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Tips for Doing Well in the Family Medicine Rotation
ruhasaul
Here are my tips for doing well in Family online pharmacy.

1) Be enthusiastic. This is good advice for every rotation actually, but especially in the outpatient clinic. You might feel like you have no intention of going into family medicine (which I don't), but that doesn't mean you can't learn something from the experience or that it isn't important.

2) Read about your patients. Even though your contacts with most of the patients will be short-term (just one visit) because the rotation is so short, you should still read up on the patients and learn more about their diseases. Discuss what you read with your preceptors.

3) Be on time. This should be an obvious thing, so don't be "that student". You'll be fine if you always keep in mind that it is ok for you to wait half an hour for the attending to show up, but the opposite is not true! ;-)

4) Keep up with your logs. You should write your H & Ps and fill out your logs every day (every half day if possible). Yeah, it sucks spending your lunch hour writing logs and H & Ps. But you see so many patients in the family medicine clinic (I'd usually see about 8 per day on average) that there is just no possible way that you will remember what you saw or did if you don't write the notes as quickly as possible. Plus, if you get all of the notes done while you're in clinic, you won't have to write them at home.

5) Read a family medicine book. The book that was suggested for this rotation wasn't very helpful, in my opinion. It's too long to possibly get through during a three week rotation. Get Case Files: Family Medicine instead and read it cover to cover. That's definitely doable in three weeks.

6) Submit EVERY log for assessment. Some preceptors won't write you an eval. If you submit every log, you will have no problem getting enough evals for the rotation. Just be sure to batch them each half day so that the preceptor isn't getting like four different eval requests per day.

7) Any time a preceptor asks, "Hey, would you like to do....?" always say yes. Stay the extra half hour, do the extra Pap smear, interview the extra patient. The more interest you show in learning, the more willing the preceptor will be to teach you something interesting.

8) Be nice to the nurses and MAs. Yes, they have been in medicine way longer than you have. Yes, they do know more about clinical stuff than you do. Yes, they will talk about you behind your back if you're an arrogant idiot. I was hearing stories about previous med students who are long done with their residencies by now....assuming that they made it through the rest of their third years!

9) Work your way into the rooms one baby step at a time. Sometimes you may run into patients who don't want to see a med student. What you should do is ask them if you can just talk to them for a couple of minutes to get their meds or find out why they came in today. You can even point out that it will speed things up since you can put their info into the computer for the doctor. Once they have been talking to you for a while and you have had a chance to build up some rapport, you can then ask them to let you listen to their heart and lungs. While they're on the exam table, you can throw in an HEENT exam or an abdominal exam if appropriate. This strategy worked for me every single time. I never had a patient refuse to let me talk to them "just for a couple of minutes," and I never walked out of the room without doing a focused physical exam. The key is that you need to project an attitude of confidence and humility at the same time.

10) Even if you hate family medicine, look at the bright side. It's only a few weeks, and there are no weekends or calls. You're totally going to miss this rotation once you start slaving away 80 hours per week on one of the inpatient services!

Pallrywyn Forte
ruhasaul
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Pallrywyn Forte
Improves performance and heightens pleasure in men and women
PALLRYWYN FORTE TABLETS COMPOSITION each coated tablet contains:
Name of Ingredient Powders and Bhasmas: Latin/ English Name Quantity
Makardhwaj >>>> 80 mg
Jaiphal Myristica fragrans 25 mg
Shwet Musli Chlorophytum arundinaceum 25 mg
Shilajit shuddha >>>> 20 mg
Kulinjan Alpinia galanga 20 mg
Abhrak Bhasma >>>> 10 mg
Akkalkara Anacyclus pyrethrum 10 mg
Lavang Caryophyllus aromaticus 10 mg
Loh Bhasma >>>> 10 mg
Pippali Piper longum 10 mg
Tamalpatra Cinnamomum iners 10 mg
Vriddhadaruk Argyreia speciosa 10 mg
Kupilu shuddha Purified Strychnos nux-vomica 5 mg
Suvarna Makshik Bhasma >>>> 5 mg
Trivang Bhasma >>>> 5 mg
Nagkeshar Mesua ferrea 2 mg
Karpur Camphora officinarum 0.5 mg
Extracts of the following: Kapikachchhu shuddha Purified Mucuna pruriens 10 mg
Amalaki Emblica officinalis 40 mg
Ashwagandha Withania somnifera 40 mg
Shatavari Asparagus racemosus 40 mg
Varahikand Tacca aspera 20 mg
Vidarikand Ipomoea digitata 20 mg
Gokhshur Tribulus Terrestris 10 mg
Bhavana Palandu Allium cepa 30 mg
Nagvalli Piper betle 30 mg
THERAPEUTIC RATIONALE: PALLRYWYN FORTE is a natural aphrodisiac and sexual performance enhancer. Mucuna pruriens (Kapikachchhu), Withania Somnifera (Ashwagandha), Myristica fragrans (Jaiphal), Anacyclus pyrethrum (Akkalkara) and Chlorophytum arundinaceum (Shwet Musli) are well known aphrodisiacs which help improve libido in both the sexes. Myristica fragrans (Jaiphal) and Carrophyllus aromaticus (Lavang) are found to be comparable to cheap viagra citrate, in enhancing the sexual performance. In females PALLRYWYN FORTE improves frigid conditions and relieves vaginismus.
Indications
Impotence – psychogenic / idiopathic
Premature senility or loss of libido in both sexes.
Dosage
1 to 2 tablets two times a day to be taken preferably with milk. A minimum medication period of 8 weeks should be allowed to assess the response.
PALLRYWYN FORTE can be co-prescribed with Charak’s other formulations for related disorders e.g. with NEO (for managing premature ejaculation) or with ADDYZOA (for improving sperm count and morphology).
Presentation
Blister pack of 20 tablets (silver-coated).
DO'S AND DONT'S
Do 's
1) Consume food ingredients having sweet and astringent taste.
2) Consumption of milk and butter is normally recommended.
3) Meat and eggs can be consumed in good quantity.
Dont 's
1) Avoid irregular dietary habits
2) Avoid smoking and consumption of alcohol.
3) Avoid sour, pungent and bitter food recipes.
4) Avoid late night and sleepless nights.
5) Avoid physical and mental stress and strain.

Ayurveda for Natural Health
Sexual Diseases - Yoga management
A sexual problem is that prevents a female from experiencing satisfaction from sexual activity. Yoga asana and breathing exercises help in obtaining the optimum health state.Lack of desire, painful intercourse, inability to get aroused and sexual climax are some problems that can keep a woman from experiencing satisfaction during sexual activity.Physical health, psychological health, stress, depression, fatigue, menopause, over weight and lifestyle are some of the contributing factors to the above-mentioned problems.How Yoga Helps:1. It breeds confidence by clearing your mind and focusing on breath helping in being more aware of yourself.2. It eases pain for some women, especially sportswomen, hip and thigh tightness can make sex tough, but yoga can ease any pain by releasing that tension and relaxing your hips. It tones your pelvic floor and strengthens your entire core.3. According to Yoga, the sexual secretions contain the seeds of life, concentrated life force and nutrients and once depletion in life force takes place, the vitality level and resistance to diseases tends to diminish. A complete branch called Kundalini Yoga, deals with harnessing the sexual power.4. Mula Bandha (Sanskrit name) an asana can even be done at your work desk. Do it seated or standing, contract and then release the muscle located between the pubic bone and the tailbone, as if you wanted to stop the flow of urine.5. Pushups and putting up legs up the wall in yoga style really helps, emphasis being on bringing awareness to your breath and focusing on it for few minutes. This position allows more oxygen-rich blood to flow from your lower body back up to the heart and the brain, so you’ll get up reenergized and refocused. Yoga as a system combines postures, breathing exercises, and meditation since remaining relaxed is perhaps one of the most essential preconditions for a harmonious sex life. Irritation, improper lifestyle, stress may prove a stumbling block in a healthy sexual life and relationship. It has been found that many wives admit to their sexual life and marital relationship improving after taking up yoga.

Ayurveda - Traditional Indian Medicine

Female sexual diseases- Ayurvedic management
Female sexual problem prevents her from experiencing satisfaction from the sexual activity. Lack of desire, pain during intercourse, sexual climax is some of the sexual problems they face. Many factors like medical, physical and psychological reasons; diet and lifestyle contribute to sexual problems.Few Ayurvedic Remedies are:1. Healing qualities of Shatavari are very effective on the female reproductive system related problems. It helps in minimizing the women’s complaints related to menstrual cycles and balancing the female hormonal system. It also helps in decreasing the inflammation of female sexual organs, in fighting tiredness and morning sickness, helps in problems related to infertility, leucorrhea, and in regulating ovulation etc, which occur during the menopause cycle. Those women, who face problems of hot flashes, they should try combination of Shatavari and Kama Duba.Shatavari helps in treating/balancing ‘Pitta dosha’. Useful for infertility, impotence and general sexual debility, decreased libido, threatened miscarriage, menopause, leucorrhea, and has the ability to balance pH in the cervical area.2. Women who exercise regularly, take vitamins regularly and eat fewer saturated fats, more full-fat dairy products and less meat have fewer ovulation problems. Chocolate contains phenethylamine, a nutrient that enhances mood and is the chemical we produce in our brains when we fall in love. Artichokes, like wine, are also good for ladies Sex is an integral part of our daily habits (Dinacharya). Night and after two hours of dinner is the ideal time for intimacy, as it is kapha time. Healthy food: Avoid refined carbohydrates emphasize on lean meats, chicken, fish, and a lot of vegetables. Homemade salad dressing consisting of flaxseed oil and freshly squeezed lemon juice is also beneficial. 3. Vajikarna is one of eight disciplines, which deals with maintenance of vitality. Women seek rejuvenation chiefly to restore their youthful beauty and attraction. This can be achieved by the concept of Rasayana (rejuvenation).

Ayurveda- Indian Healthcare
Premature ejaculation- Management with Ayurvedic medicines
According to Ayurveda, premature ejaculation is due to imbalance of Vaata (wind) element. Pitta (bile) and Kapha (phlegm) are the other two elements. Vata is characterised by heightened sensitivity to the sense of touch. This translates in to predisposition towards quicker ejaculation. Ayurveda takes a holistic view of the situation and has specific treatment for premature ejaculation using herbal combinations. A brief description about some of the drugs of choice is given below.. Ashwagandha (Withania somnifera), a herb popularly known as Indian ginseng is very widely used in treating sexual debilities. Ashwagandha is used as Rsayana (Rjuvenator) and Vaajikarna (Ahrodisiac). Kavach beej(Mucuna pruriens) is another herb of choice in premature ejaculation. It has also remarkable ability to increase the sperm count. Salab mishri(orchis mascula) is yet another frequently used herb. Jatiphala (Myristica Fragrans) used with milk is an effective remedy, Almond taken in milk is good for improving sexual drive and sexually related problems Adding saffron to this milk drink makes it even more effective. Speman tablet ( Manufactured by Himalaya Drugs) is a good drug.1 to 2 tablets taken twice a day after meals, is a useful remedy for premature ejaculation. The drug has been put through extensive clinical trials. Orchis mascula, Lactuca scariola, Mucuna pruriens, Parmelia perlata, Argyreia speciosa, Tribulus terrestris, Leptadenia reticulata, Suvarnavang (Mosaic gold) and Rauwolfia serpentina goes in to the manufacture. Tentex Forte tablet (Manufactured by Himalaya Drugs) is another formulation useful in treatment of premature ejaculation. The intake is 1 to 2 tablets taken twice a day after meals. This drug also has been put through extensive clinical trials. Saffron, Amber, Muskdana, Nuxvomica (detoxified), Makardhwaj, Shilajeet (Purified), Orchis mascula, Anacyclus pyrethrum, Withania somnifera, Sida cordifolia, Bombax malabaricum, Argyreia speciosa, Mucuna pruriens and Trivang goes in to the manufacture. The formulation is processed in Sida cordifolia, Asparagus racemosus, Ipomoea digitata, Piper betle, Withania somnifera, Tribulus terrestris, Tinospora cordifolia, Argyreia speciosa, Acacia arabica fruit, and Dashamoola. That was a quick glance at some of the options available in Ayurveda for premature ejaculation. A proper treatment under the guidance of a good Ayurvedic practitioner will bring salutary results sans any side effects.





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