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Introduction The Multi-Fiber Arrangement (MFA) has governed international trade in textiles and clothing since 1974. The MFA enabled developed nations, mainly the USA, European Union and Canada to restrict imports from developing countries through a system of quotas. The Agreement on Textiles and Clothing (ATC) to abolish MFA quotas marked a significant turnaround in the global textile trade. The ATC mandated progressive phase out of import quotas established under MFA, and the integration of textiles and clothing into the multilateral trading system before January 2005. The Agreement on Textiles and Clothing ATC is a transitory regime between the MFA and the integration of trading in textiles and clothing in the multilateral trading system. The ATC provided for a stage-wise integration process to be completed within a period of ten years (1995-2004), divided into four stages starting with the implementation of the agreement in 1995. The product groups from which products were to be integrated at each stage of the integration included (i) tops and yarns; (ii) fabrics; (iii) made-up textile products; and (iv) clothing. The ATC mandated that importing countries must integrate a specified minimum portion of their textile and garment exports based on total volume of trade in 1990, at the start of each phase of integration. In the first stage, each country was required to integrate 16 percent of the total volume of imports of 1990, followed by a further 17 percent at the end of first three year and another 18 percent at the end of third stage. The fourth stage would see the final integration of the remaining 49 percent of trade. Global Trade in Textile and Clothing World trade in textiles and clothing amounted to US $ 385 billion in 2003, of which textiles accounted for 43 percent (US $ 169 bn) and the remaining 57 percent (US $ 226 bn) for clothing. Developed countries accounted for little over one-third of world exports in textiles and clothing. The shares of developed countries in textiles and clothing trade were estimated to be 47 percent (US $ 79 bn) and 29 percent, (US $ 61 bn) respectively. Import Trends in USA In 1990, restrained or MFA countries contributed as much as 87 percent (US $ 29.3 bn) of total US textile and clothing imports, whereas Caribbean Basin Initiative (CBI), North American Free Trade Area (NAFTA), Africa Growth and Opportunity Act (AGOA) and ANDEAN countries together contributed 13 percent (US $ 4.4 bn). Thereafter, there has been a decline in exports by restrained countries; the share of preferential regions more than doubled to reach 30 percent (US $ 26.9 bn) of total imports by USA. The composition of imports of clothing and textiles by USA in 2003 was 80 percent (US $ 71 bn) and 20 percent (US $ 18 bn), respectively. Asia was the principal sourcing region for imports of both textiles and clothing by USA. Latin American region stood at second position with a share of 12 percent (US $ 2.2 bn) and 26 percent (US $ 18.5 bn), respectively, for textiles and clothing imports, by USA. In most of the quota products imported by USA, India was one of the leading suppliers of readymade garments in USA. Though China is a biggest competitor, the unit prices of China for most of these product groups were high and thus provide opportunities for Indian business. Import Trends in EU EU overtook USA as the world's largest market for textiles and clothing. Intra-EU trade accounted for about 40 percent (US $ 40 bn) of total clothing imports and 62 percent (US $ 32.5 bn) of total textile imports by EU. Asia dominates EU market in both clothing and textiles, with 30 percent (US $ 30 bn) and 17 percent (US $ 8 bn) share, respectively. Central and East European countries hold a market share of 11 percent (US $ 11.3 bn) in clothing and 7.5 percent (US $ 4 bn) in textiles imports of EU. As regards preferential suppliers, the growth of trade between EU and Mediterranean countries, especially Egypt and Turkey, was highest in 2003. As regards individual countries, China accounted for little over 5 percent (US $ 2.8 bn) of EU's imports of textiles and over 12 percent (US $ 12.4 bn) of clothing imports. In the EU market also, India is a leading supplier for many of the textile products. It is estimated that Turkey would emerge as a biggest competitor for both India and China. However, with regard to unit prices, India appears to be lower than both Turkey and China in many of the categories. Import Trends in Canada Amongst the leading suppliers of textiles and clothing to Canada, USA had the highest share of over 31 percent (US $ 8.4 bn), followed by China (21% - US $ 1.8 bn) and EU (8% - US $ 0.6 bn). India was ranked at fourth position and was ahead of other exporters like Mexico, Bangladesh and Turkey, with a market share of 5.2 percent (US $ 0.45 bn). Potential Gains It may be noted that clothing sector would offer higher gains than the textile sector, in the post MFA regime. Countries like Mexico, CBI countries, many of the African countries emerged as exporters of readymade garments without having much of textile base, utilizing the preferential tariff arrangement under the quota regime. Besides, countries like Bangladesh, Sri Lanka, and Cambodia emerged as garment exporters due to cost factors, in addition to the quota benefits. It may be said that countries like China, USA, India, Pakistan, Uzbekistan and Turkey have resource based advantages in cotton; China, India, Vietnam and Brazil have resource based advantages in silk; Australia, China, New Zealand and India have resource based advantages in wool; China, India, Indonesia, Taiwan, Turkey, USA, Korea and few CIS countries have resource based advantages in manmade fibers. In addition, China, India, Pakistan, USA, Indonesia has capacity based advantages in the textile spinning and weaving. China is cost competitive with regard to manufacture of textured yarn, knitted yarn fabric and woven textured fabric. Brazil is cost competitive with regard to manufacture of woven ring yarn. India is cost competitive with regard to manufacture of ring-yarn, O-E yarn, woven O-E yarn fabric, knitted ring yarn fabric and knitted O-E yarn fabric. According to Werner Management Consultants, USA, the hourly wage costs in textile industry is very high for many of the developed countries. Even in developing economies like Argentina, Brazil, Mexico, Turkey and Mauritius, the hourly wage is higher as compared to India, China, Pakistan and Indonesia. From the above analysis, it may be concluded that China, India, Pakistan, Taiwan, Hong Kong, Brazil, Indonesia, Turkey and Egypt would emerge as winners in the post quota regime. The market losers in the short term (1-2 years) would include CBI countries, many of the sub-Saharan African countries, Asian countries like Bangladesh and Sri Lanka. The market losers in the long term (by 2014) would include high cost producers, like EU, USA, Canada, Mexico, Japan and many east Asian countries. The determinants of increase / decrease in market share in the medium term would however depend upon the cost, quality and timely Review of Indian Textiles and Clothing Industry The textiles and garments industry is one of the largest and most prominent sectors of Indian economy, in terms of output, foreign exchange earnings and employment generation. Indian textile industry is multi-fiber based, using delivery. In the long run, there are possibilities of contraction in intra-EU trade in textile and garments, reduction of market share of Turkey in EU and market share of Mexico and Canada in USA, and thus provide more opportunities for developing countries like India. It is estimated that in the short term, both China and India would gain additional market share proportionate to their current market share. In the medium term, however, India and China would have a cumulative market share of 50 percent, in both textiles and garment imports by USA. It is estimated that India would have a market share of 13.5 percent in textiles and 8 percent in garments in the USA market. With regard to EU, it is estimated that the benefits are mainly in the garments sector, with China taking a major share of 30 percent and India gaining a market share of 8 percent. The potential gain in the textile sector is limited in the EU market considering the proposed further enlargement of EU. It is estimated that India would have a market share of 8 percent in EU textiles market as against the China's market share of 12 percent. Review of Indian textiles and Clothing Industry The textiles and garments industry is one of the largest and most prominent sectors of Indian economy, in terms of output, foreign exchange earnings and employment generation. Indian textile industry is multi-fiber based, using cotton, jute, wool, silk and mane made and synthetic fibers. In the spinning segment, India has an installed capacity of around 40 million spindles (23% of world), 0.5 million rotors (6% of world). In the weaving segment, India is equipped with 1.80 million shuttle looms (45% of world), 0.02 million shuttle less looms (3% of world) and 3.90 million handlooms (85% of world). The organised mill (spinning) sector recorded a significant growth during the last decade, with the number of spinning mills increasing from 873 to 1564 by end March 2004. The organised sector accounts for production of almost all of spun yarn, but only around 4 percent of total fabric production. In other words, there are little over 200 composite mills in India leaving the production of fabric and processing to the decentralised small weaving and processing firms. The Indian apparel sector is estimated to have over 25000 domestic manufacturers, 48000 fabricators and around 4000 manufacturer-exporters. Cotton apparel accounts for the majority of Indian apparel exports. Textiles and Garments Exports from India The share of textiles and garments exports in India's total exports in the year 2003-04 stood at about 20 percent, amounting to US $ 12.5 billion. The quota countries, USA, EU and Canada accounted for nearly 70 percent of India's garments exports and 44 percent of India's textile exports. Amongst non-quota countries, UAE is the largest market for Indian textiles and garments; UAE accounted for 7 percent of India's total textile exports and 10 percent of India's garments exports. In terms of products, cotton yarn, fabrics and made-ups are the leading export items in the textile category. In the clothing category, the major item of exports was cotton readymade garments and accessories. However, in terms of share in total imports by EU and USA from India, these products hold relatively lesser share than products made of other fibers, thus showing the restrain in this category. Critical Factors that Need Attention Though India is one of the major producers of cotton yarn and fabric, the productivity of cotton as measured by yield has been found to be lower than many countries. The level of productivity in China, Turkey and Brazil is over 1 tonne / ha., while in India it is only about 0.3 tonne / ha. In the manmade fiber sector, India is ranked at fifth position in terms of capacity. However, the capacity and technology infusion in this sector need to be further enhanced in view of the changing fiber consumption in the world. It may be mentioned that the share of cotton in world fiber demand declined from around 50 percent (14.7 mn tons) in 1982 to around 38 percent (20.12 mn tons) in 2003, while the share of manmade fiber has increased from 44 percent (13.10 mn tons) to around 60 percent (31.76 mn tons) over the same period. Apart from low cost labour, other factors that are having impact on final consumer cost are relative interest cost, power tariff, structural anomalies and productivity level (affected by technological obsolescence). A study by International Textile Manufacturers Federation revealed high power costs in India as compared to other countries like Brazil, China, Italy, Korea, Turkey and USA. Percentage share of power in total cost of production in spinning, weaving and knitting of ring and O-E yarn for India ranged from 10 percent to 17 percent, which is also higher than that of countries like Brazil, Korea and China. Percentage share of capital cost in total production cost in India was also higher ranging from 20 percent to 29 percent as compared to a range of 12 to 26 percent in China. In India, very few exporters have gone in for integrated production facility. It is noted that countries that would emerge as globally competitive would have significantly consolidated supply chain. For instance, competitor countries like Korea, China, Turkey, Pakistan and Mexico have a consolidated supply chain. In contrast, apart from spinning, the rest of the activities like weaving, processing, made-ups and garmenting are all found to be fragmented in India. Besides, the level of technology in the Indian weaving sector is low compared to other countries of the world. The share of shuttle less looms to total loomage in India is 1.8% as compared to Indonesia (10%), Bangladesh (10%), Sri Lanka (12%), China (14%) and Mexico (29%). The supply chain in this industry is not only highly fragmented but is beset with bottlenecks that could very well slow down the growth of this sector. As a result the average delivery lead times (from procurement to fabrication and shipment of garments) still takes about 45-60 days. With international lead delivery times coming down to 30-35 days, India needs to cut down the production cycle time substantially to stay in the market. Besides, erratic supply of power and water, availability of adequate road connectivity, inadequacies in port facilities and other export infrastructure have been adversely affecting the competitiveness of Indian textiles sector. Conclusions It is believed the quota regime has frozen the market share, providing export opportunities even for high cost producers. Thus, in the free trade regime, the pattern of imports in the quota countries would undergo changes. The issues that would govern the market share in the post quota regime would eventually be productivity, raw material base, quality, cost of inputs, including labour, design skills and operation of economies of scale. It is believed that quotas, by limiting the supply of goods have kept export prices artificially high. Thus, it is estimated that there would be price war in the post quota regime, with competitive price cuts. The price and quantity effects would depend on the efficiency in production process, supply chain management and the price elasticity of demand. Due to the expected fall in prices, developing countries with high production cost have little choice but to compete head-on with the biggest low cost suppliers. In this process, it is presumed that there would be better resource reallocation in these economies. It is assumed that quota restrictions would continue beyond 2005 in various forms. It is also widely recognized that removal of quota may not directly provide easy and unrestricted access to developed country markets. There would be non-tariff barriers as well. Standards related to health, safety, environment, quality of work life and child labour would gain further momentum in international trade in textiles and clothing. Strategies and Recommendations Cost competitiveness in Indian garments sector has been restrained by limited scale operations, obsolete technology and reservation under SSI policies. While retaining its traditional cost advantages of home grown cotton and low cost labour, India needs to sharpen its competitive edge by lowering the cost of operations through efficient use of production inputs and scale operations. Besides, there are needs for rationalization of charges, levies related to usage of export logistics to remain cost competitive. As fallout to the quota regime, there would be consolidation of production and restriction on supplying countries, which would necessarily mean improved scale operations. Indian players should also integrate to achieve operating leverage and demonstrate high bargaining power. It is reported that Chinese textile firms have already invested heavily to expand and grab huge market share in the quota free world. In India, organised players in this sector would require huge investments to remain competitive in the quota free world. These players need to expand and integrate vertically to achieve scale operations and introduce new technologies. It is estimated that the industry would require Rs. 1.5 trillion (US $ 35 billion) new capital investment in the next ten years (by 2014) to lap the potential export opportunities of US $ 70 billion. It is estimated that USA and EU together would offer a market of US $ 42 billion for Indian textiles and garments in 2014. Technology would play a lead role in the weaving and processing, which would improve quality and productivity levels. Innovations would also be happening in this sector, as many developed countries would innovate new generation machineries that are likely to have low manual interface and power cost. Indian textile industry should also turn into high technology mode to reap the benefits of scale operations and quality. Foreign investments coupled with foreign technology transfer would help the industry to turn into high-tech mode. Internationally, trading in textile and garment sector is concentrated in the hands of large retail firms. Majority of them are looking for few vendors with bulk orders and hence opting for vertically integrated companies. Thus, there is need for integrating the operations in India also, from spinning to garment making, to gain their attention. This would also bring down the turn around time and improve quality. Indian players should also improve upon their soft skills, viz., design capabilities, textile technology, management and negotiating skills. Garment manufacturing business is order driven. It would be difficult for the players to keep the workforce full time, even in lean season. This calls for changes in contract labour laws. Logistics and supply chain would also play a crucial role as timely delivery would be an important requirement for success in international trade. The logistics and supply chain management of Indian textile firms are relatively weak and needs improvement and efficiency. China has already created a world class export infrastructure. Given the volume of projections for exports by India, it may be necessary to create additional export infrastructure, especially investment for modernization of ports. In addition, India needs to invest for creating brand equity, supply chain management and apparel industry education. To sum up, the ability of Indian textile industry to take advantage of quota phase-out would depend upon their ability to enhance overall competitiveness through exploitation of economies of scale in manufacturing and supply chain. The need of the hour therefore is to evolve a well chalked out strategy, aimed at improvement in the levels of productivity and efficiency, quality control, faster product innovation, quick response to changes in consumer preferences and the ability to move up in the value chain by building brand names and acquiring channels of distribution so as to outweigh the advantages of competitors in the long run. Source: Export-Import Bank of India, India. pennis enlargement procedure homemade penile enlargement penis enlagement pnis enlargement pic before and after medical penis enlargement truth about penis enhancement penile enlargment review penis elargement picture

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At one time in my life I lead my marriage under my own understanding of what I thought was righteous and good. I was all-powerful. God? Who’s that? I was rebellious and stubborn to my husband because I was married to my selfish lifestyle and wayward beliefs that kept me from accepting and recognizing God. I rejected my husband sexually because I often thought all he wanted was sex. How could anyone love me, after all I didn’t like the person who I had become? I rejected God for my life too, and that was the biggest mistake I had ever made. I wanted to be in control just like most women want to be in control of their destiny and their life. And women do control well. In many marriages today women control the ship with poisonous demands while their husband’s cringe in the galleys like little lost boys who can’t find their way home. This is really happening, folks, and most people take it all in with a grain of salt. It makes movies like Broke Back Mountain come alive in its all its perverted sexuality. Hollywood filmmakers and the Foreign Press promote and support the woman’s movement by slowly creating men to be distorted wimpy guys. The agenda has been going on for sometime now. It is a slow brainwash movement through the use of Hollywood and TV to make people think it is acceptable to be homosexual. Whether this is done for political reasons or not, it doesn’t matter because it is all in direct rebellion to God of Creation. I truly don’t believe there are so many perverted individuals in the world to elect this garbage for top performance. These Hollywood programs are rigged. It is a bunch of propaganda to get people to give in and to believe in them instead of God. Ask yourself this. Did God make another man out of the rib of Adam to be his companion? How could two men make babies and multiply the earth? They would both die old men and creation would be over!! Did God give Eve a penis? Why is woman made with such beauty and sexual care if not to give the “real man” great satisfaction in bed? [Do not lie with a man as one lies with a woman; … Leviticus 18:22] Did you know that that according to the Golden Globe Awards the top motion picture in Hollywood this year is about a couple of gay cowboys? This establishes a precedent for Hollywood to continue making more perverted trash. It’s nothing but filth! Is this what you want your children to watch? When debauched films like BrokeBack Mountain become highly praised for their outright deviance the world is surely living in Sodom. Ah yes, biblical history coming back alive in the world. It happens all the time. I don’t take the bible literally but you don’t have to!! Look at the whole theme of the bible and it will answer all your questions on morality and ethics. [Do you not know that the wicked will not inherit the kingdom of God? Do not be deceived; neither the sexually immoral nor idolaters nor adulterers nor male prostitutes nor homosexual offenders or thieves or the greedy nor drunkards nor slanderers nor swindlers will inherit the kingdom of God. 1Corinthians 6:9] Why do you think there is so much divorce in this country? Some men are rethinking their own sexuality and deciding to go ahead and give the woman the lead to direct the ship to shore. They are bowing down to the woman’s movement because they have no spirituality, belief and religious conviction within them. They’re not the captains of their own ships because they themselves have no captain! This is the root of the problem. Where there is no God, there is no righteousness. When a man does not allow God to command his own life he has no direction for his wife and family and cannot lead his home correctly because his heart does not hold the proper guidance of scripture. There is no spiritual conviction to lead the home. The woman will take advantage of her spiritual bankrupt husband and become out of control thinking she is really in control. She will become bossy, stubborn, controlling and rebellious in the marriage because she has been brainwashed into believing she is superior to her male counterpart. You see this happening in Hollywood films all the time. You see it on TV every single night. Women being belligerent in the home, ignoring her children, committing adultery because she wants to have her own career and live the way SHE WANTS. It doesn’t matter what God wants for her. Neither spouse realizes that the home only needs proper spiritual guidance to lead it according to its true purpose. To love, honor, and commit your self to one another. It is an unethical philosophy taking over the mind of women today. It is destroying families. It is appalling how this accepted wisdom from the world is overtaking the minds of men. Men should be giving in to God, not some unspiritual woman who is trying to find her own way home and thinks she found it through some meaningless woman’s movement. I believe that if a woman of the home can see clear enough to take her role as wife and mother seriously by acknowledging the spiritual Christ within her soul, she will see the truth for what it is. She doesn’t know that the truth will set her free from her self and that the unethical movement she is believing in is in direct rebellion to God and is untruth - a lie told by satan to break marriages apart. [God made them male and female and said, “For this reason a man will leave his father and mother and be united to his wife, and the two will become one flesh? So they are no longer two, but one. Therefore what God has joined together, let man not separate. Mathew 19:4] She must FIRST fix herself before she can love the man she married. She will discover how unique she is of her husband in a good way, and that she can compliment and help buildup her husband rather than constantly battle with him for her missing self. She should not be hesitant to be the beautiful creature God made her to be. [Then they can train the younger women to love their husbands and children, to be self-controlled and pure, to be busy at home, to be kind, and to be subject to their husbands, so that no one will malign the word of God.] Titus 2:4-5 Bottom line is marriage is not designed to accommodate two captains. Have you ever seen two captains charting one ship? Have you ever seen two Chief Executive Officers controlling one corporation? Have you ever seen two master chefs in one restaurant? Have you ever seen two dentists in one office? Have you ever seen two train conductors guiding the train? You get my point, right? What can a man do when his wife abuses his manhood and won’t let him lead? He desperately needs to become the spiritual leader of the home and take the lead in that arena now! Accept God for you life! Study the bible diligently and seek out all that God wants for you and your marriage. A man will never truly be happy until he realizes his purpose and calling in life and then goes after those things with gusto. [Therefore everyone who hears these words of mine and puts them into practice is like a WISE MAN who built his house on the rock. The rain came down, the streams rose, and the winds blew and beat against the house; yet it did not fall, because if had its foundation on the rock.] Matthew 7:24-25 ~~ enlargement manhattan penis penis enlagement surgery picture penis enlargement surgery picture vimax manual penis enlargement penis enargement before and after picture top rated pennis enlargement pills penile enlargement drug penis enlagement exercise penis elargement

When digital cameras first hit the news, I thought, “Wow! Never to have to buy film again!” This much has remained true, but it took ten years for digital cameras to come up to the quality performed by film cameras. At first, the pixels were too few to enlarge to 3 by 5 much less an 8 by 10 with any quality. Today, pixels are not a problem and every feature adorning the film camera is now available on a digital camera. I spent many months researching the available models and weighing the cost versus the features until I came up with a digital camera that pleased me. The camera is the Konica Minolta Dimage A200. While some functions are not as sophisticated as their film cousins, the advantages far outweigh its short comings. In 2004 a decent SLR costs from $900 to $1500. I use an SLR as a comparison because they are the only type camera that shows exactly what the lens sees. The K/M A200 sells for about $600. Its 8 megapixels allows enlargements up to 13 by 19 inches with a sharpness equal to a fine 35mm photo from an SLR. The features I like best are the manual zoom ring (motorized zoom controls are slow and cumbersome), the stabilization chip (which produces sharp images even with slow shutter speeds) and the control over white balance (even custom balances). Another terrific advancement is the flip out rotating LCD viewer. Never again will I be held to an eye level view. With computer enhanced perspective control, all angles are possible. To be fair, there are a couple of areas that can be improved, but can be lived with. One is the delay after pressing the button to take the picture while the camera focuses and sets aperture and speed. It’s only a tenth of a second, but you’d better get used to it or you will miss your shot. A remedy is to take a series of pictures and pick the best one. Another is inherent in all digital cameras and that is the artifacts that appear in the image at higher ISO settings. Artifacts are like the grain in fast film that appears like little dots in the picture. If you use the slower ISO settings like 50 or 100 ISO, then the artifacts are practically invisible. If ISO 200, 400, or 800 are needed to get the picture, then additional processing through PureImage or similar software will solve the problem nicely. A word about the lens is in order. A zoom range of 28mm to 200mm (35mm equivalent) covers just about any focal length an advanced amateur could need. No other 8MP EVF (electronic view finder) has this wide an angle. The lens is custom made for a digital camera and is very sharp edge to edge. Only a very slight barrel distortion (1%) is visible at the 28mm focal length. Some software can correct this if perfection is demanded. You never have to worry about dust getting on the CCD sensor since the lens is not detachable. If wider or more telephoto effects are needed, there are accessory lenses that will make the wide end 50% wider and the telephoto twice as long. The A200 also has a 4x digital zoom but I recommend that this only be used as a last resort since the number of pixels are halved when you double the zoom. The auto focus works very quickly except in extreme low light. A manual focus is available with a nice auto 4x enlargement of the center for critical focusing. No Compact Flash card is included in the package, so I bought a 512 80x CF card for $69.00. The 80x refers to the fact that it unloads to your computer in a jiffy and the 512 Megabytes allows 81 pictures of the extra fine quality JPEG that I always use. The pop up flash lights up subjects at 12 feet away at 100 ISO. For more versatility I bought the Vivitar DF 200 slave flash ($69.00) that works to 50 feet at night. This camera is a joy to use and has everything I could ever want in the way of features. In the six months I have owned it, I have created dozens of 13 by 19 images for the two Digital Art Shows I have had. Viva la digital generation! does vigrx really work manual penile enlargment exercise vig rx pill com enhancement penis penis pump cheapest penis enlagement pills penis enlarement compare penis enlargement pill pnis enlargement program penis elargement

Male sexual dysfunction is one of the most common health problems affecting men and is more common with increasing age. Chronic ED affects about 5% of men in their 40s and 15-25% of men by the age of 65. Transient ED and inadequate erection affect as many as 50% of men between the ages of 40 and 70. In around 95% of the cases, a suitable treatment can be found. Erectile dysfunction is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for erectile dysfunction. Viagra, Levitra and Cialis Currently, there are three oral medications approved by the Food and Drug Administration (FDA) for the treatment of erectile dysfunction: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). All these agents block the enzyme phosphodiesterase type 5 (PDE-5) and belong to a class of drugs called phosphodiesterase (PDE) inhibitors. Viagra was the first and is probably the most famous of the three PDE-5 inhibitors used to treat erectile dysfunction. Viagra was approved as an effective agent for treating erectile dysfunction in March 27, 1998. Viagra is manufactured by Pfizer, Inc. Levitra was the second PDE-5 inhibitor to come to market in the United States, and it was approved by the FDA in August 19, 2003. Levitra is manufactured by Bayer Pharmaceuticals Corporation. Cialis was the third PDE-5 inhibitor to come to market and was approved by the FDA at the end of November 21, 2003. Cialis is manufactured by Lilly ICOS LLC. The major advantage of PDE-5 inhibitors is that they do not cause an erection at inappropriate times, because they act only in response to sexual stimulation. If there is no sexual stimulation drug remains in the background. All three are taken orally prior to planned sexual activity, acting to increase blood flow in the penis in response to sexual stimulation. However, there are important differences between the three, differences that could influence safety, specificity, duration of action, adverse effects, and ultimately, public acceptance within this class of drug. Mechanism of Action PDE-5 inhibitors do not directly cause an erection of the penis, but they alter the body's response to sexual stimulation by enhancing the effect of the nitric oxide, a chemical that is normally released during stimulation. Nitric oxide causes relaxation of the muscles in the penis, which allows for better blood flow to the penile area. Effectiveness of PDE-5 Inhibitors All 3 PDE-5 inhibitors have demonstrated excellent efficacy. Viagra, at 84%, is slightly more effective than Cialis at 81% and Levitra at 80%. Pharmaceutical Forms, Onset of Action and Duration of Effect Viagra and Levitra differ only minimally in terms of their structure, while Cialis differs markedly from Viagra and Levitra in terms of its molecular structure, which is also reflected in pharmacokinetic differences. Viagra: 25 mg, 50 mg 100 mg tablets Onset of action: 30 minutes (effect delayed if taken with food) Duration of action: 4 to 5 hours Levitra: 2.5 mg, 5 mg, 10 mg, 20 mg tablets Onset of action: 25 minutes (effect delayed by fatty meal) Duration of action: 4 to 5 hours Cialis: 5 mg, 10 mg, 20 mg tablets Onset of action: 16-45 minutes (effect NOT delayed by food) Duration of action: 36 hours All three drugs require sexual stimulation to be effective. Viagra should be taken on an empty stomach it works better if you do not eat a high-fat meal around the time you take it. Levitra may be slightly less effective if you eat a high-fat meal, but a moderate-fat meal does not reduce its effectiveness. Cialis works without regard to what you eat. Viagra and Levitra have similar half-lives, and onset and duration of action. Cialis has a slower onset of action and longer duration of action, which is attributed to its longer half-life. Patients who wish for spontaneity may opt for Cialis, which may allow for successful intercourse up to 36 hours postdose, even though it takes longer to reach peak effect. The considerably longer duration of effect for Cialis will likely allow less frequent dosing and greater impulsiveness between partners, but also could potentially prolong adverse effects. Dosage The recommended dose for Viagra is 50 mg, and the physician may adjust this dose to 100 mg or 25 mg, depending on the patient. The recommended dose for either Levitra or Cialis is 10 mg, and the physician may adjust this dose to 20 mg if 10 mg is insufficient. A lower dose of 5 mg is available for patients who take other medicines or have conditions that may decrease the body's ability to use the drug. Levitra is also available in a 2.5 mg dose. None of these PDE-5 inhibitors should be used more than once a day. Possible Side Effects Although all three drugs are generally well tolerated, side effects are still possible. Most common side effects: Viagra: facial flushing, headache, indigestion Levitra: facial flushing, headache Cialis: headache, indigestion Less Common Side Effects: Viagra: altered vision, dizziness, nasal, congestion Levitra: indigestion, nausea, dizziness, nasal congestion Cialis: back pain, muscle aches, nasal congestion, facial flushing, dizziness Precautions and Contraindications All PDE-5 inhibitors are absolutely contraindicated in persons who take organic nitrates. Alpha-blockers Viagra has precautionary labeling advising against taking 50 mg or 100 mg doses within four hours of taking a alpha-blocker. The 25 mg dose of Viagra has not been shown to significantly decrease blood pressure and in patients who take 25 mg of Viagra, use of any of the alpha-blockers is considered safe. Levitra is contraindicated in patients taking alpha-blockers. Cialis is contraindicated in patients taking alpha-blockers, except for tamsulosin (Flomax). Since both Viagra and Levitra have moderate vasodilatory and hypotensive effects, they should not be given in the presence of marked arterial or orthostatic hypotension, and should only be administered with caution in aortic stenosis or hypertrophic obstructive cardiomyopathy. Men who have had a heart attack or stroke within the past 6 months and those with certain medical conditions (e.g., uncontrolled high blood pressure, severe low blood pressure or liver disease, unstable angina) that make sexual activity inadvisable should not take Cialis. Dosages of the drug should be limited in patients with kidney or liver disorders. Conclusions The differences between the 3 drugs are not great. All appear to be effective and safe. Levitra has less side effects compared to Viagra and lasts about the same time as Viagra in the body. Cialis has few side effects and lasts longer in the body. This allows increased spontaneity and less frequent dosing than either Levitra or Viagra. However, the longer half-life of Cialis imposes increased risk for drug interactions. penis enargement procedure best penis enlargement pills free penis enargement video pro fitness health solution enlarement free penis pills sample vimax cheap penis enlargement pills penis enlargement surgery herbal natural penis enlargement penis elargement

Penis girth is something most men fail to realize is what pleasures a woman over the actual length of the penis. To define girth, it is the measurement of how thick your penis is. Girth measurements are taken from the circumference of the penis. The woman’s vagina is most sensitive within the first 1/3 of its length. Longer penises will only fit to a certain point, while thicker ones will apply the pressure to the more sexually sensitive areas at the front. Logic dictates that a longer penis isn’t going to be able to fit all the way inside her, while a thicker penis can (a woman’s vagina can stretch to huge amounts, for example in birth). To find out your own penis girth, simply get your penis into an erect state, and take a tape measure and wrap it around the thickest part of your penis shaft. This will be your girth size, and if it is above 5.2 inches, you’ll be above average. What you’re probably more concerned with though is, is it possible to increase your penis girth size? Well the answer is yes. Using natural penis exercises, and possibly a combination of penis enlargement pills to help promote the blood flow, a man can increase his penis girth maybe up to an inch of what it was previously. Although with girth sizes, it is important to remember that even a few millimeters in increase has a huge effect on the overall diameter of the penis. Below are two techniques you can use to help promote penis girth expansion. Remember, it is important to do a warm up exercise before you attempt any from below. To warm up get a cloth and soak it in some warm water and then rinse it. Wrap it around your penis and hold it there for about 4 minutes and then when you remove it, dry it with a towel to make sure you can get a good grip. You’re now all ready to perform your penis girth gaining exercises. The first technique I will talk about is commonly nicknamed The Flexing Girth or the Ultimate Jelq. First of all, take your penis in your hand, and massage it to around 60% to 80% erect. It is important not to do make it fully hard; else you can damage the blood vessels within it. Make an OK sign with your thumb and index finger, and then grip around the base of your penis. Squeeze the base for about 3 to 4 seconds then release and move up the penis shaft a bit. Repeat the squeeze and continue till you get to the head of your penis. Do this for about 5 minutes, or until you’ve done around 100 strokes. The second technique you can also use is nicknamed the Penis Squeeze. This one you can have your penis fully erect with, and is in fact essential that you do. Like the previous exercises, make an ok sign with your fingers on your left hand and grip tightly the base of the penis. Then with your right, gently push down on the head of the penis, like you’re trying to bend it in two. Perform the exercise for around 5 minutes. Remember, with any type of exercise, you’re not going to get results on the first day. You may not see anything until after a month of doing these, but the most important thing is to not stop.