2019, Trinity Christian College, Zuben's review: "Buy cheap Kamagra Soft - Discount online Kamagra Soft OTC".
Usage subject to terms and conditions of license Laskaris purchase kamagra soft pills in toronto erectile dysfunction causes mayo, Pocket Atlas of Oral Diseases © 2006 Thieme All rights reserved discount kamagra soft 100 mg erectile dysfunction meditation. Usage subject to terms and conditions of license 223 7 Gingival Enlargem ent A common characteristic of this group of lesions is that they are located on the gingiva and present as a submucosal enlargement covered by normal epithelium. Local diseases, drug-induced lesions, systemic diseases, and tumors are included in this particular group of disorders. Usage subject to terms and conditions of license 224 Gingival Enlargement Generalized Hyperplastic Gingivitis Definition Hyperplastic gingivitis is a chronic inflammatory process that produces gingival enlargement. Local and systemic factors may involve sus- ceptibility to the oral microbial flora, and the host response. Clinical features Clinically, the interdental papillae and marginal gin- giva appear diffuse, red, and swollen, and significantly increased in size due to connective-tissue fibromatosis and edema (Figs. Loss of normal stippling, gingival bleeding even after mild local stim- ulation, and formation of pseudopockets are common findings. Differential diagnosis Gingivitis of pregnancy, drug-induced gingival overgrowth, mouth-breathing gingivitis, leukemias. Treatment Oral hygiene improvement, elimination of causative fac- tors, and, in severe hyperplasia, surgical reconstruction. Usage subject to terms and conditions of license 226 Gingival Enlargement Mouth-Breathing Gingivitis Definition Mouth-breathing gingivitis is a unique formof hyperplastic gingivitis. Clinical features This formof gingivitis affects the anterior facial gin- giva in young persons. Clinically, the gingiva appear swollen, red, dry, and shiny, covering part of the crown of the teeth (Fig. Differential diagnosis Drug-induced gingival overgrowth, hyperplas- tic gingivitis. Usage subject to terms and conditions of license 228 Gingival Enlargement Drug-Induced Gingival Overgrowth Definition Drug-induced gingival overgrowth is a relatively common disorder of the gingiva due to several drugs. Etiology The most common drugs associated with the condition are phenytoin, ciclosporin, and calciumchannel blockers. Clinical features The gingival overgrowth is usually related to the dose of the drug, the duration of therapy, the serumconcentration, and the presence of dental plaque. Clinically, both marginal gingiva and inter- dental papillae appear enlarged and firm, with a surface that may be smooth, stippled, or lobulated, with little or no inflammation (Figs. The gingival overgrowth may be localized or gener- alized, and can partially or entirely cover the crown of the teeth. The diagnosis is made on the basis of the medical history and the clinical features. Usage subject to terms and conditions of license 230 Gingival Enlargement Differential diagnosis Hereditary gingival fibromatosis, mouth- breathing gingivitis, leukemia, Crohn disease, amyloidosis. Treatment Improvement of oral hygiene, gingivectomy, discontinua- tion of the offending drug. Usage subject to terms and conditions of license 232 Gingival Enlargement Gingival Overgrowth in Pregnancy Definition Gingival overgrowth in pregnancy, or pregnancy gingivitis, is a relatively rare formof gingival hyperplasia that occurs exclusively during pregnancy. Clinical features The condition presents as significant gingival en- largement, generalized or localized in one or more quadrants. The gin- giva is soft, edematous, bright red, with dense inflammation, and is hyperplastic and bleeds easily (Fig. Usage subject to terms and conditions of license 234 Gingival Enlargement Gingival Overgrowth due to Leukemia Gingival overgrowth is a common and early finding in leukemia (see also p. Gingival swelling occurs most frequently in patients with mye- lomonocytic and myelocytic leukemia. Gingival infiltration by leukemic cells causes diffuse enlargement of the gingiva, which becomes edema- tous, red, and inflamed, and bleeds spontaneously (Figs. Differential diagnosis Scurvy, agranulocytosis, drug-related gingival overgrowth, hereditary gingival fibromatosis. Usage subject to terms and conditions of license 236 Gingival Enlargement Hereditary Gingival Fibromatosis Definition Hereditary gingival fibromatosis is a unique gingival en- largement caused by collagenous proliferation of the fibrous connective tissue of the gingivae. It is transmitted as an autosomal dominant or rarely as an autosomal recessive trait. The gingival enlargement is usually generalized, but less commonly may be localized in one or two quadrants. The gingiva are firm, smooth, and occasionally papillary or nodular, with no or only minimal inflammation, and a normal color (Fig. Although either jaw may be involved, the maxillary gingiva are more frequently and severely affected. Differential diagnosis Drug-related gingival overgrowth, gingival fi- bromatosis associated with several genetic syndromes, Crohn disease, amyloidosis, leukemia. Usage subject to terms and conditions of license 238 Gingival Enlargement Scurvy Definition Scurvy is a rare systemic nutritional disorder that primarily affects the gingiva, skin, hair, nails, muscles, and joints. Clinical features The oral manifestations consist of generalized swel- ling and redness of the marginal and the interdental gingiva, followed by gingival bleeding, ulceration, and tooth mobility (Fig. Petechiae, ecchymoses, spontaneous hemorrhage, and delayed wound healing are commonly seen, both orally and systemically. Differential diagnosis Acute necrotizing ulcerative gingivitis, herpetic gingivitis, leukemia, agranulocytosis, thrombocytopenic purpura. Usage subject to terms and conditions of license 240 Gingival Enlargement Localized Pyogenic Granuloma Definition Pyogenic granuloma is a common tumorlike granulation tissue overgrowth of the oral tissues in reaction to mild irritation. Clinical features Pyogenic granuloma presents as a painless, exophytic nodular mass that is usually pedunculated or sessile, with a deep red color (Figs. The surface of the lesion may be smooth or lobu- lated, is often ulcerated, and is covered by a whitish-yellowish fibrinous membrane. It grows rapidly and may range in size from a few millimeters to several centimeters. The gingiva is commonly affected (about 70–75%), followed by the tongue, lips, and buccal mucosa. Differential diagnosis Peripheral giant-cell granuloma, peripheral os- sifying fibroma, hemangioma, Kaposi sarcoma, bacillary angiomatosis, leiomyoma, hemangioendothelioma, metastatic neoplasms. Usage subject to terms and conditions of license 242 Gingival Enlargement Peripheral Giant-Cell Granuloma Definition Peripheral giant-cell granuloma is a relatively uncommon reactive tumor of the oral cavity. Clinical features The lesion occurs exclusively on the gingiva or eden- tulous alveolar ridge. It typically presents as a well-circumscribed sessile or pedunculated mass, dark red in color, which hemorrhages easily and may or may not be ulcerated (Figs. Differential diagnosis Pyogenic granuloma, peripheral ossifying fibro- ma, brown giant-cell tumor of hyperparathyroidism, Kaposi sarcoma. Usage subject to terms and conditions of license 244 Gingival Enlargement Peripheral Ossifying Fibroma Definition Peripheral ossifying fibroma is a relatively common reac- tive growth on the gingiva, with a characteristic histomorphological pattern. Clinical features The lesion occurs exclusively on the gingiva, and it is more common in children and young adults, with a female predilection.
Treatment and nursing care Epidemiological summary There is no specific treatment for this virus buy kamagra soft paypal impotence your 20s, but Most cases are reported during the summer for severe cases cheap 100 mg kamagra soft with mastercard erectile dysfunction kidney failure, supportive measures and intensive especially in rural and semi-rural areas. Manifestations • Nephropathia epidemica • Initially a flu-like illness then renal failure and oliguria • Raised liver enzymes • Less than 0. Early diagnosis can be made by the detection of • Further complications include disseminated antigen in urine. Treatment Intravenous Erythromycin and/or oral Rifampicin Risk factors is the treatment of choice, substituted with oral A person’s risk of acquiring legionellosis following Erythromycin once symptoms improve. With exposure to contaminated water depends upon a appropriate antibiotic therapy the mortality of number of factors including: legionnaires disease is low in immunocompetent • The type and intensity of exposure patients. Intensive supportive care will be required Page 105 • The exposed person’s health status (those with for those who develop severe symptoms. Module 4 Page 105 Leishmaniasis Infection control Definition This disease is not contagious from person to Leishmaniasis is caused by the protozoan person, so isolation precautions are not required. Sterile water should be used to fill reservoirs of devices used for nebulization or for rinsing such Mode of transmission devices and other respiratory care equipment after Leishmaniasis is transmitted to humans by the disinfection. The sandfly bites on an animal or create aerosols should not be used unless they can human in order to obtain a blood meal to develop be sterilised or subjected to high-level disinfection. If this blood contains the leishmania parasites, these will continue to develop inside the Prevention of spread sandfly over a period of 4–25 days. When the Environmental health measures should include sandfly feeds again on a fresh source, transmission regular cleaning and maintenance of water supplies of the disease continues. Diagnosis The most accurate way to diagnose is to identify Manifestations of Visceral Leishmaniasis (also the parasite by microscopy or to culture material known as Kala-azar) on a medium that allows their growth. This type This is the most serious form of leishmaniasis, and of diagnosis will involve obtaining material from is fatal if left untreated. Page 107 Early infection • After inoculation by the biting sandfly, the Blood tests can be used to try and identify parasite may multiply locally causing a cellular antibodies, but this can give a false positive result. Their nutritional status and potential deficiencies must be addressed, and any associated bacterial infections promptly diagnosed and treated. These are given over a period of 30 days, but haematological and parasitological follow up should extend to one year to prevent any relapse. Prevention of spread This is dependant upon: • control of the sandfly population through reducing breeding sites such as dark, moist habitats (cracks in masonry, piles of rubble and the bark of dead trees. However, although infected dogs can be identified by their appearance, infected foxes appear healthy and are thus more difficult to control. Page 108 Leptospirosis Definition more severe cases, antibiotics (Doxycycline, Leptospirosis is a spirochaetal infection. It affects Amoxicillin or Ampicillin) should be administered wild and domestic animals worldwide, especially early to shorten the duration of early disease and rodents, but is rarely transmitted to humans. Delayed antibiotic treatment after complications Mode of transmission have occurred may be of some help. Leptospirosis is transmitted when infected animal urine or other excretions come into contact with Nursing care skin abrasions. In cases of severe infection, patients may present with impaired renal and hepatic function, Epidemiological summary haemorrhage, and alterations in conscious level. In Reliable figures on morbidity and mortality related such cases hospitalization and full supportive care to leptospirosis are generally lacking and the disease is necessary (Appendix 1). Weil’s disease has a fatality rate of 10–20% Risk Factors Farmers, veterinary surgeons, sewerage workers, fish farmers and those bathing or participating in water sports in contaminated water are particularly at risk. In Page 109 Louse-borne typhus Definition be started if clinical diagnosis of this disease is Louse-borne typhus is a rickettsial disease caused suspected. Treatment Mode of transmission If treatment begins before serious complications Rickettsia prowazekii is transmitted by the human occur, the risk of fatal illness is virtually eliminated. The lice become Treatment is a single dose of 200 mg doxycycline, infected while feeding on the blood of a patient regardless of the patient’s age. Infected lice then excrete rickettsia in faeces when feeding on a second human host. The rickettsia enter humans through Prevention of spread rubbing or scratching either infected faecal matter Prevention is through: or crushed lice into the bite wound or any other • Cleanliness to prevent body louse infestations entry site on the skin. It is recommended for high risk groups only, for Manifestations example, workers who live in or visit areas where • Incubation period is 1–3 weeks. Risk factors The disease is associated with poor living conditions and overcrowding, as may be experienced by refugees or those living in war zones. Diagnosis Serological diagnosis can be made but takes several weeks to become positive. Mode of transmission • Multiple areas of erythema migrans can be seen Borrelia burgdorferi is transmitted in tick (Ixodes on the skin. Ixodes • Migratory arthritis may affect one or more of ricinus is found throughout North America and the large joints. The ticks feed on blood by Chronic or persistent disease inserting their mouthparts into the skin of the host • Months to years after the tick bite animal, but because they are slow feeders, a • Arthritis complete blood meal can take several days. As they • Encephalopathy – confusion, memory loss, feed their bodies slowly enlarge. It is rarely, if ever, fatal, but can be debilitating for those with the chronic condition. Manifestations Lyme disease is a multi-system disease, which Risk factors can be described in three broad categories, based Ticks do not fly or jump. They can only crawl, on the clinical features and the time since and are transferred to humans and animals as they acquisition. Those at high risk of Early localized disease being bitten are outdoor workers, campers, hikers, • A few days to a month after the tick bite. Page 111 Early disseminated disease Methods of treatment • Weeks to months after the tick bite. At the early-localized stage, it can be successfully Page 111 treated with antibiotics (Amoxycillin or tetracyclines). Treatment at the later stage is with long-term (4 weeks or more) antibiotics such as cefotaxime (I. Patients will require support and reassurance throughout this debilitating illness. Prevention is through: • Avoidance of tick bites: those at risk should wear protective clothing (long trousers and socks), and use an insect repellent. Skin should be inspected for ticks every few hours and any ticks found should be removed immediately. There • Malaise, headache, diarrhoea, nausea, muscle pain are four Plasmodium species that affect humans. Plasmodium falciparum causes the most dangerous • If Plasmodium falciparum is left untreated, type of malaria and can quickly cause life- progressive life-threatening complications can threatening cerebral malaria and multi-organ failure develop within a few days (such as cerebral malaria), if left untreated or not treated properly. Plasmodium malariae cause the other three types • Ominous signs are jaundice, drowsiness or of malaria which can cause significant morbidity, confusion and occasionally black urine (“black- but which rarely causes death.
These are arranged the upper part of the lateral wall and upper in three main groups buy discount kamagra soft online erectile dysfunction treatment after radical prostatectomy. The greater palatine artery enters through The anterior group of cells drain into the the incisive canal into the nose and supplies anterior part of the middle meatus 100 mg kamagra soft mastercard causes of erectile dysfunction and premature ejaculation. The the anteroinferior part of the septum and middle ethmoidal cells drain in the middle adjacent areas of the floor and lateral wall. The superior labial branch of the facial the posterior ethmoid cells drain into the artery supplies the septum and nasal alae. The ethmoid air cells are related laterally Venous Drainage to the orbit and are separated from it by a thin Veins form a plexus which drains anteriorly bone lamina papyracea. Posteriorly the eth- into the facial vein, posteriorly into the moids are related to the optic foramina. Anterior ethmoidal branch of the naso- Sphenoid sinuses develop in the body of the ciliary nerve, supplying the upper part of sphenoid bone. The two sinuses are unequally the lateral wall and the septum divided by a septum. Sphenopalatine nerves (long and short), Superiorly the sinus is related to the frontal branches from the sphenopalatine gang- lobe and olfactory tracts. The Sympathetic Supply fibres in the greater superficial petrosal nerve The preganglionic fibres arise from the first end in the sphenopalatine ganglion. Postgang- and second thoracic segments of the spinal lionic fibres arise from this ganglion and both cord and end in the corresponding sympathe- sympathetic and parasympathetic fibres are tic ganglia. These fibres ascend in the cervical distributed through the sphenopalatine nerves sympathetic chain to synapse in the superior to the nasal mucosa. Submandibular lymph nodes collect lymph from Parasympathetic Supply the external and anterior parts of the nasal The preganglionic fibres arise in the superior cavity. Airconditioning and humidification: The system and serves the following important highly vascular mucosa of the nose main- functions. Respiratory passage: Normally, breathing thus, prevents the delicate mucosa of the takes place through the nose. The inspired respiratory tract from any damage due to air passes upwards in a narrow stream temperature variations. The humidified air medial to the middle turbinate and then is necessary for proper functioning and downwards and backwards in the form of integrity of the ciliated epithelium. Vocal resonance: The nose and paranasal sinuses serve as vocal resonators and nasal restricted to the central part of the nasal passages are concerned with production of chambers. Thus obstructive lesion in this region is obstructions of the nasopharynx and nose important, as this disturbs the air flow. Vibrissae (nasal hair) in the nasal include sneezing, and nasopulmonary, vestibule arrest large particulate matter nasobronchial and olfactory reflexes. Olfactory are deposited on the mucus blanket reflexes influence salivary, gastric and which covers the nasal mucosa. The nasal cavity serves as an outlet for lacrimal lysozymes having antibacterial proper- and sinus secretions. This sensa- is carried by the ciliary movements tion plays the most important role in posteriorly to the oropharynx, to be behaviour and reflex responses of lower swallowed. Normally the olfactory sense smells nasal cavity and adjacent area of superior one olfact. The Olfactometry gives information about the olfactory cells are distributed in the olfactory following. Qualitative Olfactometry Parosmia The olfactory sense is assessed by taking a It is a qualitative change. The following primary odours are usually It may occur in the following conditions: tested: i. Obstructive lesions in the nose and Quantitative Olfactometry nasopharynx The measurement of olfactory sense can be ii. As is evident from the appearance of the different animals, nature has provided Exaggeration of the olfactory sensitivity is nose at such a place and in such a form as the termed hyperosmia and it occurs with the concerned species needs it for its survival. Pregnancy, hunger, strychnine poison- anterior nares are placed high up on the snout, ing so that the animal may breathe when under iii. The temperature buffers: It is regarded that has nostrils that can be closed under water. Probably, sinus formation in the cranial troglodytes) the nose is very short in relation bones helps in reducing the weight of the to snout. The following symptoms may be The common conditions of the nose and para- present alone or in combination depending nasal sinuses which result in nasal obstruction upon the disease process. Mucoid discharge is associated with a history of breathing through usually a feature of allergic rhinitis while mucopurulent discharge occurs in infective the mouth, and dryness of the throat due to lack of the humidifying action of the nose. Purulent discharge is a feature of atrophic Facial Pain and Headache rhinitis, foreign bodies in the nose, furuncu- losis and long-standing sinusitis. Nasal and paranasal sinuses are frequently Blood-stained nasal discharge usually blamed for headaches and facial pain. Pain indicates an underlying malignant process, due to involvement of different sinuses has foreign body or nonhealing granulomas, etc. Nasal Obstruction Frontal Sinus Headache Obstruction to the passage of air through the Pain due to inflammation of the frontal sinus nose may be unilateral or bilateral. The pain Common Symptoms of Nasal and Paranasal Sinus Diseases 159 is more during early hours of the day and coming into the oropharynx causing various subsides or diminishes in intensity by after- pharyngeal symptoms. Pain due to the involvement of the maxillary Speech Defect sinus is more over the maxillary region. Ethmoid Disorders of the nose and nasal sinuses may sinus pain usually occurs along sides of the result in loss of the resonating function and nose or in the orbits. Sphenoid Sinus Headache Symptoms due to Extension of the The pain is referred to the vertex or occiput Disease to the Adjacent Regions or may be present behind the eyes. Facial pain due to other nasal and para- Diseases of the nose or paranasal sinuses may nasal lesions may occur as in furunculosis, involve adjacent structures like the orbit, syphilis, due to nerve infiltration as in sinus cranial cavity, cavernous sinus, etc. Epistaxis Sneezing Bleeding from the nose may be unilateral or Sneezing is the normal nasal reflex to clear bilateral and may be due to a variety of lesions secretion from the nose and is of great impor- of the nose, paranasal sinuses and the tance in young children who have yet not nasopharynx. The sensory side of the Various olfactory derangements have already reflex is transmitted through the trigeminal been discussed. Normally the secretions from the nose and nasopharynx are carried to the oropharynx by Snoring the mucociliary mechanism of the nose, where from these are swallowed. Many times the Abnormal sound produced through nose patient complains of excessive nasal discharge during sleep is called snoring. It has many 160 Textbook of Ear, Nose and Throat Diseases causes like adenoids in children or polypi or pharynx which results in collapse of airway growth in nose, too much hypertrophied due to suction effect and as respiratory effort turbinates, oedematous mucosa of nose or soft increases, the resulting apnoea causes prog- palate. While the treatment of all pathological ressive asphyxia, which results in arousal from conditions relieves snoring, but some people sleep, with restoration of patency and airflow. Under local anaesthesia, a small glossia, retrognathia in a minority of patients, needle connected to a radio-frequency and a subtle reduction in airway size in a generator is inserted into the soft palate majority of patients. The be usually demonstrated by imaging and radio-frequency energy is directed through acoustic reflection techniques. Over few weeks, the In central sleep apnoea there is transient body naturally reabsorbs some of the loose abolition of central drive to ventilatory musc- tissue thus relieving snoring.
Only if the aluminum and asbestos are removed from her home environment kamagra soft 100 mg otc erectile dysfunction jacksonville florida, his vigilance with dairy food keeps up buy 100mg kamagra soft otc impotence blood pressure medication, and she stays on a maintenance parasite program. The first day he arrived, the intestinal flukes in his brain were found and killed. In another three days, he could hold a conversation consisting of very short sentences. He was started on orni- thine (4) and valerian capsules (6) at bedtime: this produced a beautiful nights sleep (especially for his caretakers! There are plenty of nonagenarians and centenarians with clear minds and good memories to prove that age is not the deciding factor in the dementias. Telephone numbers that left you with no recall, unless you wrote them down, number by number, now form groups as you hear them, and you can jot them down the way you always did! You can remember things that happened earlier in the day and talk about it later, at mealtime. Although circulation and blood pressure play a role, the effect of toxins is much greater. The same polluted water and food causes disorientation in the elderly when it only gives a young person a stomach ache. The answer, then, is to stop giving it toxic substances and shortening your life span. As the liver is less able to detoxify them, common toxins are allowed to roam the body with the circulation, doing harm to all the organs. At first, the liver can “catch up” its work and finally clear the toxin for excretion. The body, notably the brain, is bathed in toxic chemicals that interfere with its functioning. All these signs of aging (dementias) can be reversed by sim- ply removing the common toxins with which we are already familiar. If you have a loved one with symptoms of aging, and this person is willing to cooperate with you, you can honestly promise them numerous improvements. Spend a good deal of your effort on persuasion since living longer or being healthier may not seem worth giving up a coffee and doughnut breakfast. On the other hand, they might respond to the goal of needing fewer pills, getting into their own apartment again or becoming freed from a walker. He appeared to have the same kind of mental deteriora- tion as his mother, but at a much earlier age. He also had Acanthocephala, Dipe- talonema (a chicken roundworm), amoeba (Entamoeba histo- lytica) and Fischoedrius in the thinking part of his brain. He had been in the poultry business all his life: his mother probably shared this exposure, as well as other lifestyle habits that gave them solvents and pollutants besides parasites. He had constant ringing in his ears, this could affect hearing an ordinary conversation. He had a water softener that would have supplied a daily dose of aluminum to the brain, too. Perhaps the marvel is that he was no worse off, a tribute to human strength in general. If many people can live to 100 years, then surely this is the human life span, not three score and ten. If we knew which organ is failing, we could come to its as- sistance and prevent the collapse of the whole body. Diet If your aging friend or relative is in a home for the elderly, you may be able to persuade him or her to choose a diet that is wiser than the average diet people eat there. Just stopping drinking the coffee, decaf, iced tea and carbonated beverages that are served, and switching to the recipes in this book could get them off some of their medicines. Milk has the organic form of calcium, chelated with lactic acid, and it has the cream to pro- mote absorption. If there is not sufficient acid, it will pass undi- gested into the intestine, causing new problems. We must listen to the elderly when they say milk gives them gas or other troubles. Milk served hot with cinnamon accomplishes two purposes: it will stimulate acid secretion and the cinnamon is an insulin aid. Milk served hot with honey adds the nutritive value of honey, displacing the need for other unnatural sweets. It does not have to be added to the milk; it can simply be included with the meal somewhere. Lemon juice or vinegar can be put in certain foods but the most reliable way to get it into the diet is to put 1 tablespoon into the water glass along with a teaspoon of honey. This gives the water a “sweet and sour” flavor, enough to make it interesting throughout the meal. Bring these two items to your loved one at the “home” if it cannot be provided regularly and reliably. The lemon and honey habit, alone, can add years (healthier years) to an elderly person. The extra acid taken with lunch and supper (the stomach has its own best supply of acid in the morning, for breakfast) improves overall digestion and helps dissolve the calcium, magnesium, iron, zinc, manganese, and other minerals in the food so they can be absorbed. The habit of using vinegar and honey in water as a beverage was made famous by Dr. We must use only white distilled vinegar, even though it lacks potassium, aroma and popularity. Get orange blossom, linden blossom, buckwheat, wildflower, and sage honey, besides clover blossom. To detoxify the ergot, you simply add vitamin C to the honey as soon as it arrives from the supermarket. If your elderly loved one has not tolerated milk in years, start with the vinegar and honey beverage, or lemon and honey, and be patient until that is accepted. It must be heated until it bubbles up and almost goes over the container for ten seconds. Milk that is marketed in paper containers that need no re- frigeration has been sterilized; it is safe. Once the body, even an aged body, finds a nutritious food that does not cause troubles of its own, it asks for more. Your loved one will accept it and drink it without forceful coaxing, if there is no problem with it. As long as your loved one tries to avoid drinking it, your challenge is to find the problem and solve it. When your loved one is drinking three cups of milk (or buttermilk or whey) a day and three cups of water, there will be no room (nor request) for the usual coffee and tea and other bad beverages.