Monday, October 22, 2018

Free Hot Physical Fitness and Health Tips

Free Hot Physical Fitness and Health Tips


The secret of a good sound and health through proper care of the body and needs, regular exercise and attention to seek medical advice.
A number of diseases on the planet today are functions of the human consumption (what you eat) and carelessness. With migraine as a case study, usually by stress, sleeplessness, lack of adequate blood flow to the brain and so caused can lead to stroke if aura (visual disturbances) is added to migraine. Although these studies suggest is used in women who smoke and oral contraceptives.
As mentioned above, play an important role in our receiving our physical health and fitness status. You will agree with me that it is a suicidal mission for a diabetic with the consumption of sugary, starchy roots and fruits, if he or she is expected to do to increase away from their use in the community.
In summary, the following measures should be considered appropriate if you want a good physical fitness and health condition:
1. Maintain a clean and tidy environment always
2. Determine your body and give him so if necessary.
3. Eat plenty of fruit and vegetables – both are immune to many complaints.
4. Try to know a lot about your body system, for example, if you need a break to read and at the right time for everything you do.
5. Try as much as possible to know about your health at intervals through regular medical check-up.
6. If more than 35 years old, will seek, or take your dinner before 7:00 clock.

7. Engage in light exercise on a daily basis.

HEART


HEART


The heart is a muscular pump in the chest, which beats continuously, sending blood to the lungs and the rest of the body. It is like the engine room of the body; without the heart a person would not be able to survive. A constant supply of blood is needed to circulate round the body to keep a person healthy.

Facts about the heart
The heart is in fact a very strong piece of muscle, which is about the size of a clenched fist and weighs around 350 grams in an adult (a man’s heart usually weighs more than a woman’s). The heart lies to the left of the chest cavity between the lungs and is protected by the sternum (breastbone).

What does the heart do?
Its job is to pump blood round the body by way of the cardiovascular system and with each heartbeat, blood is sent to all parts of the body, delivering oxygen and nutrients to help a person live. The heart beats about 100,000 times a day, to pump the equivalent of 7,000 litres a day through a 60,000 mile network of arteries, veins and capilliaries.

When someone is exercising or frightened by something, the heart is told by the brain to beat faster to deliver oxygen round the body, similarly during resting or sleep, the heart beats at a slower rate.

Structure of the heart
The heart is made up of four chambers which are divided from each other by thick muscular walls.

Each heart chamber has a valve, which prevents the blood from flowing back into the chamber, and ensuring that all the blood flows in one direction. These valves contract (open and close) at every heart beat, and send blood out from the ventricles into arteries (singular artery).

The heart is divided into two sides, the right and left, by a septum (wall) and each side is divided into an atrium (left and right) and ventricle (left and right).

The function of the atria (plural of atrium) is to receive blood into the heart (like a reservoir) to supply the ventricles which pump the blood away from the heart.

Pumping blood
The right side of the heart receives the dark de-oxygenated (blue) blood from the body and sends it to the lungs through the pulmonary artery, where it is given fresh oxygen and becomes bright red again (oxygenated). This newly oxygenated blood is sent back to the left side of the heart which is then pumped through the aorta to the rest of the body.

The pericardium
The heart is contained within the pericardium, which is a strong sac protecting the heart from other organs.

The heart wall itself is made up of three layers, the epicardium, myocardium and endocardium.


Like all living tissues, these layers need to receive a constant supply of blood, and the myocardium in particular will be damaged as a result of a heart attack.





Saturday, October 13, 2018

Hair Loss Causes and Treatments


Hair Loss Causes and Treatments
Hair loss is a worldwide problem. At least 40 % of men and women are either bald or have thinning hair in any given inhabitants. There are various hair loss causes and treatments that help recognize the problem and then diagnose it.
The normal cycle of hair loss and re-growth is in 3 stages. The first is the rising stage. Hair grows at about one centimetre each month and this stage lasts for about two to five years. This is followed by the inactive stage, during which there is no growth of hair. This phase lasts for about 5 months. At the end of the latent phase, the hair is shed and is replace by new hair that begins to grow out of the follicle. At any given time, about 90 % of the hair follicles of the scalp include of growing hairs in the first phase. When the rate of hair loss overtakes the rate of hair substitute, abnormal hair loss or universal thinning occurs.

Hair Loss Causes and Treatments for you:

It is perfectly normal to lose 50-to 100 hair strands daily. It only becomes a matter of anxiety if you end up losing more than 100 hairs a day or hair no longer produce back on any part of the scalp.
Hair loss can be triggered by a variety of causes. Most of the time, it is very complicated to identify the exact cause. Mainly, heredity, hormones and elderly are considered to be the main causes of hair loss. The demanding lives we lead and wrong dietary habits only add on to the difficulty. The build up of sebum on the scalp is supposed to block hair follicles and contribute to hair loss.
From time to time, excessive hair fall can also be drug induce. There are many drugs that we take in our day to day live with no even suspect that that they can also be responsible for the situation of our hair, which include cholesterol subordinate drugs, birth control pills, acne control drugs, Parkinson medications, ulcer drugs, anticonvulsants for epilepsy, antidepressants and some antibiotics.
Insufficient nutrition and a sedentary lifestyle also tend to incite hair loss. Low fibre intake, inadequate iron and protein in the body also add to the loss of hair.
Women often experience an unexpected spurt in hair fall some months after childbirth, which is a result of changes in hormonal levels. In most cases, the hair returns to normal in 9 to 12 months after the child’s birth.

Treatments of Hair loss:

Hair loss cause and treatment go hand in hand. The difficulty can only be treated once the right cause has been diagnosed.
In order to combat hair loss, your first step should be to include necessary nutrients in your daily diet. It is essential for you to intake a diet rich in proteins, minerals, vitamins and iron. Green verdant vegetables, fruit, figs, wheat germ, eggs, yeast and milk should be included in the diet.
Keep away from cutting on your sleep time as this can have damaging consequences on your hair. Get yourself checked for anaemia, which is known to be one of the biggest causes of hair loss.
Increase the ingestion of iron-rich food to fight it.
Massage your oil with Aloe, Jojoba or Amla oil that is known to have healing properties and promote hair growth.
Style your hair simply when it is dry. Styling wet or damp hair can reason it to stretch and in the end break. Also, try to keep away from teasing your hair, especially when you are going from side to side a hair loss phase.
If the difficulty is drug induced, it is best to ask your doctor to modify your medication else it may lead to baldness over a period of time.

Whatever the reason, most cause of hair loss are a consequence of lack of care. Hair must be protected and treat likes any other receptive body part so that you can cultivate a well-nourished and beautiful mane.

Causes for Hair Loss


Causes for Hair Loss

The thinning of hair on the scalp is recognized as hair loss. In medical terms it is referred to as alopecia, which can be temporary or permanent. The most ordinary form of hair loss occurs slowly and is known as androgentic alopecia, a mixture of hormones and heredity. Other types of hair loss comprise alopecia areata, telogen affluvium and grip alopecia. Age is the most famous cause of hair loss in both men as well as women, but is normally found to be more prominent in men.
Hair is made up of a protein describe keratin. A single hair include of a hair strand, a root under the skin and a follicle from which the hair grows. The hair bulb is situated at the lower end of the follicle, which produces the hair’s dye color or melanin.
It is regular to lose an average of 50-100 hairs a day, as they tend to grow back in the same follicle. But if you are experience curious or more hair loss accompanied by visibly thin or hairless patches you need to visit your doctor. It is essential to take sound medical advice and determine the exact cause for hair loss. Accurate diagnosis will lead to the correct treatment and can aid in rectify any underlying reason for the loss of hair.

Causes for Hair Loss:

There are several reasons for hair loss range from genetic tendency and hormonal imbalance to ill health and poor nourishment. Several of the cause of hair loss is: 
Alopecia Areata: This is an autoimmune skin disease which activate the damage of hair follicles by a person’s own resistant system. It causes hair loss on the scalp as well as somewhere else on the body. Do research shows that over 4 million people are pretentious by alopecia areata in the United States alone. The sickness is said to affect 1.7 per cent of the population at the global level. Alopecia areata start as a single or multiple round hairless patches on the scalp and can lead to total hair loss. It can affect both men and women and often start in childhood. The hair typically grows back in a period of 6 months to 2 years, apart from for a few cases.
Androgenetic alopecia: This is also called male-pattern hairlessness and affects the majority of men. Androgenetic alopecia is caused by a number of issue including hormones called androgens and hereditary causes. Some males begin to show signs of hair loss in their middle teens. This type of hair loss can also take place due to intake of steroids like testosterone used in bodybuilding.
Medical conditions and hormonal imbalance: Hair loss can also be triggered by endocrine (hormonal) situation affecting the body such as diabetes or thyroid. People with kidney and liver disorders can also experience extreme hair loss. Young girls and women might experience hair loss due to the hormone inequity that occurs in polycentric ovary syndrome.
Telogen effluvium: Women often experience extreme shedding of hair after childbirth. Hair loss can also result after passion, a long-term illness, surgery, and intake of anaesthesia or sudden weight loss. These types of hair loss are typically temporary and correct itself with time.
Medications: convinced medications also have hair loss as a side effect similar to lithium, isotretinoin, diet pills and chemotherapy drugs. Long-lasting intake of these drugs can lead to total hair loss.
Trichotillomania: It is a psychological chaos where people frequently pull their hair out. This results in hairless patches and hair damage. People pain from this disorder needs expert help and medication.
Poor nutrition: An unfortunate diet can also result in hair loss. Consumption disorders like anorexia and bulimia are known to start hair loss. It is important for the body to get enough proteins, vitamins and minerals in order to maintain hair growth. A balanced diet is necessary for hair growth along with the correct amount of supplements.
Hair Treatments: Regular hair styling and exposure of hair to cruel chemicals such as hair dyes, bleaching creams, hair gels, hair straightens and perming element can result in temporary or permanent hair loss. This can also result in permanent hairlessness in some cases. Wearing your hair pulled back tremendously tightly that it places tension on the scalp is called traction alopecia and can result in permanent hair damage if the style is worn for a long period of time.

Hair Care Tips:

It is significant to take good care of your hair in order to keep away from hair loss. It is necessary to intake a healthy diet rich in all the necessary vitamins, minerals and proteins necessary for hair growth to maintain beautiful hair for a longer time.
Use shampoos that are gentle such as baby shampoos as they are less harsh on the hair in comparison to the stronger ones. Do not change your shampoo on a usual basis. Shampooing more than once in a day leads to hair harm. Lather your hair quietly and do not dry it energetically with a towel.
Let your hair dry logically; stay away from using a blow drier every now and then. Regular use of blow drier results in hair smash up and the hair loses most of its natural lustre.
Fashion your hair only when it’s dry. Brushing or comb wet hair can cause it to extend and break.

Everybody wants to have beautiful hair. Thus, it is necessary to take proper care of it and consult a good doctor in case of extreme hair loss. The secret to having well-nourished tresses lies in a healthy diet, keeping fit and going low on chemicals.

Male Hair Loss: Causes and Cure

Male Hair Loss: Causes and Cure 
  
male-hair-lossThe thinning of hair on the scalp is identified as hair loss. In medical expressions it is referred to as alopecia, which can be temporary or permanent. Androgenic alopecia or more usually known as male hair loss is the most common type of hair loss. It is the outcome of enlarged compassion to male sex hormones called androgens in certain parts of the scalp. It may also be due to inherited reason and could pass on from generation to generation.
Though, we could see male hair loss in an optimistic way in these days. In the past, baldness was often seen as something unlucky or undesirable. But the approach has changed over the years, as a clean-shaven head is frequently considered both fashionable and attractive.

What Causes of Male Hair Loss?

Most of the men have areas on the scalp, which are very responsive to the male sex hormones that circulate in blood. These hormones make the hair follicles get smaller. In turn, they become a factor that deters hair growth and cannot put back lost hairs.
hair loss.


among men frequently starts at the age between the age groups of 20 to 30. It continues as a distinctive pattern. Following the receding hairline growth, it gradually decreases the hair on top of the head. Finally the 2 balding areas meet to form a typical U-shape around the back and sides of the head.

Preventive Measures

As male hair loss is careful to be genetically determined, passed on from parents, there are certain preventative actions to be taken in time. Although doctors can provide effective treatments, it may sometimes lead to some specific side effects. That’s why many people take on natural treatments to prevent this type of hair loss.
At home, you can start some helpful methods that can nurture your hair in a big way treatment. But it’s significant to try to accept male hair loss for what it is - something natural. And it can be maintain with proper nutritional intake and using herbal treatments. Drinking plentiful water helps your hair keep healthy and strong. Keep away from excessive saline water while washing your hair.

Treatment with Medication

In spite of the fact that there are certain side effects, there are some effectual medical treatments discuss below. But you should keep in mind that hairlessness is natural phenomenon, not a disease.  Minoxidil lotion is best way to get back to your hair loss. This medicine would usually apply twice daily to the scalp.
Minoxidil was initially invented as a treatment for high blood pressure. In this admiration, the hair growth is a side effect that, in this case, has proved useful. Approximately 60 % of patients benefit from it to varying degrees. An additional useful medication is the management of Finasteride (Propecia) taken in tablet form that partially blocks the possessions of the male hormones (an 'anti-androgen'). This medicine has been shown to halt further hair loss and promote re-growth of scalp hair in around 80 % of patients after three to six months.

Plastic surgery

Plastic surgery is also one of the most reliable ways that prevent your hair loss instantly. This system for restoring hair growth is continually improving male hair fall. In the procedure, you must select a well-trained surgeon to move non-sensitive hairs from the back of the head to the top.
The surgery treatment is the leading option for those whose hair loss is limited to the front of the scalp. Though, there are certain factors formative whether you are suitable for this treatment. The right patients are indulging on age, hair color, the nature of hair loss, and whether the hairstyle is straight or curly. Flap-surgery, which involves making the part of the scalp, is one of most not compulsory method for retrieval you’re lost hair at large. But, the bottom line in this feature is that every physician or advisor suggests ‘bald and beautiful’ is the eventual mantra.

Thursday, October 11, 2018

Hair Loss in Children

Hair Loss in Children   
hair-loss-in-childrenHair loss among children is not a very ordinary phenomenon but in the past few years this trouble has increased in the US as nearly two million children undergo from at least one form of alopecia (hair loss) in the country. With a variety of forms of hair loss, a reversal and total restoration of hair takes time, sometimes up to a year or more. In most children the difficulty is impulsively resolved. But around 40 % of the kids don’t have such luck, which can be quite trying both for the parents and the child affected by alopecia.

Causes for Hair Loss in Children:

It should be kept in mind that hair loss among children is not cause by vitamins deficiency, poor scalp circulation, headbands, hats, or cold weather. So the analysis of hair fall among children is classically as simple as an evaluation of the risk factors. In order to control hair loss among children, a visual assessment of the type of loss, and some tests need to be conducted.

Common Cases

The following are the most ordinary childhood hair loss conditions that trichologists or other healthcare specialized could give proper treatment.
Loose Anagen Syndrome: It is a provisional disorder of connective hankie competency. In this case, the hair can be painlessly pulled from the scalp with little attempt. More or less, it may there as ‘disperse’ hair loss or the appearance of trichotillomania. This condition is seen commonly in fair-haired girls of 2 and 9 years age groups.
With the help of short course of mineral treatment, the loose anlagen syndrome is generally resolved. It is optional to tale present rule of silica 33 mg and calcium fluoride 0.5 mcg three times daily (as a duo-celloid supplement). For children between 5 to 10 years of ages, this dose should be bisecting.
Fail to Grow: This type of hair problem with failure to grow scalp hair is consideration to be a temporary delay in the growth reply mechanism. By and large, this syndrome is seen in girls of ages of 2 and 9 years, with fine hair of thin thickness. Usually this problem take place when the child’s hair is not cut since birth and the children with this hair loss symptom have never full-grown their hair beyond collar-length. With proper nutritional correction, this problem is regularly prevented in many young children. The best way to cure this hair loss difficulty is by including short-term nutritional supplementation, chiefly an amino acid complex, iron and zinc.
Alopecia Areata: It may be there in children of any age. It also infrequently progress to the more harsh forms where all body hair is lost. This hair loss difficulty is considered to be an innate autoimmune condition. It happens when certain white blood cells in the body begin react alongside the dye hair cells within the hair shaft. That is why the early hair re-growth in alopecia areata  is nearly always white.
This kind of hair disorder is usually found among dark-haired children, for instance, the Asian people moving both boys and girls evenly. Around two to five percent of children who expand alopecia are found to be gluten bigoted.
As anyone who develops alopecia areata has an inherited predisposition, it is widely believed that some event is necessary to precipitate its activation. Triggers in children are illness of childhood, vaccinations, any food reaction with dairy (lactose), gluten, or red fruits & berries being the common ones. Our recurrent practice of spray-on ‘temporary’ hair dye for sporting carnivals etc. appears to be a usual cause for triggering alopecia areata among children and young people.

Best Remedies for Child Hair Loss:

Don’t worry much about the hair loss of your young ones, as there are some remedies available for it. The innate conditions that potentially affect normal hair growth are thankfully uncommon for a child to be anxious with anything more than hair loss of a temporary kind. If your kids face such trouble, most can be treated productively with simple alterations to the child’s diet and/or hair care routine.


Thursday, September 27, 2018

Coffee and tea against diabetes

Statistics show that annually around the world consumed more than 400 billion cups of coffee. In the U. S. alone 30 million adults drink coffee every day. Meanwhile, new research shows that coffee and tea – drinks are not only familiar and delicious but also useful: they can significantly reduce the risk of diabetes.
 A study published in the edition of Archives of Internal Medicine, including statistics on nearly two dozen smaller studies on the effects of tea and coffee on human health. The study authors collected data from 18 different small studies examining the health statistics of nearly half a million people. It was found that each additional cup of coffee is used daily, reduces the risk of diabetes type II by nearly 7%.
Diabetes type II is diagnosed in more than 90% of people who get diabetes. This disease poses a significant threat to human health: diabetes increases the risk of damage to small blood vessels and nerves due to high blood glucose. Furthermore, diabetes type II leads to disruption of the cardiovascular system, which in turn increases the risk of heart attack or seizure. Suffer from diabetes, eyes, kidneys and nerves.
 Studies show that regular consumption of coffee, even decaffeinated, helps reduce the risk of diabetes type II by approximately 7%. However, this does not mean that daily consumption of several dozen cups of coffee can is guaranteed and gets rid of the risk of disease. A useful effect is achieved by use of 4-5 cups of coffee per day, thus reducing the risk of diabetes type II by up to 25%.
Tea has the same advantages as the coffee, regardless of caffeine content, the use of four or five cups of tea a day reduces the risk of diabetes type II by up to 25% compared with people who do not use tea. Pledge effectiveness of tea – regular use of it. Moreover, contained in a green and black tea antioxidants reduce the risk of skin cancer, stomach and esophagus.
  •  Eye problems in diabetes
If you have diabetes, in order to avoid problems with the eyes, you should regularly visit your ophthalmologist. In fact, diabetes is the leading cause of blindness among adults aged 20 to 74 years.
High blood sugar levels in diabetes causes swelling lens that alters your ability to see. To correct for this type of impairment you need to return your blood sugar to target levels. From the moment you start a good control of concentration of sugar in your blood, before your vision can fully recover, it may take up to three months. Blurred vision in diabetes may also be a symptom of more serious eye problems. People, who suffer from diabetes, can develop three main types of eye problems: cataracts, glaucoma and retinopathy.
 Although cataracts can develop in each, people with diabetes, these eye problems can occur at an earlier age and the condition progresses faster than in people without diabetes. If you are diabetic and you have cataracts, your eye can not focus the light source and at the same time disturbed vision.
 When normal drainage of fluid stops inside the eye, it accumulates, there is increasing pressure and is developing other eye problems that can occur in diabetes and is called glaucoma. Treatment of eye problems in diabetes may include special eye drops, laser treatments, medications and surgery.
Diabetic retinopathy is a vascular (related to blood vessels) complications arising from diabetes. This diabetic eye disease occurs due to damage to small blood vessels called microangiopathy. Kidney disease and nerve damage due to diabetes mellitus is also related to microangiopathy. Damage to large blood vessels (also known as macroangiopathy) includes complications such as heart disease and stroke.
Diabetic retinopathy – the leading cause of irreversible blindness in developed countries. Duration of diabetes is the single most important risk factor for retinopathy. The longer you have diabetes, the higher the likelihood of developing this serious eye problem. If you do not detect retinopathy at an early stage or not to treat it, it can lead to blindness.
  Thus, in order to prevent the development of eye problems due to diabetes, you should: monitor your blood sugar level, control high blood pressure.



Insulin


Concepts of diabetes and a diet are inseparable, for only competent restriction of receipt of sugars with food it is possible to prevent clinical course deterioration when insulin will not cope with formed glucose. And at diabetes of insulin and so it is formed a little because of infringement of work of a pancreas and as insulin is responsible for mastering by a sugar organism, last at diabetes is acquired badly, and remains basically in blood that can lead to the most unpleasant consequences.
  Therefore, correctly picked up diet at a diabetes helps to normalize a carbohydrate exchange and to facilitate work of the weakened pancreas. And first of all restrictions in a diet at a diabetes concern which are easily acquired carbohydrates which in an organism are split to glucose. It is sugar, honey, jam and jams, sweets, fancy bread and other sweets, sweet fruit and berries: grapes, bananas, raisin, dates.
Quite often there are even recommendations completely to exclude these products from a diet, but it is really necessary only at the heavy form of diabetes.
At easy, and illness moderate severity level, under a condition of the regular control of the level of sugar in the blood, the use of a small number of sweets it is quite admissible. But serious researches have proved that in progressing of diabetes the big contribution brings and the raised maintenance of fats in the blood. Therefore restriction of the use of fat food is quite proved.
Diabetic Diet 


The basics to diabetic diet meal planning are simple once we understand the way our body breaks down food. Everything we eat is broken down into sugar eventually. Sugary foods such as sweets or fruit hit the bloodstream almost immediately, followed by the slower starches (carbohydrates, or carbs), which take an hour or two to break down depending on their complexity. Proteins are next, taking about four hours, then between six and eight hours the fats finally break down. If strict attention is paid to diet and exercise, many diabetics can control their blood sugar with minimal dependence on medication.
Diabetic Diet Plan And Goal

Diabetic diet plan differ from person to person due to our daily nutritional needs and type of diabetes a person suffers. Following are the most common type of diabetes diet:
  • Type 1 Diabetes Diet- Type 1 diabetes always requires insulin treatment, the main focus is to find a balance between the food intake and insulin.
  • Type 2 Diabetes Diet- Type 2 diet focus on controlling weight in order to improve the body’s ability to utilize insulin. In most cases Type 2 diabetes can be controlled through proper diet and exercise alone.
  • Gestational Diabetes Diet - unlike the Type 2 diet, gestational diabetes diet focus on adequate energy and nutrients to support both the mother’s body and growing baby while maintaining stable blood glucose levels for the pregnant mother.
The diet goal is to eat a balanced, portion controlled meal that will allow our body to stay on an even keel throughout the day as the components of each meal hit the system. Eating every two to three hours is best, five or six small meals being recommended, and light exercise after each meal will help kick start the digestive system and prevent a spike in sugar levels. If we can include appropriate servings from each food category at each meal, they will break down at different rates, delivering a steady trickle of sugar into the bloodstream and keeping our energy level stable. This saves our system from having to deal with a great influx all at once, as it would if we ate only carbs, or only protein.

Diabetes in the elderly

Diabetes in the elderly.

Many people successfully live to 70, 80 and 90 years, but, unfortunately, among them the frequent incidence of type II diabetes. It has been estimated that almost half of Americans with Type II diabetes is a disease develops after 60 years, and one in five aged 65 years. Basically, here we are talking about type II diabetes.
 But in those communities that are at risk of developing type II diabetes, for example, the Spaniards and Americans of African origin, these proportions are higher as well, among them one of the three ill with type II diabetes after 65 years. In addition, much is changing with age: the pancreas produces less insulin, increases insulin resistance, disturbed metabolism.
 The deterioration diabetes observed angry elderly people suffering from obesity, smoking, sedentary lifestyle, not diet. High blood pressure, characteristic of many elderly people, also complicates the control of diabetes, causing complications. In addition, they have to take a large amount of drugs against various diseases, and the interactions of some of them may also be negative.
Older people quickly develop complications, most often occurs due to the late detection of diabetes. These complications are more serious, compared with complications developing in relatively young people. Reduced physical and mental abilities will also complicate control of diabetes.
  But despite all this, the goal in the treatment of type II diabetes in older people remains the same – to improve the quality of life and reduction of diabetic complications. However, many doctors agree that if older people need more individualized treatment approach; the treatment should take into account the social status of the patient’s overall health and, of course, wish to cooperate with the doctor and to participate directly in the treatment of their illness.
 In most cases it is better to start treatment with diet and small doses of exercise that will help, if not eliminate, insulin, and then at least reduce the dose.

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