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The drive across Maasai country is enlivened by the sight of these proud warriors and by wildlife scattered across the plains, often in close proximity to domestic stock. Amboseli National Park is reached in time for lunch. A rest before an afternoon game drive enables you to explore the wonderland set so picturesquely at the foot of Africa’s highest mountain Kilimanjaro. Meals and overnight in a lodge or camp in the park.
Day 02 Amboseli – Tsavo
Before breakfast a final game drive can be taken in Amboseli when Mt Kilimanjaro usually appears from its mantle of clouds. After breakfast, cross into Tsavo West National Park past the Chyulu range of extinct volcanoes. From one cone “sheitani” which is not more than a couple of hundred years old, black lava streams extend across the dry bush country. The forest patches on top of the Chyulus are of great interest to ornithologists. This is Kenya’s largest park noted for its large elephant population. The interesting Mzima springs are in this park. Hippos, crocodile and a variety of fish co-exist in the pool and can be seen from the sunken glass chamber. Meals and overnight at a lodge/ camp in Tsavo. Full board
Day 03 Tsavo West – Mombasa
After breakfast the tour continues to Mombasa, which is reached by lunchtime. The most interesting feature of this route to Mombasa is its vegetation. The baobab tree with its large swollen trunk. It is one to the largest around the trunk and longest living trees in the world. It is believed to live up to 2000 years, ranking with the sequoias of America. It is found only in Kenya and a few grow in South Africa. Very few leaves are found on the tree, Dr. Livingstone referred to it as “a carrot planted upside down”. The baobab is noted as the most unique in the world. It has many uses: most parts of the tree are used for food. Soap, glue, rubber fibres and medicine come from this tree (In African Trees by Dorothy and Bob Hargreaves, 1972). The other interesting trees are the types of acacias one sees a long the road. The tour ends on arrival in Mombasa before lunch.
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One of the forms of phophodiesterase is termed PDE5. The prescription PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are prescription drugs which are taken orally. They work by blocking the action of PDE5, which causes cGMP to degrade. CGMP specific phosphodiesterase type 5 causes the smooth muscle of the arteries in the penis to relax, allowing the corpus cavernosum to fill with blood.
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Formal neurological testing is not needed in the vast majority of patients with ED. Those with a history of CNS problems, peripheral neuropathy, diabetes, or penile sensory deficit would probably benefit from some level of neurological testing. The sensitivity of the skin of the penis to detect vibrational stimuli, ie, biothesiometry, can be used as a simple nerve function office screening test. This involves the use of a small electromagnetic test probe placed on the right and left sides of the shaft and on the glans. The vibrational amplitude is adjusted until the subjective sensory threshold is reached, which is determined by questioning the patient. A series of these tests determines the average vibrational sensory threshold in each location, which are then compared to reference range standards for the patient's age group. Although this test does not directly measure the erectile nerves, it serves as a reasonable screening for possible sensory deficit and is simple to perform. Formal nerve conduction studies, such as bulbocavernosus reflex latency time, are reserved for very select situations.
Adult 10 mg PO 1 h before sexual activity; may increase to maximum recommended dose of 20 mg or decrease to 5 mg based on efficacy and adverse effects
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Results: Of the 2,010 men interviewed, 257 (12.8%) reported ED. The prevalence increased with age, from 2% in men aged 18-39 to 48% in those >70 years (tested for trend, p = 0.0001). A history of cardiopathy, diabetes, hypertension, neuropathy, thrombotic/hemorrhagic stroke, peripheral vascular disorders, pelvic/medullary injury and pelvic surgery/radiation all increased the risk of ED. The association of hypertension and diabetes tends to increase the risk of ED. In comparison with nondiabetic and nonhypertensive men, the odds ratio (OR) was 1.4 (95% confidence interval (CI), 0.7-3.2) for hypertensive men without diabetes, 4.6 (95% CI, 1.6-13.7) for diabetic men without hypertension and 8.1 (95% CI, 1.2-55.0) for men with diabetes and hypertension. In comparison with never smokers, the OR of ED was 1.7 (95% CI, 1.2-2.4) for current smokers and 1.6 (95% CI, 1.1-2.3) for ex-smokers and increased with duration of the habit.
The major difference between tadalafil and the other PDE-5 inhibitors is its prolonged half-life of 17.5-21 h compared with sildenafil (4-5 h) and vardenafil (4.8-6 h). In those who respond, coitus has been recorded from 30 min to 36 h after administration.
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When the sufferer is aged the problem is generally physical in nature. Physical causes of Erectile Dysfunction include damage to penis caused by an injury, blockage of arteries and veins in the penile area, consequence of diabetes or drug and alcohol overdose or old age for that matter. No matter what the cause is ED pills like Viagra, cialis and levitra are very potent in over coming sexual dysfunction of Erectile Dysfunction in males of any age. So zero in on to ED pills to enable yourself to overcome your erectile dysfunction problem.
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Erectile dysfunction affects, to some degree, 52 percent of men aged 40 to 70 years in the United States and 322 million men worldwide. The condition is linked with age, risk factors for atherosclerosis (hardening of the arteries) and heart disease, according to background information for the study. The paper was expected to be published Wednesday in the online edition of the European Heart Journal.
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Liver and kidney function testsLiver and kidney disease can create horomonal imbalances. Blood tests for liver function involves analysis of enzyme and serum creatinine levels, which are indicators of kidney efficiency.
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Vardenafil was evaluated in four multicenter, randomized, placebo-controlled trials involving more than 2400 men (78% white, 7% black, 2% Asian, 3% Hispanic) with erectile dysfunction. Two of these trials were conducted in special erectile dysfunction populations; one in men with diabetes mellitus, another in men who developed erectile dysfunction after prostate surgery. The doses of vardenafil in the four studies were 5 mg, 10 mg, and 20 mg.
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Sex therapy is a short-term form of counseling, generally involving 5 to 20 sessions with a sex therapist. A typical session may be one hour every week or every other week.
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WT 24 - Amboseli-Tsavo-Mombasa