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WHY FEMALES DON’T PROMOTE ORAL-GENITAL STIMULATION?
A few females reciprocate genital stimulation but if they reciprocate it is a good gesture and gives an intense feeling of self satisfaction and recognition to the male partner. He expects it. But most of the females prefer being oro-genitally stimulated because it leads to orgasm very easily. Even then they very rarely oblige the male in return.
Female’s reluctance may have resulted from shyness, igonarance of what to do or fear of indecency or perversion. The possibility and fear that man might ejaculate in the process is further deterrent. But certain women in Paris, and Denmark etc. each are noted to have no hesitation in deliberately bringing a man to orgasm in this fashion.
What are the standard procedures of oral genital contacts?
Usually a man initiates and gently caresses the clitoris, the minor lips and the area of introit us with his tongue, occasionally sucking and nibbling them. Saliva produced acts as an extra lubricant and females enjoy it till orgasm. Women who are lucky to be excited this way get satisfaction of their lives reaching orgasm on more than 60 percent occasions.
In the male the glans is the primary focus of excitement. Gentle stroking of the frenulum with the tongue and lips and sucking the glans while firmly holding the penis and grasping and pulling gently at the scrotal sac with the other hand, gives the pleasure.
If the genitals are clean and body is perfumed then objections are difficult to support on hygienic grounds.*107\301\2*

HIV: OPTIONS FOR MEDICAL CARE-PHYSICIANS: PRIMARY CARE PHYSICIANSMost people receive medical care for HIV infection from one or more kinds of physicians: primary care physicians, AIDS physicians, and specialists.     Primary Care Physicians-Primary care physicians are usually family practice physicians or internists who have broad medical knowledge, and who may or may not have a special interest in HIV infection. Many people have gone to their primary care physicians for medical care for years and have developed close relationships with them. For a person with HIV infection, however, whether this relationship continues depends on whether the primary care physician feels able or willing to care for HIV infection and how much confidence the person with HIV infection has in the adequacy of that care.     Some primary care physicians practice in groups of between three and ten. Physicians in such groups usually have different areas of expertise: some treat stomach problems, for example, and some treat lung problems. The person with HIV infection will usually see the same physician for general health care, but will see other physicians for specific problems. The advantage of group practice is that these physicians are all under the same roof, and communication between physicians with specializations is good. Group practice is especially useful when one member of the group becomes skilled in AIDS care and becomes the primary physician or a consultant for people with HIV infection.     Most primary care physicians, whether they practice alone or in groups, received their training before HIV infection was known. Furthermore, new diagnostic tests and drugs and other therapies emerge constantly, so that many physicians have found it difficult to maintain their knowledge of both this field and the rest of medicine as well. As a result, some primary care physicians simply do not accept patients with HIV infection and will refer their previous patients who have become infected with HIV to another physician. Other primary care physicians provide medical care during early stages of the infection when medical complications are few and the guidelines for treatment are relatively simple.     During later stages of infection, the primary care physician will often either refer the person with HIV infection to a specialist or consult with a physician more experienced in HIV infection. If the primary care physician is in group practice, the referral may be to another physician in the group; if the physician practices alone, the referral may be to a completely different physician, to a clinic specializing in the care of HIV infection, or to a teaching hospital. In any case, the person with HIV infection will often see physicians informally called AIDS physicians.*153\191\2*

NONCONCLUSIVE STATUS EPILEPTICUS AND ITS TREATMENT: JOANE’S CASE HISTORYJoanne was a bright, sparkly second grader when we first met her. She was referred because of a “weird” episode the previous week. One day in school, she quite suddenly did not seem herself. She was quiet, wandered about the class, and responded inappropriately to the teacher. Her mother took her home, and after another hour or two, when she still wasn’t herself, she had been taken to another hospital. No cause for the sudden change was found, but the next morning an EEG showed slowing, as if she might have previously had a seizure.When we saw her the following week, she was fine and back to her usual self. Since she had never had seizures, and was otherwise normal, we asked her mother to bring her back during another episode, should one occur.It was almost a year later when we received a call from Joanne’s mother in the middle of the day. “She is doing it again.” We didn’t remember Joanne, but told her mother to bring her in immediately. A very attractive, dull ten-year-old came into the office. She could answer questions and count, but seemed to be mildly retarded. If her mother had not insisted that this was not Joanne’s usual state, and if our records had not confirmed a previously sparkling young lady, we might have been fooled.An immediate EEG confirmed “spike-wave stupor,” a continuous electrical status on the EEG, and after a small dose of diazepam (Valium), she immediately returned to her usual state. When she was admitted from the EEG lab to the ward, the resident wanted to know why we were admitting this perfectly normal, charming young lady. With anticonvulsant medication, she has never had another episode.There is no evidence that spike-wave stupor causes permanent damage to the brain, even when it goes on for hours or days. However, it clearly disrupts the child’s level of function. Spike-wave stupor can easily be treated, but it is far better to prevent these seizures with continued use of an appropriate anticonvulsant medication.Although many myths and fears still persist about status epilepticus, with early recognition and appropriate treatment, children who have an episode of status should return to their previous function and have no residual effects.*134\208\8*