommended for the treatment of uncomplicated falciparum malaria in areas with signifcant resistance. Chloroquine, which is usually well tolerated at the required dosage, is preferred where P. The combinaton of proguanil with chloroquine may overcome mild chloroquine resistance. Chloroquine must be started 1 week before exposure and be contnued in pregnant women untl afer delivery and for at least 4 weeks afer the last risk of exposure in the case of non-immune individuals. Mefoquine may be used for prophylaxis in areas of high risk or where multple-drug resistance has been reported. Where possible prophylaxis should be started 2-3 weeks before travel to enable any adverse reactons to be identfed before expo- sure (over three-quarters of adverse reactons occur by the third dose) and should be contnued for 4 weeks afer last exposure. It should be used in early pregnancy only if alternatve drugs are either not available or unlikely to be efectve and when it is impractcable for the woman to leave the endemic area. Proguanil, a predominantly tssue schizontcide with litle blood schizontcidal actvity, is a causal prophylactc agent since it is actve against pre-erythrocytc intrahepatc forms, partcularly of P. Proguanil is used for prophylaxis with chlo- roquine in areas where there is resistance to chloroquine but a low risk of infecton as it may give some protecton against and may alleviate symptoms if an atack occurs. Proguanil and chloroquine may also be used prophylactcally in areas of high risk or mult-drug resistance as a second choice where mefo- quine is not appropriate. There is no evidence that proguanil is harmful in prophylactc doses during pregnancy. Because of the vulnerablility of preg- nant women to falciparum malaria, it should be used at full prophylactc dosage wherever the disease is prevalent and likely to be responsive to proguanil, if chloroquine is not avail- able or with chloroquine, if the later alone is unlikely to be efectve. Dose Oral Adult- Immediately 600 mg, afer 6 h 300 mg followed by 300 mg daily for 2 days. Child- 10 mg/kg body weight followed by 5 mg/kg body weight afer 6 h, thereafer once a day for 2 days. Contraindicatons Severe haematologic distress or gastrointestnal distress; eye dysfuncton; liver disease. Severe infectons including refractory urinary tract infecton: 200 mg daily can be used. Early syphilis: 100 mg twice daily for 14 days and for latent syphilis 200 mg twice daily for 28 days is used. Uncomplicated genital Chlamydia, non- gonococcal urethrits: 100 mg twice daily for 7 days. Child- Only if alternate antbacterial cannot be given 5 mg/kg body weight in two divided doses. Contraindicatons Pregnancy (Appendix 7c); children under 8 years; porphyria; systemic lupus erythematosus; prolonged exposure to sunlight, severe hepatc dysfuncton. Precautons Avoid exposure to sunlight or sunlamps- photosensitvity reported; renal impairment; hepatc impairment (Appendix 7a); lactaton (Appendix 7b); interactons (Appendix 6c). Storage Store protected from light and moisture at a temperature not exceeding 30⁰C. Dose Radical treatment Adult- 15 mg daily for 14 days, may be increased to higher dose. Contraindicatons Hypersensitvity, granulocytopenia, pregnancy, lactaton, children below 1 year. Proguanil Pregnancy Category-B Schedule H Indicatons With chloroquine, prophylaxis of malaria in areas of low resistance. Dose Oral Prophylaxis Adult- Preferably 200 mg once daily, start 1 to 2 days before entering endemic area and contnue for 4 weeks afer leaving. Child- (11-20 kg) - 25 mg once daily; (21-30 kg)- 50 mg once daily; (31-40 kg)- 75 mg once daily; more than 40 kg- 100 mg once daily. Child- Up to 1 year: 25 mg; 1 to 4 years; 50 mg; 5 to 8 years: 100 mg; 9 to 14 years: 150 mg; above 14 years: 200 mg. Contraindicatons Use in areas of known resistance to either proguanil or pyrimethamine. Precautons Renal impairment; pregnancy (folate supplements required, Appendix 7c); lactaton. Adverse Efects Mild gastric intolerance, diarrhoea; occasional mouth ulcers and stomatts; skin reactons and hair loss reported; rarely, hypersensitvity reactons such as urtcaria and angioedema. Dose Oral Adult- Prophylaxis: 300 mg once weekly, start one week before entering endemic area and contnue for 4 weeks afer leaving. Patents and their caretakers should be told how to recognize the signs of blood disorders and advised to seek medical atenton as soon as possible if symptoms such as fever, sore throat, rash, mouth ulcers, purpura, bruising or bleeding develop. They should also be told how to recognize signs of hepatts and advised to seek medical atenton if symptoms such as anorexia, abnormal weight loss, asthenia, abdominal pains, fever, nausea or vomitng develop.

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Some antsep- tcs are applied to the unbroken skin or mucous membranes discount 100 mg kamagra oral jelly visa, to burns and to open wounds to prevent sepsis by removing or excluding microbes from these areas 100 mg kamagra oral jelly with mastercard. The iodophore, povidone- iodine, is efectve against bacteria, fungi, viruses, protozoa, cysts and spores and signifcantly reduces surgical wound infectons. Chlorhexidine has a wide spectrum of bactericidal and bacteriostatc actvity and is efectve against both Gram-positve and Gram-negatve bacteria although it is less efectve against some species of Pseudomonas and Proteus and relatvely inactve against mycobacteria. Chlorhexidine is incompatble with soaps and other anionic materials, such as bicarbonates, chlorides, and phosphates, forming salts of low solubility which may precipitate out of soluton. Ethanol has bacteri- cidal actvity and is used to disinfect skin prior to injecton, venepuncture or surgical procedures. Precautons Avoid contact with eyes; avoid use in body cavites; meninges and middle ear. Chlorhexidine* Pregnancy Category-B Indicatons Antseptc; disinfecton of clean instruments; gingivits. Dose Antseptc (pre-operatve skin disinfecton and hand washing): use soluton in alcohol (70%). Adverse Efects Occasional skin sensitvity and irritaton; Upper respiratory tract infecton. Ethyl Alcohol* Indicatons Disinfecton of skin prior to injecton, venepuncture or surgical procedures. Precautons Flammable; avoid broken skin; patents have sufered severe burns when diathermy has been preceded by applicaton of alcoholic skin disinfectants; lactaton (Appendix 7b). Storage Store in a tghtly closed container at a temperature not exceeding 30⁰C, away from fre and protected from moisture. Contraindicatons Avoid regular or prolonged use in patents with thyroid disorders or those taking lithium; avoid regular use in neonates; avoid in very low birthweight infants; burn covering large surface area; hypersensitvity to iodine. Precautons Pregnancy (Appendix 7c); lactaton (Appendix 7b); broken skin (see below); renal impairment; avoid contact with eyes; neonates. The applicaton of povidone iodine to large wounds or severe burns may produce systemic adverse efects such as metabolic acidosis; hypernatraemia; and impairment of renal functon. Adverse Efects Irritaton of skin and mucous membranes; may interfere with thyroid functon tests; systemic efects (see under Precautons). Disinfectants do not necessarily kill all organ- isms but reduce them to a level, which does not harm health or the quality of perishable goods. Disinfectants are applied to inanimate objects and materials such as instruments and surfaces to control and prevent infecton. They may also be used to disinfect skin and other tssues prior to surgery (see also Antseptcs, above). Where water is not disinfected at source it may be disin- fected by boiling or by chemical means for drinking, cleaning teeth and food preparaton. It is highly corrosive in concentrated soluton and splashes can cause burns and damage the eyes. Appropriate precautons must be taken when concentrated chlorine solutons or powders are handled. The chlorinated phenolic compound, chloroxylenol, is efec- tve against a wide range of Gram-positve bacteria. It is less efectve against staphylococci and Gram-negatve bacteria; it is ofen inefectve against Pseudomonas spp. The aldehyde bactericidal disinfectant, glutaraldehyde, is strongly actve against both Gram-positve and Gram-negatve bacteria. A 2% w/v aqueous alkaline (bufered to pH 8) glutaral soluton can be used to sterilize heat-sensitve pre-cleansed instruments and other equipments. Dose Surface disinfecton (minor contaminaton): apply solutons containing 1000 parts per million. Instrument disinfecton: soak in soluton containing 1000 parts per million for a minimum of 15 min; to avoid corrosion do not soak for more than 30 min; rinse with sterile water. Chloroxylenol Pregnancy Category-C Indicatons Antseptc; disinfecton of instruments and surfaces. Dose Antseptc (wounds and other skin damage): apply a 1 in 20 diluton of 5% concentrate in water. Disinfecton of instruments: use a 1 in 20 diluton of 5% concentrate in alcohol (70%). Precautons Aqueous solutons should be freshly prepared; appropriate measures required to prevent contaminaton during storage or diluton; pregnancy (Appendix 7c); lactaton. Precautons Signifcant peripheral neuropathy; patents with diabetes at risk of neuropathic ulcers; protect surrounding skin and avoid broken skin; not suitable for applicaton to face; anogenital region; or large areas; increased levels of serum aminotransferase. Glutaraldehyde* Indicatons Disinfecton and sterilizaton of instruments and surfaces; conditons like warts and hyperhidrosis of palms and soles.

Nanospheres are spheri- cal particles composed of natural polymers such as gum cheap 100mg kamagra oral jelly visa, chitosan purchase 100mg kamagra oral jelly overnight delivery, gelatin, albumin, or collagen and the drug or gene is uniformly dispersed in it (7,16). Nanocapsules are vesicular materials in which the drug or gene is encased in a cavity surrounded by a polymeric material (16). Aquasomes are spherical particles composed of cal- cium phosphate or ceramic diamond covered with a polyhydroxyl oligomeric film (7). Recently, biodegradable polymeric nanoparticles, consisting of poly(glycolide) or poly(lactide-co-glycolide), are attracting considerable attention as potential gene delivery vehicles, as they are able to deliver peptides and genes through a peroral route of administration (16). Application of nanotechnology in cancer research: Review of progress in the National Cancer Institute’s Alliance for Nanotechnology. Scientific community worldwide has been working toward discovering “nanoscale” solutions to treat these diseases by using nanoparticle-based drug delivery systems. The applications of such sys- tems for cancer treatment are discussed in the following sections. Surgical treatment (excision of the tumor) is usually the first choice of treatment preferred by physi- cians. However, surgical excision is not effective when the cancer cells have infil- trated the nearby vital organs or have spread to distant parts of the body (metas- tasis). Cryosurgery is another surgical technique that is used for freezing and killing the tumor cells. It is an alternative to surgical excision and is used to treat tumors that have not spread to distant organs and for the treatment of precancerous or noncancerous lesions. Chemother- apeutic drugs may destroy healthy tissue along with cancer cells and carcinoma- tous tissue (cytotoxicity). The cytotoxic effect of chemotherapeutic drugs is highest in bone marrow, gonads, hair follicles, and digestive tract, all of which contain rapidly proliferating cells. The adverse effects of chemotherapy include fatigue, nausea, vomiting, alopecia (loss of hair), gastrointestinal disturbance, impaired fer- tility, impaired ovarian function, and bone marrow suppression resulting in ane- mia, leucopenia, and thrombocytopenia (3,4). Another technique of cancer treat- ment is radiation therapy, which uses radiation energy to destroy cancer cells and reduce the size of tumors. Bone marrow transplantation and peripheral blood stem cell transplantation are done to restore stem cells that are destroyed by high doses of radiation or chemotherapy. Recent research work has been focused on studying gene therapy for cancer treatment. Gene therapy is an experimental treatment that involves introducing genetic material into the cancer cells to destroy the cells (6). Angiogen- esis plays an important role in the growth and spread of cancer cells (7). New blood vessels act as a source of oxygen and nutrients to the cancer cells, allowing these cells to grow, invade nearby tissue, spread to other parts of human body, and form new colonies of cancer cells. Angiogenesis inhibitors are used to prevent the for- mation of blood vessels, thereby depleting the cancer cells of oxygen and nutrients. Hyperthermia (also called thermal therapy or thermotherapy) is a type of cancer treatment technique in which the cancer cells are exposed to high temperatures (up to 113◦F). Research has shown that high temperatures can damage and kill cancer cells with minimal injury to normal tissues (8). By damaging proteins and func- tional structures within cells, hyperthermia destroys cancer cells (9). Hyperthermia may make some cancer cells more sensitive to radiation or harm other cancer cells that radiation cannot damage. Thus, it is almost used with other forms of cancer therapy, such as radiation and chemotherapy (10). Laser therapy is most commonly used to treat super- ficial tumors on the surface of the body or the lining of internal organs. Photody- namic therapy is a type of cancer treatment that uses a drug called a photosensitizer or photosensitizing agent (12). When photosensitizers are exposed to this specific wavelength, they produce singlet oxygen, which destroys cancer cells. Targeted cancer therapy uses target-specific drugs that invade cancer cells and block the growth and metasta- sis of cancer cells by interfering with specific molecules involved in carcinogenesis and tumor growth (13). To overcome the disadvantages of current cancer treatment techniques, the scientific community has turned toward nanotechnology to develop newer and more effective drug carrier systems to safely shepherd the anticancer drugs to the cancer cells. Examples of drugs in this class include methotrexate, fluorouracil, hydroxyurea, and mercaptopurine. A few examples of drugs in this class include cisplatin and antibiotics such as daunorubicin, doxorubicin, and etoposide. Disruption of Synthesis or Breakdown of Mitotic Spindles Mitotic spindles serve as molecular railroads with “north and south poles” in the cell when it starts to divide.

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