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Can a Man Maintain Male Organ Health with Surgical Enhancements?

For the past several decades – and possibly even longer – male enhancement products have turned low confidence into a billion-dollar business. Ads tout everything from supplements to surgical procedures that promise to make a man larger, harder, longer, and even last longer. But the truth is that there are extremely few options out there that actually work as a male enhancement. Most men realize the use of questionable methods is definitely not a part of good member care.

Once a man cuts through all the claims in search of true male enhancements, he usually finds that there is nothing out there – except a few options that include serious surgical changes to his manhood. One of those changes is called the Penuma, a silicone member implant that promises to add girth and length to the member over a period of time.

However, remember that this is an implant – and that means a man must undergo a very serious surgical procedure in order to obtain it. For those who are curious, read on for more about this very rare and innovative procedure.

Is this a real male enhancement?

The Penuma is the mastermind of Dr. James Elist, a urologist from Beverly Hills. For many years he has worked with those who needed member implants for a variety of reasons; one of his patients was infamous publisher Larry Flynt, who needed an implant following severe injuries after being shot. There is little doubt Dr. Elist knows his way around male enhancement and male organ health.

The Penuma is a sheath of silicone designed to fit around the shaft of the member. It is fitted during a short operation (albeit one that costs at least $13,000, barring any complications), has a 95 percent success rate, and results in a larger girth immediately; a longer length occurs over the span of a few months. Men usually need a few months to recover from the procedure before testing out the new equipment, so to speak.

Dr. Elist is currently the only doctor cleared by the FDA to perform the procedure. This means two significant things: First, that there is a long waiting list to get the job done, and secondly, that there really isn’t a large pool of men to study for after-effects or problems that might result many years down the road.

A man who can get past the gasp-inducing price tag might be tempted to pursue the Penuma implant; however, it is important to remember that any surgical procedure, no matter how proven, can have complications that occur during or after the procedure. Any tampering with the delicate member tissue can lead to serious problems with male organ health later, including scarring, lumps where the interior scarring has occurred, issues with sensitivity and much more.

Maintaining good male organ health

While it might be tempting to turn to male enhancements to increase girth or length, most men will be well-served to focus on the health of what they have been given by nature. In order to do this, paying close attention to good member care is essential.

One of the most important components of good member care is the use of a superior male organ health crème (health professionals recommend Man 1 Man Oil, which is clinically proven mild and safe for skin). A man should search for a crème that helps keep his member skin health, smooth and ready for action. This includes vitamin B5, also known as pantothenic acid, which is great for maintaining cellular health, as well as vitamin C, which is great for skin elasticity. Those who want strong firmness can look for a crème that contains L-Arginine, which opens up the blood vessels and promotes hardness. Add more great vitamins in a Shea butter base, and a man has the recipe for a great-looking and wonderfully-functioning manhood.

Visit http://www.menshealthfirst.com for additional information on most common male organ health issues, tips on improving member sensitivity and what to do to maintain a healthy member. John Dugan is a professional writer who specializes in men’s health issues and is an ongoing contributing writer to numerous websites.

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Navigating Income Tax Consultancy in Pune: A Comprehensive Guide

The Role of Income Tax Consultants in Pune
Pune’s economic landscape is dotted with diverse businesses requiring adept handling of financial and tax-related matters. Income tax consultants play a vital role in ensuring compliance with changing tax laws, which are often updated during the annual financial budget presentations by the finance minister. These professionals are instrumental in managing tax filings, especially for Non-Resident Indians (NRIs) who meet specific criteria mandating them to file returns in India.

Services Offered by Tax Consultants
Tax consultants in Pune provide a broad spectrum of services tailored to individual and corporate needs:

Tax Planning: Strategizing to utilize available deductions and rebates effectively.
Tax Saving Advice: Recommending financial instruments and investments that reduce taxable income.
Advance Tax Calculation: Estimating taxes that need to be paid in advance to avoid penalties.
Income Computation: Calculating taxable income after considering applicable deductions.
Filing of Income Tax Returns: Completing and submitting tax returns in accordance with statutory timelines.
Handling Assessments and Notices: Assisting clients during audits and in responding to notices from the tax authorities.
Amendments and Rectifications: Making necessary changes to previously filed returns to correct any discrepancies.
A prominent example of a consultancy firm in Pune is A N Bhutada & CO, known for their expertise across various industries including IT, BPO, and trading sectors. They offer tailored tax solutions that have reportedly led to significant tax savings for their clients.

Critical Timelines and Documentation
Key Filing Deadlines
The deadlines for filing income tax returns can vary based on the type of assesse:

Individuals and firms not requiring audits: July 31 of the assessment year.
Entities requiring audits: September 30 of the assessment year.
Belated returns: Up to March 31 of the assessment year following the financial year.
Essential Documents for Tax Filing
The documentation required for filing tax returns depends on the taxpayer’s source of income:

For Salaried Individuals:

Form 16
Form 26AS
PAN and Aadhaar Card
Details of bank interest income
Proof of investments under sections like 80C, 80D, etc.
For Business Owners:

Bank statements
Sales and purchase invoices
Expense records
Credit card statements
Loan accounts
Understanding the Costs Involved

The fees for income tax filing services in Pune vary widely. For individual taxpayers, the charges can range from INR 500 to INR 5,000, depending on the complexity of the return. It’s important to note that these fees are indicative and can differ based on the specific requirements and the consultant’s expertise.

Conclusion
Navigating the complexities of income tax in Pune requires professional expertise, particularly given the city’s dynamic economic environment. Engaging a knowledgeable tax consultant can help in effectively managing tax liabilities, ensuring compliance, and avoiding legal pitfalls. For those looking to explore further, reputable sources like the Income Tax Department of India provide extensive information on tax laws and regulations.

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Instability of the pelvic ring combined with hemodynamic instability

The initial treatment in this condition is to focus on immediate control of pelvic hemorrhage. Although any single method is not effective for controlling the bleeding. Different treatment protocols for emergency hemostasis have been documented recommending a wide variety of methods. On a combination of treatments like early pelvic stabilization followed by surgical hemostasis if required and then a priority-based procedure should be followed which can prove favorable in the patient’s survival. But to evaluate the efficiency of these methods, continue evaluation of resuscitation procedure is significant.

Treatment Protocol

For patients admitted in multi-trauma condition, a standardized protocol is used for initial clinical treatment. This protocol can be expanded by a complex pelvic fracture module if hemodynamic instability is caused by the pelvic fracture. In this case, three prompt decisions are to be made within 30 minutes after the admission of the patient. While in the rare case of critical pelvic hemorrhage, immediate surgical intervention is required. Generally, a primary diagnostic evaluation including clinical examination, pelvis AP x-rays, ultrasound abdomen is performed. But if there is unstable hemodynamics due to pelvic instability, emergency stabilization must be done as soon as possible.

Effective stabilization can be attained using the pelvic C-clamp or the simple external fixator within 10–15 minutes in case of emergency. If these devices are not available at hand then other non-invasive techniques such as traction and ring closure with a sheet or pelvic sling, pneumatic anti-shock garment, and vacuum splints, can be used for immediate stabilization. Though the amount of pelvic blood loss is reduced after mechanical stabilization but does not provide complete hemostasis therefore, if even after 10–15 minutes of application, the patient’s hemodynamics is not stable then immediate surgical hemostasis with reconsideration and repair of the pelvic retro-peritoneum should be followed.

The technique of pelvic packing in a hemodynamically unstable patient

For pelvic packing in a hemodynamically unstable patient. The patient needs to be positioned supine with the entire abdomen and pelvis draped. If little or no intra-peritoneal free fluid is discovered in primary or controlled ultrasound examination then, a lower midline incision is used to center the origin of bleeding to the pelvic region. A formal laparotomy is administered together with intraperitoneal hemorrhage, and the extension of incision is done to the pubic symphysis region.

As disruption of all para-pelvic fascial planes is common so through the right or left para-vesical space down to the pre-sacral region, direct manual access is obtained without further dissection. Rare arterial bleeding should be the primary concern which can be managed by clamping, ligature, or a vascular repair. In case of mass bleeding, provisional clamping of the infra-renal aorta proves useful but in such case, laparotomy is required. Usually, diffuse bleeding originates from the surfaces of fracture or the venous plexus. in type C injuries the bleeding usually originates from the pre-sacral region. Mostly in external rotation-type injuries, the source of bleeding is close to the anterior pelvic ring. Tight pre-sacral and para-vesical packing can be used to control the hemorrhage. If the posterior pelvic ring is stable enough then tamponade can be effective. If considerable posterior displacement still occurs which can be examined by palpation, the reduction needs to be optimized by loosening the clamp, and then prior to the application of tamponade, the further manual reduction is done.

At last, a symphysis orthopedic implant plate is applied for the stabilization of the anterior pelvic ring, and an external fixator is used in case of trans-pubic instabilities. General surgical rules are applicable for repairing the additional intra-abdominal organ injuries. And the patient’s general condition should be considered for further surgery. Damage control procedures such as insertion of a transurethral catheter, suprapubic urine drainage, and suture of the bladder after urological injuries or, in rectal injuries, a diverting colostomy with prograde wash-out and drainage are recommended at an early stage. The tamponade packs can be left for 24–48 hours. These can be removed or replaced in planned second-look surgery. If a subsequent and considerable pelvic blood loss continues even after the effective tamponade, then angiography and embolization are strongly advised.

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