Doctors: Never pass judgment on the human being in front of you needing help

Oh, how we all learn and change with our experiences. It’s one of the greatest things in life that most of us (hopefully) are not the same person now that we were a few years ago. Looking back to when I first become a physician at the age of 22 (yes, that’s the typical age […]

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Comment on Alternative To Sleeping Pills and Why the iPhone NightShift Mode Doesn’t Work by Margaret Ehr

According to the first reading of sleep types that I saw on your site, I am a Bear. I seem to be out of sync with the rest of the world as I peak in the afternoon. I need to figure out how to blend my schedule to function better and get to sleep, stay asleep and not end up being awake for two or three hours in the middle of the night. I’d like more information on Bears. I don’t know how to do Facebook. I take three – up to four Ropinirole (Requip) 0.25mg. tabs for Restless Legs and Melatonin 10 mg. at 9:30 PM. Then at bedtime about 10:30 PM, I take two Trazodone 50mg hcl tabs. I usually can get to sleep fairly soon unless I have issues bothering me. I do believe in keeping hydrated, thus I have to get up two to four times a night. I try to drink fluids earlier in the day rather than in the evening, but taking pills does mean drinking a glass of water with them. I am on a diuretic. I don’t know what to do when I can’t get back to sleep after getting up at four or five in the early morning. Does your book cover that aspect?

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Gender inequities and being a physician-mom [PODCAST]

“As the COVID-19 pandemic unfolds day by day at an exponential rate, we as doctors have been called to duty in unprecedented ways. Speak with any physician in the last few weeks, and you will be hard-pressed to find one who didn’t feel an intrinsic obligation- indeed, wish- to rise to the occasion with an […]

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Tadalafil belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. These medicines prevent an enzyme called phosphodiesterase type-5 from working too quickly to help men with erection disorder sustain a long lasting erection. It is used as an effective treatment plan for erectile dysfunction (ED) under the brand name Cialis as well as for the treatment of pulmonary arterial hypertension under the brand name Adcirca. It is only taken when needed and not taken casually.

Tadalafil generic is currently developed and marketed worldwide by Lilly ICOS, LLC, the joint venture of ICOS Corporation and Eli Lilly and Company.On November 21, 2003, the FDA approved tadalafil (as Cialis) for sale in the United States as the third erectile dysfunction prescription drug pill. In late November 2008, Eli Lilly sold the exclusive rights to commercialize the generic for pulmonary arterial hypertension in the United States and in May 2009, tadalafil was approved in the United States for the treatment of pulmonary arterial hypertension. The tablets come in four strengths and they include 2.5mg, 5mg, 10mg and 20mg.

Uses of Tadalafil

  • It is also used in both men and women for the treatment of the pulmonary arterial hypertension symptoms. Pulmonary arterial hypertension is a high blood pressure that occurs in the main artery which carries blood from the right side of the heart which is calledthe ventricle to the lungs.
  • It is used for the treatment of erectile dysfunction in men.
  • It is also used in treating men who have signs and symptoms of benign prostatic hyperplasia (BPH). BPH is caused by an enlarged prostate which causes difficulty in urinating, a decreased flow of urination, hesitation at the beginning of urination, and a need to get up at night to urinate.

How it works

For the treatment of pulmonary arterial hypertension, when the smaller blood vessels in the lungs become more resistant to blood flow, the right ventricle must work harder to pump enough blood through the lungs. Tadalafil works on the PDE5 enzyme in the lungs to relax the blood vessels. This will increase the supply of blood to the lungs and reduce the workload of the heart.

For treating erectile dysfunction, when a man is sexually stimulated, his body’s normal response is to increase blood flow to his penis to produce an erection. By controlling the enzyme, it helps to maintain an erection after the penis is stroked by increasing blood flow to the penis. Without physical action to the penis, such as that occurring during sexual intercourse, it will not work to cause an erection.


The dosage is different for different patients. You are highly recommended to follow your doctor’s prescription or the directions on the label. If your dosage is different from the advice you have received here, please do not change it unless your doctor approves that you to do so. 5mg is to be taken once daily if the medication is needed daily. The dosage may be increase to 10mg or 20mg depending on the body tolerance. You are advised not to take this medication in the days when you are not expecting to have sexual intercourse.

Side effects

A few side effects have been noted to include a slight headache, dizziness, facial flushing, nasal congestion, and indigestion. Outside the mentioned adverse effect are rare cases. Please report to your medical care centre if you realized you have taken an overdose or feel any serious abnormality while using this medication.

Where to buy cheap Tadalafil

A few reviews from most users revealed they usually buy online. It may be easy or to buy from an online store because they are known to offer the best price with more convenience, but be please be sure the online drug store is licensed by FDA. Also, your medical adviser would also recommend best places you can buy the medication at a cheap price

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Viagra oral Jelly

Use Viagra oral Jelly to end erectile dysfunction

Have you lost your zeal for sexual activity? Has a loss of erection kept you from reaching your former sexual peaks? Worry no more, Viagra oral jelly is here. Using Sildenafil citrate as its active ingredient, the gel increases blood flow to the penis leading to erections that last up to 4 hours after the medication has been taken. Viagra oral jelly comes in 100mg tablets that have different flavors. It can be taken from the sachet directly or with the assistance of a spoon. This Ed treatment option is so much flexible and kicks in real quickly. The gel dissolves in the mouth with or without water and should be taken about 30 minutes before sexual activity. This makes it much better than other Sildenafil based pills.

How to use

To enjoy the full benefits attached to the oral jelly, it is essential not to exceed the stated dosage. The most widely accepted dose is 100mg once a day for those with severe cases, and 50mg for those with milder forms of ED. A sachet is taken with or without water but preferably For patients taking certain protease inhibitors such as for the treatment of HIV), it is recommended not to exceed a maximum single dose of 25mg of Viagra jelly in a 48 hour period.


Viagra oral jelly is available online or physical drug stores and can be purchased from manufacturers or suppliers.When buying Viagra oral jelly online, there is a tendency to be offered the generic oral jelly as it is generally assumed to be the cheapest Viagra oral jelly. This does not translate to it being a safe place to buy the drug. To reduce the cost of the drug, coupons can be used. With coupons,the cost can be reduced from $2.33 (average price) to about $1.92 per sachet. It is also possible to benefit from free trial programs some suppliers use to lure customers and to also show the reliability of their products. Such can be the best place to buy if the free trial went successfully for you. Affiliate programs may also assist with bringing down the price, which is highly recommended if you come across any. Lastly, you can order Viagra oral jelly online irrespective of your current location a reliable UK store.

Possible Side Effects

Usually, the side effects accruing to Viagra oral jelly usage are mild and disappear after a short while. They include light sensitivity, dizziness, facial flushing, nasal congestion, and indigestion. More severe side effects include blurred vision, colour blindness, urinary tract infection, irregular heartbeat, swelling in your hands, ankles or feet, shortness of breath, fainting or an erection that is painful or lasts longer than 4 hours. It is imperative to note that you must not take this medicine if you are already taking any nitrate drug or any other substances that contain nitrate as the combination of Viagra oral jelly and nitrates can make your blood pressure suddenly drop to unsafe levels. Other contraindicated drug groups include macrolides, azoles, and antiretroviral drugs.


This is a truly miraculous drug! I wish I had not waited so long to try it. I only take a sachet of the 100 mg and it is amazing! My wife is as excited and pleased I am. The only side effect is a slight headache, but totally worth it. I had actually forgotten how hard I could get! An extra benefit is that my cold hands and feet are warm when taking this dose. It was uncomfortable initiating the conversation with my Doctor, but I am so glad that I did. Don’t wait! – Reviewer

It works great – Bigdog

I found the original drug very effective, but since the generic drug has been available, it is next to useless – Clancy

I tried 50 mg and it worked great. My urologist suggested that I try 25 mg and it worked just as well. Then I tried 12.5 mg and that dose worked also. Yesterday I tried having intercourse without it. I had an erection during oral sex and during initial intercourse, but I couldn’t maintain it. I took 12.5 mg and an hour later I had an amazing erection. I am a 60 year old who uses generic Viagra from a Canadian supplier that my doctor recommended. – Eric

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The first day of medical training during a pandemic

The faculty and staff welcome us warmly. They know each of our names as we walk through the door, and further conversation reveals that they have also studied the short biographical sketches we sent in last month. We are reassured – we belong here. I scan the atrium for students I might have seen at […]

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Doctors are fleeing the medical field. Here’s why.

The first day I started work as an attending physician in primary care medicine, I knew I had made a terrible mistake. This was not the heroic, selfless, service-oriented job or the romantic life “as seen on TV” I had imagined. Riddled with heavy school debt, despite my best efforts to join debt relief programs, […]

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Kamagra Oral Jelly

Kamagra oral jelly cures the inability of a man to give satisfaction to his partner which has been a source of concern to every sexual relationship. Penis erection failure which dreads every man has led to various researches, which have yielded many cures. One of these with most convenience is the kamagra oral jelly. Kamagra oral jelly is an innovative cure for ED. It is a tasty jelly occurring in different flavors that make it easy for anybody to consume it. In fact, you can buy different gel tastes until you discover which of the tastes is most preferred by you. Kamagra Oral Jelly provides a high-quality sexual experience for men of all ages who suffer from ED.

Working principle of kamagra Oral jelly

Kamagra Oral Jelly comes in about 7 different flavors(pineapple, orange, strawberry, vanilla, banana, black currant and butterscotch). Kamagra Oral Jelly does not require the consumption of water and dissolves easily in the oral cavity without any inconvenience.  The active ingredient for Kamagra Oral Jelly, Sildenafil citrate is a PDE5 inhibitor (PDE5 is an enzyme found in the penis). By inhibiting PDE5 production, the smooth muscles of the penis remain relaxed for a longer period of time, allowing blood to flow into the cavernous tissues of the penis to generate an erection.

Kamagra Oral Jelly usage and dosage

Each Kamagra Oral Jelly tablet contains 100mg of Sildenafil citrate and it is commonly referred to as Kamagra Oral Jelly 100mg. Kamagra generic (Sildenafil citrate) is also the active ingredient in Viagra. The most commonly prescribed dose is 50mg per use and the dose should be taken about 45 minutes before the erection is required as the effect of the pill is experienced by most users about 40mins after ingestion. If the patient is older than 65yrs or suffers from heart or liver diseases, the dose recommended is 25mg. It should be noted that the doses are not to exceed 100mg. It should be noted that Kamagra Oral Jelly despite its numerous potential, does not cause an erection unless the male organ is stimulated into sexual activity by any of the different means of arousal. The efficacy of the Kamagra Oral Jelly last about 4 to 6 hours and the man does not need any recovery period between the interval of orgasms and the resumption of intercourse. It is advisable to take Kamagra Oral Jelly only once a day.

Kamagra Oral jelly side effects and interactions

Some of the common side effects of Sildenafil include but are not limited to; dizziness, headache, flushing, diarrhea, blurred vision, indigestion. More serious side effects include; unusual heartbeat, urinary tract infection, painful or prolonged erection, and ringing in the ear.

Kamagra Oral Jelly can interact with certain alpha blockers; azole anti-fungal, macrolide antibiotics, nitrate medicines and high blood pressure medicines. It is important to tell your Doctor if you are on any of these medications.Alcohol is not advised to be combined with Kamagra Oral Jelly. And as the drug may cause dizziness, care should be taken when driving or operating machinery.Fatty foods should be avoided as it interrupts the reactions of the Sildenafil citrate by reducing the absorption of the Sildenafil. This increases the onset of action to more than an hour.


  • Kamagra Oral Jelly active ingredient is FDA-approved for ED treatment
  • Kamagra is in oral jelly form, which is easier to take if compared to pills and capsules
  • Kamagra oral Jelly is made with different flavor, making it very palatable
  • Kamagra Oral Jelly works faster than other Sildenafil generic ED treatment medications


  • Other ingredients used are not listed
  • There are no free trials of Kamagra Oral Jelly
  • Kamagra oral Jelly has no clinical trials
  • Kamagra oral Jelly is not FDA approved even though it’s made of SILDENAFIL
  • You must use the drug to experience the efficacy
  • Kamagra oral jelly active ingredient (SILDENAFIL) does not last as long as other ED medications


Should you experience any of the mentioned side effects, ensure immediate medical consultation with the doctor. Also, seek medical attention whenever erection lasts beyond the prescribed time or when erection takes place without any sexual cause or excitement.

It is however not advisable to take Kamagra Oral Jelly on a daily basis for a prolonged period of time. If the desired therapeutic effect of the drug is not being observed on usage, it is best to seek medical advice before continuing on use. The drug will usually take about 20minutes to 30 minutes to begin action and the effect lasts for about 4 to 5 hours.


Kamagra Oral Jelly should be kept away from children because its color and flavor could cause them to consume it. The patients too should not overdose on the drug; knowingly or otherwise as its effects could be potentially life threatening. In any of the mentioned cases, emergency help should be sought immediately.

Buying kamagra Oral Jelly

The estimated price of kamagra 100mgOral Jelly is $19.95 for a pack of 7 sachets. If you wish to buy Kamagra Oral jelly online, ensure that the company from is FDA approved. Some people wrongly assume that there exists Kamagra Oral jelly USA or Kamagra Oral Jelly UK, produced to suit only citizens of those countries. But Kamagra oral jelly exists only as Kamagra Oral jelly 100mg and suitable for any male user irrespective of his country of citizenship. There are several Kamagra Oral jelly reviews, both negative and positive on the internet to help you ascertain the authenticity of the Kamagra Oral Jelly supplier as well as consider if Kamagra oral jelly is actually a flavored cure for erectile dysfunction.

Kamagra Oral Jelly Reviews

My girlfriend got me Kamagra oral jelly. I tried it, and both were happy with results. I am now a regular customer of ADC. She is more than happy now. Thank you, Kamagra

I have been using Satibo for years with unstable effect. After trying out Kamagra Oral Jelly I had a wonderful sex and I think my red face was not too visible in the darkness, so, yes – this is a wonderful ED treatment! I recommend buying from trusted suppliers, though, as the number of fakes are overwhelming, so do your research before making a decision. Thanks to Kamagra oral Jelly and this site for my reliable manpower! – Maxwell

I didn’t have an orgasm for many years, despite being really active and open for experimenting. None of my partners was able to turn me on enough and after all, I began thinking that was due to some things being wrong with me. My urologist said everything was all right, but the therapist said my blood supply was not adequate and prescribed Kamagra oral Jelly. It worked unbelievably well and I had an orgasm of such magnitude I thought the bed will be broken! I recommend you take Kamagra oral jelly! – Lloyd

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Generic Levitra

As the name implies, erectile dysfunction is when the penile organ of the man produces substandard results as to what is expected of it. Unfortunately, many men are and will be under the threshold of this worrisome malfunction. At this point, a man can no longer achieve and sustain an erection which is important for extreme sexual ecstasy. This has wrecked havoc in so many homes and will if the menace is not taken care of early or well enough. That is why the manufacturers of the Generic Levitra have taken it upon themselves to help ailing men in terms of potency and sexual gratification. With this Generic Levitra 20 mg, sexual advancement now comes with refinement and by relying on this all time solution to impotence, sexual satisfaction takes a new leap!

Is there a generic for Levitra?

Yes, there is. As approved by the FDA, there is the production of a generic Levitra. It doesn’t mean that it is any different from the main drug although the commercial production of the generic Levitra is not available. From available sources, it has been gathered that there might be an expiration of the patent that produces the main drug. Notwithstanding, one can still get the generic Levitra (VARDENAFIL) to buy either online or otherwise medicine stores where permitted.

Does Generic Levitra work?

Levitra generic is composed of VARDENAFIL and other pharmacological properties of the original drug that is, it is the same as the non- generic form. Although is in its generic form does not make it substandard but it is only an added advantage to buyers who may not afford the original product. It is effective even though it is just the main ingredient name that is used to sell the drug making it cheaper than those sold under a brand name. Now, how does generic Levitra work? This cheap generic Levitra works as effectively as the main drug as a PDE-5 inhibitor. The action principles are not any different from each other in that they help to relax the pelvic floor muscles and with a good amount of sexual stimulation, increase blood flow to the penis.

What is the Levitra generic name?

Being as a common as ABC, the Levitra generic name is a household name to the extent that so many manufacturers whether true or not incorporate it in their ED products. Vardenafil is the generic name for Levitra and is in effect its main composition. It is an important feature in the generic Levitra. However, many unapproved manufacturers are using the name to sell their drugs. That is why, when you want to buy generic Levitra, visit a trusted outlet to avoid buying fake products.

Where do I trust to buy generic Levitra?

This is an important question frequently asked due to the practices of some hoodlums who are out to rob people their money for desiring cheap generic Levitra. There are nevertheless some tested and proven outlets to choose from to purchase the cheap generic Levitra. When you want to buy generic Levitra, it is always safe to buy generic Levitra online from outlets that are over time reliable and have through generic Levitra reviews proven to deliver nothing short of genuineness. It also adds to it the advantage of privacy as the buyer now eliminates any form of shyness that he would have encountered if it was to be that he bought it over the counter.

If peradventure you are still not able to get a reputable online service to your use, there is an online pharmacy known as where genuine generic Levitra is delivered into your hands. This otherwise preferred pharmacy where you can get cheap generic Levitra online is equipped with all necessary modalities to make sure that any medicine offered up for sale by them has undergone appropriate tests to ascertain its authenticity. Also with the are some advantages such as easy ordering, online payments, home delivery and some shipping options which include overnight shipping and international merchandise for your convenience.

The cheapest generic Levitra is also available if you can contact Generic Levitra Canada for ships from Canada for the convenience of people around Canada and its environs.

Is there a recommended dosage?

Apart from being a trusted measure to alleviate erection disorders, it also comes with its dos and don’ts. Even so, the manner in which the generic Levitra is used is paramount in accessing its effectiveness. This powerful erectile dysfunction therapy conveniently comes in three different dosages available for use at any stage of the disorder. It comes in 5 mg, 10 mg and 20 mg and the dosages are likewise different. The 10 mg dose is usually administered at the onset of usage. The Generic Levitra 20 mg is mostly given to those with more severe cases of the dysfunction and if a person’s case is just at the initial stage, 5 mg dosage is permitted.

The maximum dosage isgeneric Levitra20 mg daily and should be taken like 30 minutes before the onset of any sexual activity and upon stimulation, an erection is guaranteed. It can be taken with or without water or food. Alcohol and fatty foods although do not have any impending effects, but they interfere with the drug reducing its effectiveness and should be avoided.

Do not on any account exceed the recommended dosage because this increases the risk of the side effects on a person that’s why a visit to the doctor before an onset of medication is necessary so that the actual stage of the disorder is ascertained and will in effect reveal the required dosage.

Is there any side effect attached to the Generic Levitra?

As effective as it can be the Levitra generic name is not without downsides. On a lighter note, a number of cases that have been recorded showed that ingestion by some patients gave rise to reactions such as headaches, giddiness, nausea, nasal congestion, back pain and sensitivity to light. These reactions, however, do not last for a long time but if in any case on ingestion of the Generic Levitra a more prolonged effect is noticed, the attention of a doctor must be sought after.

According to statistics, more pronounced and although rare cases of the reaction are severe dizziness, heart attacks, strokes, priapism, cardiovascular problems, chest pain, high blood pressure etc.

How much can I buy Generic Levitra?

The generic Levitra is not available in regular stores and so the prices are not feasible there, but on online shopping outlets depending on the mg and how many pills per package, the prices are different. As a generic medication, it is as affordable as any other ED medication.

What are their ratings?

As gathered from generic Levitra reviews, responses from correspondents have shown that the cheap generic Levitra is efficient in kissing goodbye to the strongholds of impotence as it was rated high. As simple as it may sound, it has restored back the spark in sexual partners as they can now last longer in bed.

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Women in medicine: a conversation with my daughter about lessons learned 

A few weeks ago, I became a full professor of medicine. The grand moment happened 28 years after graduating from medical school. The week after the promotion letter, my daughter’s MCAT results were in, and she was hitting submit on medical school applications. Fun fact, I had her at age 28, my chief resident year.  […]

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