The essence of humanity cannot be truly fulfilled without the liberation of the mind....
Saturday, 14 September 2013
US and Russia agree Syria chemical weapons deal in Geneva
Syria's chemical weapons must be destroyed or removed by mid-2014, under an agreement between the US and Russia.
US Secretary of State John Kerry outlined a framework document under which Syria must hand over a full list of its stockpile within a week.
If Syria fails to comply, the deal could be enforced by a UN resolution backed by the threat of sanctions or military force.
The US says the Syrian regime killed hundreds in a gas attack last month.
The government of Bashar al-Assad denies the allegations and has accused the rebels of carrying out the attack on 21 August.
In a joint news conference with Russian Foreign Minister Sergei Lavrov, Mr Kerry called on the Assad government to live up to its public commitments.
"There can be no room for games. Or anything less than full compliance by the Assad regime," he said.
The US believes the materials are located in 45 sites, all in regime hands, half of which have useable quantities of chemical agents, the official added.
However, it is thought that Russians have not agreed the number of sites, nor that they are all under control.
'Important advance' The agreement says initial on-site inspections must be complete by November.
It also stipulates that production equipment be destroyed by November, with "complete elimination of all chemical weapons material and equipment in the first half of 2014".
Mr Kerry outlined six points to the agreement:
French Foreign Minister Laurent Fabius said it was an "important advance". France was the only country willing to join the US in taking military action in Syria.
British Foreign Secretary William Hague said: "The onus is now on the Assad regime to comply with this agreement in full. The international community, including Russia, must hold the regime to account."
UN Secretary-General Ban Ki-moon also welcomed the news of the agreement and in a statement pledged "the support of the United Nations in its implementation".
However, the military leader of the anti-Assad Free Syrian Army rejected the deal and promised to continue fighting.
"There is nothing in this agreement that concerns us," said Gen Salim Idriss, describing it as a Russian initiative designed to gain time for the Syrian government.
"What we agreed on here today could conceivable be the first critical concrete step in that direction."
Mr Lavrov suggested there could be another international peace conference on Syria by October.
"The main thing is to make sure that all Syrian sides are represented at the conference," he said.
Over the years there have been several conferences, some of which have included the Syrian opposition and excluded the government.
More than 100,000 people have died since the uprising against President Assad began in 2011.
Millions of Syrians have fled the country, and millions more have been left homeless by the fighting.
US Secretary of State John Kerry outlined a framework document under which Syria must hand over a full list of its stockpile within a week.
If Syria fails to comply, the deal could be enforced by a UN resolution backed by the threat of sanctions or military force.
The US says the Syrian regime killed hundreds in a gas attack last month.
The government of Bashar al-Assad denies the allegations and has accused the rebels of carrying out the attack on 21 August.
In a joint news conference with Russian Foreign Minister Sergei Lavrov, Mr Kerry called on the Assad government to live up to its public commitments.
"There can be no room for games. Or anything less than full compliance by the Assad regime," he said.
Mr Kerry and Mr Lavrov said if Syria failed to
comply, then a UN resolution would be sought under Chapter VII of the
UN charter, which allows for the use of force.
Russia and the US have agreed on an assessment that the
Syrian government possesses 1,000 tonnes of chemical agents and
precursors, according to a US official.The US believes the materials are located in 45 sites, all in regime hands, half of which have useable quantities of chemical agents, the official added.
However, it is thought that Russians have not agreed the number of sites, nor that they are all under control.
'Important advance' The agreement says initial on-site inspections must be complete by November.
It also stipulates that production equipment be destroyed by November, with "complete elimination of all chemical weapons material and equipment in the first half of 2014".
Mr Kerry outlined six points to the agreement:
- The amount and type of chemical weapons must be agreed and "rapidly" placed under international control
- Syria must submit within one week a comprehensive listing of its stockpiles
- Extraordinary procedures under the Chemical Weapons Convention will allow "expeditious destruction"
- Syria must give inspectors "immediate, unfettered access" to all sites
- All chemical weapons must be destroyed, including the possibility of removing weapons from Syrian territory
- UN will provide logistical support, and compliance would be enforced under Chapter VII
French Foreign Minister Laurent Fabius said it was an "important advance". France was the only country willing to join the US in taking military action in Syria.
British Foreign Secretary William Hague said: "The onus is now on the Assad regime to comply with this agreement in full. The international community, including Russia, must hold the regime to account."
UN Secretary-General Ban Ki-moon also welcomed the news of the agreement and in a statement pledged "the support of the United Nations in its implementation".
However, the military leader of the anti-Assad Free Syrian Army rejected the deal and promised to continue fighting.
"There is nothing in this agreement that concerns us," said Gen Salim Idriss, describing it as a Russian initiative designed to gain time for the Syrian government.
Mr Kerry said he hoped the deal would help kick-start a wider peace process.
"We could also lay the groundwork for further co-operation
that is essential to end the bloodshed that has consumed Syria for more
than two years," he said."What we agreed on here today could conceivable be the first critical concrete step in that direction."
Mr Lavrov suggested there could be another international peace conference on Syria by October.
"The main thing is to make sure that all Syrian sides are represented at the conference," he said.
Over the years there have been several conferences, some of which have included the Syrian opposition and excluded the government.
More than 100,000 people have died since the uprising against President Assad began in 2011.
Millions of Syrians have fled the country, and millions more have been left homeless by the fighting.
Friday, 13 September 2013
Halting Heartburn at Home
Halting Heartburn at Home
f you're one of the 50 million Americans diagnosed with heartburn, you may very well know the agony: that painful burning feeling under your breastbone; the discomfort of chest pain just after bending over, lying down or eating; trouble swallowing, or the ever-annoying classic – that hot, sour nastiness at the back of your throat. That's heartburn for you.
Sure, there are plenty of medicines and over-the-counter treatments available that can provide relief, even in cases where heartburn is chronic or severe, but why a trip to the doctor and the pharmacy? Check out these 10 home remedies for heartburn.
1. Pay Close Attention to What You Eat
Just by the sound of it, you know a jalapeno taco burger is a bad idea. Still, there are lots of specific foods that can trigger heartburn. To keep heartburn in check, monitor your diet closely, and know what's in the foods you eat. Some stealthy heartburn generating culprits are peppermint, caffeine, sodas, chocolate, citrus fruits and juices, tomatoes, onions, and high-fat foods.
2. Avoid Eating Too Much Food
Q: When is heartburn is mostly likely to occur?
A: After overindulging on food! With respect to heartburn, the volume of what you eat is critical. If your belly is too full, your stretched stomach can put pressure on the muscles that keep stomach acids in place. After a wonderful meal, the last thing you want is a late, great heartburn haunt. It's best to keep your portions reasonable.
3. Bid Farewell to Fried and Fatty Foods
Fatty foods linger in your stomach, causing it to produce excess acid. This acid overload irritates the digestive system. Remember those stomach acid-controlling muscles? High-fat foods make them fall asleep on the job, allowing that foul stomach acid to occasionally make its way back up through your esophagus to splash around in the back of your throat.
4. Lose Weight/Maintain a Healthy Weight
Losing weight is daunting; but it can mean relief for people plagued by heartburn. The idea behind weight loss/maintenance as a heartburn management strategy is to keep a healthy weight; it will eliminate abdominal stress caused by carrying extra pounds, especially since excess belly fat creates pressure that can force acids back into the esophagus.
5. Think Before You Drink!
These drinks listed lend themselves to heartburn flares: coffee (regular or decaffeinated), caffeinated tea, colas (and other carbonated soft drinks), and alcohol. Caffeine in some drinks increases acid production in the stomach; sodas cause bloating and alcoholic beverages relax stomach acid-regulating muscles, all of which can lead to heartburn misery.
6. Write It Down
Keep a food journal to keep heartburn at bay. When heartburn occurs, jot down what you've eaten and done so you can pinpoint and avoid foods, beverages, and activities (such as lying down after eating) that may trigger heartburn. Once a pattern appears, you can take proactive steps to avoid things that activate heartburn.
7. Quit Smoking
Smoking can reduce the effectiveness of the muscles that keeps acids in the stomach. Stomach acids are made to help break down food. While the stomach is naturally protected from the acids it produces, the esophagus is not. Smoking weakens the acid-restraining muscles in the stomach. Over time, acid flow into the esophagus can cause injury and damage.
8. Avoid Acidic Foods
Tomatoes, tomato-based products, citrus fruits, vinegar, and vinegar-based foods are all major heartburn triggers. Citrus fruits like oranges, grapefruits, lemons, and limes can trigger serious heartburn, especially if eaten by themselves. Vinegar, often a main ingredient in salad dressings, also can provoke heartburn.
9. Eat Dinner Early and Avoid Nighttime Snacking
Turning in for the night while your belly is full will increase the chance of a heartburn attack. An engorged stomach puts pressure on the stomach valve that keeps acid in place. It's best to finish your last meal two to three hours before bedtime to give food a chance to digest. Avoid nighttime snacking to prevent the stomach from having to digest food overnight.
10. Prop Up
Invest in a wedge pillow! A wedge pillow is a slanted pillow that is designed to prop up the upper body during rest. When the upper body is slightly raised, simple gravity keeps stomach acid in place and out of the esophagus. Wedge pillows are great for propping, but if you find that you need an extra boost, stuff wooden blocks under your mattress for a few added inches.
Keep In Mind...
A common theme that has been consistent throughout this piece is to keep stomach acid from migrating into the esophagus, and to avoid foods, drinks, habits, and behaviors that provoke or exacerbate heartburn. These drug-free tips and tricks suggest small diet and lifestyle changes you can make to help manage severe, chronic, occasional, or pregnancy-induced heartburn. Good luck!
f you're one of the 50 million Americans diagnosed with heartburn, you may very well know the agony: that painful burning feeling under your breastbone; the discomfort of chest pain just after bending over, lying down or eating; trouble swallowing, or the ever-annoying classic – that hot, sour nastiness at the back of your throat. That's heartburn for you.
Sure, there are plenty of medicines and over-the-counter treatments available that can provide relief, even in cases where heartburn is chronic or severe, but why a trip to the doctor and the pharmacy? Check out these 10 home remedies for heartburn.
1. Pay Close Attention to What You Eat
Just by the sound of it, you know a jalapeno taco burger is a bad idea. Still, there are lots of specific foods that can trigger heartburn. To keep heartburn in check, monitor your diet closely, and know what's in the foods you eat. Some stealthy heartburn generating culprits are peppermint, caffeine, sodas, chocolate, citrus fruits and juices, tomatoes, onions, and high-fat foods.
2. Avoid Eating Too Much Food
Q: When is heartburn is mostly likely to occur?
A: After overindulging on food! With respect to heartburn, the volume of what you eat is critical. If your belly is too full, your stretched stomach can put pressure on the muscles that keep stomach acids in place. After a wonderful meal, the last thing you want is a late, great heartburn haunt. It's best to keep your portions reasonable.
3. Bid Farewell to Fried and Fatty Foods
Fatty foods linger in your stomach, causing it to produce excess acid. This acid overload irritates the digestive system. Remember those stomach acid-controlling muscles? High-fat foods make them fall asleep on the job, allowing that foul stomach acid to occasionally make its way back up through your esophagus to splash around in the back of your throat.
4. Lose Weight/Maintain a Healthy Weight
Losing weight is daunting; but it can mean relief for people plagued by heartburn. The idea behind weight loss/maintenance as a heartburn management strategy is to keep a healthy weight; it will eliminate abdominal stress caused by carrying extra pounds, especially since excess belly fat creates pressure that can force acids back into the esophagus.
5. Think Before You Drink!
These drinks listed lend themselves to heartburn flares: coffee (regular or decaffeinated), caffeinated tea, colas (and other carbonated soft drinks), and alcohol. Caffeine in some drinks increases acid production in the stomach; sodas cause bloating and alcoholic beverages relax stomach acid-regulating muscles, all of which can lead to heartburn misery.
6. Write It Down
Keep a food journal to keep heartburn at bay. When heartburn occurs, jot down what you've eaten and done so you can pinpoint and avoid foods, beverages, and activities (such as lying down after eating) that may trigger heartburn. Once a pattern appears, you can take proactive steps to avoid things that activate heartburn.
7. Quit Smoking
Smoking can reduce the effectiveness of the muscles that keeps acids in the stomach. Stomach acids are made to help break down food. While the stomach is naturally protected from the acids it produces, the esophagus is not. Smoking weakens the acid-restraining muscles in the stomach. Over time, acid flow into the esophagus can cause injury and damage.
8. Avoid Acidic Foods
Tomatoes, tomato-based products, citrus fruits, vinegar, and vinegar-based foods are all major heartburn triggers. Citrus fruits like oranges, grapefruits, lemons, and limes can trigger serious heartburn, especially if eaten by themselves. Vinegar, often a main ingredient in salad dressings, also can provoke heartburn.
9. Eat Dinner Early and Avoid Nighttime Snacking
Turning in for the night while your belly is full will increase the chance of a heartburn attack. An engorged stomach puts pressure on the stomach valve that keeps acid in place. It's best to finish your last meal two to three hours before bedtime to give food a chance to digest. Avoid nighttime snacking to prevent the stomach from having to digest food overnight.
10. Prop Up
Invest in a wedge pillow! A wedge pillow is a slanted pillow that is designed to prop up the upper body during rest. When the upper body is slightly raised, simple gravity keeps stomach acid in place and out of the esophagus. Wedge pillows are great for propping, but if you find that you need an extra boost, stuff wooden blocks under your mattress for a few added inches.
Keep In Mind...
A common theme that has been consistent throughout this piece is to keep stomach acid from migrating into the esophagus, and to avoid foods, drinks, habits, and behaviors that provoke or exacerbate heartburn. These drug-free tips and tricks suggest small diet and lifestyle changes you can make to help manage severe, chronic, occasional, or pregnancy-induced heartburn. Good luck!
What is Prostatitis
What is prostatitis?
Prostatitis is the general term used to describe prostate inflammation (-itis). Because the term is so general, it does not adequately describe the range of abnormalities that can be associated with prostate inflammation. Therefore, four types of prostatitis are recognized.
What are the types and symptoms of prostatitis?
There are four types of prostatitis:
acute bacterial prostatitis
chronic bacterial prostatitis
chronic prostatitis without infection
asymptomatic inflammatory prostatitis
Acute bacterial prostatitis causes and symptoms
Acute bacterial prostatitis is an infection of the prostate that is often caused by some of the same bacteria that cause bladder infections. These include E. coli, Klebsiella, and Proteus. While it may be acquired as a sexually transmitted disease, the infection can also spread to the prostate through the blood stream, directly from an adjacent organ, or as a complication of prostate biopsy.
Patients with acute bacterial prostatitis present with signs of an infection and may have:
fever,
chills, and
shakes.
Commonly there is urgency and frequency of urination and dysuria (painful or difficult urination).
Chronic bacterial prostatitis causes and symptoms
Chronic bacterial prostatitis is an uncommon illness in which there is an ongoing bacterial infection in the prostate. Chronic bacterial prostatitis generally causes no symptoms, however, on occasion; the low grade infection may flare and be associated with a bladder infection.
Chronic prostatitis without infection causes and symptoms
Chronic prostatitis without infection, also known as chronic pelvic pain syndrome, is a condition where there is recurrent pelvic, testicle, or rectal pain without evidence of bladder infection. There may be difficulties with painful urination or ejaculation, and erectile dysfunction. The cause of chronic prostatitis without infection is not clearly understood.
Asymptomatic inflammatory prostatitis causes and symptoms
Asymptomatic inflammatory prostatitis is exactly as its name describes. There are no symptoms. The cause of asymptomatic inflammatory prostatitis is not clearly understood.
How is prostatitis diagnosed?
The diagnosis of prostatitis relies on a careful history and physical examination by the health care practitioner.
The most important laboratory test is a urinalysis to help differentiate the types of prostatitis. The need for other blood tests or imaging studies like ultrasound, X-ray, and computerized tomography (CT) will depend upon the clinical situation and presentation.
Acute bacterial prostatitis diagnosis
After taking a history, the health care practitioner will likely have a directed physical examination concentrating on the scrotum, looking for inflammation of the testicle(s) or epididymis, and the flank and mid-back, where the kidney is located. If a rectal examination is performed, the prostate may be swollen and boggy, consistent with acute inflammation.
Laboratory testing may include urinalysis, looking for white blood cells and bacteria, signifying infection. The urine may also be cultured to identify the bacteria that are responsible for the infection, but results will take up to seven days to return. The results will help confirm that the antibiotic chosen is correct and may help choose an alternate antibiotic should the illness progress.
Chronic bacterial prostatitis diagnosis
The diagnosis is made by finding an abnormal urinalysis. Sometimes, a urinalysis is collected after prostate examination. This may allow some prostatic fluid to be expressed into the urine and cultured.
A blood test called PSA (prostate surface antigen) may be elevated in this type of prostatitis. While PSA is used as a prostate cancer screening tool, it can also be elevated whenever the prostate is inflamed.
Chronic prostatitis without infection diagnosis
To make the diagnosis of chronic prostatitis without infection, symptoms should be present for at least three months. The cause of chronic prostatitis without infection (chronic pelvic pain syndrome) is not known.
This is a frustrating condition for the patient and the health care practitioner since there is controversy as to the aggressiveness of testing, and exactly what tests should be done. Often, this is a diagnosis of exclusion, meaning that blood tests, urine tests, x-rays and ultrasounds tend to be normal, yet the patient continues to suffer.
Asymptomatic inflammatory prostatitis diagnosis
There are no symptoms with this type of prostatitis, however, when routine lab tests are performed, white blood cells (a sign of inflammation) are found in the urine, but there are no associated bacteria or infection.
What is the treatment for prostatitis?
Comment on this Read Doctor's View Read 2 Comments Share Your Story
Acute bacterial prostatitis treatment
Treatment for acute bacterial prostatitis is a prescription for antibiotics by mouth, usually ciprofloxacin (Cipro) or tetracycline (Achromycin). Home care includes drinking plenty of fluids, medications for pain control, and rest.
If the patient is acutely ill or has a compromised immune system (for example, is taking chemotherapy or other immune suppression drugs or has HIV/AIDS), hospitalization for intravenous antibiotics and care may be required.
Chronic bacterial prostatitis treatment
Chronic bacterial prostatitis treatment is with long-term antibiotics, up to eight weeks, with ciprofloxacin (Cipro, Cipro XR), sulfa drugs [for example, sulfamethoxazole and trimethoprim, (Bactrim)], or erythromycin. Even with appropriate therapy, this type of prostatitis can recur. It is uncertain as to why, but it may be due to a poorly emptying bladder. A small amount of stagnant urine allows the potential for recurrent infection to occur. This situation can be caused by benign prostatic hypertrophy (BPH), bladder stones, or prostate stones.
Chronic prostatitis without infection treatment
Chronic prostatitis without infection treatment addresses chronic pain control and may include physical therapy and relaxation techniques as well as tricyclic antidepressant medications.
Other medication possibilities include alpha-adrenergic blockers. Tamsulosin (Flomax) and terazosin (Hytrin) are drugs that block the non-heart adrenaline receptors and are used in treating BPH and bladder outlet obstruction. Allowing better bladder emptying may help minimize symptoms.
Asymptomatic inflammatory prostatitis treatment
Treatment is not required for this type of prostatitis.
In patients undergoing infertility assessment, this inflammation may be treated with a course of either a nonsteroidal anti-inflammatory medication (ibuprofen, Motrin, Advil) or antibiotics.
What is the prognosis for prostatitis?
Acute bacterial prostatitis is curable with a short course of antibiotics.
Chronic bacterial prostatitis is often recurrent even with appropriate therapy. Fortunately, the disease tends to be asymptomatic.
Chronic pelvic pain syndrome will be challenging for the patient and the health care practitioner. Symptoms tend to linger and be difficult to control.
Asymptomatic inflammatory prostatitis is not clinically significant and does not require treatment.
Prostatitis is the general term used to describe prostate inflammation (-itis). Because the term is so general, it does not adequately describe the range of abnormalities that can be associated with prostate inflammation. Therefore, four types of prostatitis are recognized.
What are the types and symptoms of prostatitis?
There are four types of prostatitis:
acute bacterial prostatitis
chronic bacterial prostatitis
chronic prostatitis without infection
asymptomatic inflammatory prostatitis
Acute bacterial prostatitis causes and symptoms
Acute bacterial prostatitis is an infection of the prostate that is often caused by some of the same bacteria that cause bladder infections. These include E. coli, Klebsiella, and Proteus. While it may be acquired as a sexually transmitted disease, the infection can also spread to the prostate through the blood stream, directly from an adjacent organ, or as a complication of prostate biopsy.
Patients with acute bacterial prostatitis present with signs of an infection and may have:
fever,
chills, and
shakes.
Commonly there is urgency and frequency of urination and dysuria (painful or difficult urination).
Chronic bacterial prostatitis causes and symptoms
Chronic bacterial prostatitis is an uncommon illness in which there is an ongoing bacterial infection in the prostate. Chronic bacterial prostatitis generally causes no symptoms, however, on occasion; the low grade infection may flare and be associated with a bladder infection.
Chronic prostatitis without infection causes and symptoms
Chronic prostatitis without infection, also known as chronic pelvic pain syndrome, is a condition where there is recurrent pelvic, testicle, or rectal pain without evidence of bladder infection. There may be difficulties with painful urination or ejaculation, and erectile dysfunction. The cause of chronic prostatitis without infection is not clearly understood.
Asymptomatic inflammatory prostatitis causes and symptoms
Asymptomatic inflammatory prostatitis is exactly as its name describes. There are no symptoms. The cause of asymptomatic inflammatory prostatitis is not clearly understood.
How is prostatitis diagnosed?
The diagnosis of prostatitis relies on a careful history and physical examination by the health care practitioner.
The most important laboratory test is a urinalysis to help differentiate the types of prostatitis. The need for other blood tests or imaging studies like ultrasound, X-ray, and computerized tomography (CT) will depend upon the clinical situation and presentation.
Acute bacterial prostatitis diagnosis
After taking a history, the health care practitioner will likely have a directed physical examination concentrating on the scrotum, looking for inflammation of the testicle(s) or epididymis, and the flank and mid-back, where the kidney is located. If a rectal examination is performed, the prostate may be swollen and boggy, consistent with acute inflammation.
Laboratory testing may include urinalysis, looking for white blood cells and bacteria, signifying infection. The urine may also be cultured to identify the bacteria that are responsible for the infection, but results will take up to seven days to return. The results will help confirm that the antibiotic chosen is correct and may help choose an alternate antibiotic should the illness progress.
Chronic bacterial prostatitis diagnosis
The diagnosis is made by finding an abnormal urinalysis. Sometimes, a urinalysis is collected after prostate examination. This may allow some prostatic fluid to be expressed into the urine and cultured.
A blood test called PSA (prostate surface antigen) may be elevated in this type of prostatitis. While PSA is used as a prostate cancer screening tool, it can also be elevated whenever the prostate is inflamed.
Chronic prostatitis without infection diagnosis
To make the diagnosis of chronic prostatitis without infection, symptoms should be present for at least three months. The cause of chronic prostatitis without infection (chronic pelvic pain syndrome) is not known.
This is a frustrating condition for the patient and the health care practitioner since there is controversy as to the aggressiveness of testing, and exactly what tests should be done. Often, this is a diagnosis of exclusion, meaning that blood tests, urine tests, x-rays and ultrasounds tend to be normal, yet the patient continues to suffer.
Asymptomatic inflammatory prostatitis diagnosis
There are no symptoms with this type of prostatitis, however, when routine lab tests are performed, white blood cells (a sign of inflammation) are found in the urine, but there are no associated bacteria or infection.
What is the treatment for prostatitis?
Comment on this Read Doctor's View Read 2 Comments Share Your Story
Acute bacterial prostatitis treatment
Treatment for acute bacterial prostatitis is a prescription for antibiotics by mouth, usually ciprofloxacin (Cipro) or tetracycline (Achromycin). Home care includes drinking plenty of fluids, medications for pain control, and rest.
If the patient is acutely ill or has a compromised immune system (for example, is taking chemotherapy or other immune suppression drugs or has HIV/AIDS), hospitalization for intravenous antibiotics and care may be required.
Chronic bacterial prostatitis treatment
Chronic bacterial prostatitis treatment is with long-term antibiotics, up to eight weeks, with ciprofloxacin (Cipro, Cipro XR), sulfa drugs [for example, sulfamethoxazole and trimethoprim, (Bactrim)], or erythromycin. Even with appropriate therapy, this type of prostatitis can recur. It is uncertain as to why, but it may be due to a poorly emptying bladder. A small amount of stagnant urine allows the potential for recurrent infection to occur. This situation can be caused by benign prostatic hypertrophy (BPH), bladder stones, or prostate stones.
Chronic prostatitis without infection treatment
Chronic prostatitis without infection treatment addresses chronic pain control and may include physical therapy and relaxation techniques as well as tricyclic antidepressant medications.
Other medication possibilities include alpha-adrenergic blockers. Tamsulosin (Flomax) and terazosin (Hytrin) are drugs that block the non-heart adrenaline receptors and are used in treating BPH and bladder outlet obstruction. Allowing better bladder emptying may help minimize symptoms.
Asymptomatic inflammatory prostatitis treatment
Treatment is not required for this type of prostatitis.
In patients undergoing infertility assessment, this inflammation may be treated with a course of either a nonsteroidal anti-inflammatory medication (ibuprofen, Motrin, Advil) or antibiotics.
What is the prognosis for prostatitis?
Acute bacterial prostatitis is curable with a short course of antibiotics.
Chronic bacterial prostatitis is often recurrent even with appropriate therapy. Fortunately, the disease tends to be asymptomatic.
Chronic pelvic pain syndrome will be challenging for the patient and the health care practitioner. Symptoms tend to linger and be difficult to control.
Asymptomatic inflammatory prostatitis is not clinically significant and does not require treatment.
Malian troops in first clash with MNLA rebels since truce
The truce between Malian troops and Tuaregs paved the way for elections
Malian government forces have clashed with separatist Tuareg rebels in the first fighting since the two sides signed a peace accord in June.
The fighting took place near the western town of Lere, close to the Mauritanian border, leaving three soldiers injured.
Both sides have accused the other of provoking the attack.
A Malian army spokesman has warned that such fighting could jeopardise the truce.
A spokesman for the MNLA rebels told the BBC that government soldiers shelled positions that rebels had agreed to occupy under the ceasefire deal.
However, the army says a group of rebels refused to co-operate with an army patrol and opened fire first.
"An army patrol came across some gunmen in four-wheel drives. They refused to follow the army's orders and opened fire," said spokesman Capt Modibo Naman Traore.
He added: "It could throw into question the entire accord. That's the danger here."
Capt Traore said three soldiers suffered minor injuries and were evacuated for treatment.
Reconciliation The violence comes a week after President Ibrahim Boubacar Keita was sworn in.
Under the ceasefire deal, President Keita has 60 days from the naming of his government last Sunday to start talks with the rebels, who want independence for the deserts of northern Mali, which they call Azawad.
Mr Keita has promised national reconciliation and an end to the cycles of uprisings.
The BBC's Thomas Fessy in neighbouring Senegal says the clashes come as a reminder that tension in Mali is still high and that the path to peace will not be easy.
Rebel forces, which included Tuareg separatists and militant Islamists, took advantage of a coup last year to seize the vast north of the country.
France sent more than 4,000 troops in January and together with West African troops regained control of towns and cities, paving the way for elections in July and a run-off between the two main candidates in August.
Kenya's William Ruto formed an army for war, ICC hears
Anna Holligan explains why William Ruto is in court, in 60 seconds
Kenya's Deputy President William Ruto formed an army prior to the elections in 2007 "to go to war for him", the prosecution has alleged at his trial.
He pleaded not guilty to crimes against humanity charges as the trial began at the International Criminal Court (ICC).
Mr Ruto and President Uhuru Kenyatta are accused of orchestrating violence after elections in 2007, and are being tried separately at The Hague.
Mr Ruto becomes the first serving official to appear at the ICC.
The two trials are seen as a crucial test of the ICC's ability to prosecute political leaders.
This is a politically controversial trial with a complex legal history, says the BBC's Anna Holligan in The Hague.
Mr Kenyatta and Mr Ruto were on opposite sides during the
2007 election and are accused of orchestrating attacks on members of
each other's ethnic groups.They formed an alliance for elections in March, saying they were an example of reconciliation.
Analysts say the ICC prosecutions bolstered their campaign as they portrayed it as foreign interference in Kenya's domestic affairs.
'Influential network' Mr Ruto watched and smiled during proceedings and pleaded not guilty to each of the three counts of murder, persecution and forcible transfer of people, our correspondent says.
Mr Ruto's defence lawyer, Karim Khan, accused the prosecution of building its case on "a conspiracy of lies".
"We say that there is a rotten underbelly of this case that the prosecutor has swallowed hook, line and sinker, indifferent to the truth, all too eager to latch on to any... story that somehow ticks the boxes that we have to tick [to support charges]," Mr Khan said.
Kenya's violent elections
- Then-President Mwai Kibaki declared the winner of December 2007 elections - Raila Odinga cries foul
- Opposition protests lead to clashes with police and degenerate into ethnic violence across the country
- Some 1,200 killed and 600,000 flee homes
- Incumbent President Uhuru Kenyatta in Kibaki camp; accused of orchestrating violence against ethnic groups seen as pro-Odinga
- Incumbent Deputy President William Ruto in Odinga camp; accused of targeting pro-Kibaki communities
- Power-sharing deal signed in April 2008 after mediation by ex-UN chief Kofi Annan
- Mr Kenyatta and Mr Ruto form alliance and win March 2013 election
- Mr Ruto's trial started on 10 September; Mr Kenyatta's due in November
He downplayed claims his client
was driven by ethnic hatred, telling the judges that two of Mr Ruto's
sisters of the Kalenjin ethnic group were married to members of the
rival Kikuyu group.
Chief prosecutor Fatou Bensouda said Mr Ruto had planned
violence over an 18-month period prior to the 2007 elections, exploiting
existing tensions between his Kalenjin group and Mr Kenyatta's Kikuyu
group.Mr Ruto used his power to procure weapons, secure funds and co-ordinate the violence, Ms Bensouda said.
A group of Kenyan MPs and other supporters welcomed Mr Ruto and his co-accused Joshua arap Sang as they arrived for the trial, AFP reports.
He is the head of a Kalenjin-language radio station and is accused of whipping up ethnic hatred.
In Kenya, many people are following the case closely and opinion is split with opposition supporters welcoming the trial and government supporters opposed to it, says the BBC's Caroline Karobia in the capital, Nairobi.
Some 1,200 people were killed and 600,000 forced from their homes in weeks of violence after the disputed December 2007 election.
More than 40,000 people are estimated to be still living in camps, which Mr Kenyatta last week promised to close by 20 September.
On Sunday, he gave cheques worth more than $4,500 (£3,000) per family so they could move out of camps and rebuild their lives.
Ex-UN chief Kofi Annan said, in an article in The New York Times, that the trials were not an assault on Kenya's sovereignty but the "first steps toward a sustainable peace that Kenyans want, deeply".
The Kenyan view
Gabriel Gatehouse
BBC News, Nairobi
William Ruto and Uhuru Kenyatta have been successful in
linking their personal legal problems with the national interest, in the
Kenyan public imagination. There are plenty who agreed with the Ethiopian Prime Minister, Hailemariam Desalegn, when he said in May that the ICC is "hunting Africans". The notion that the court has a racist, neo-colonialist agenda is gaining currency.
But there are others who remember how the Kenyan parliament failed repeatedly to pass legislation that would allow the suspects to be tried at home. Many believe that, even with a reformed judiciary, the Kenyan courts do not have the teeth to put an entrenched political elite on trial.
Then there are the thousands of victims of the post-election violence, still living in camps some five years after they were chased from their homes. Many of these people see little connection between the proceedings at The Hague, and their own efforts to seek justice and redress.
"Making clear that no one is
above the law is essential to combat decades of the use of violence for
political ends by Kenya's political elite," he wrote.
Mr Annan brokered the peace deal that brought an end to the brutal killings. It included an agreement that those responsible for the violence must be held to account.
A commission was set up to investigate the violence and it recommended that if efforts to establish special tribunals in Kenya failed, the matter should be sent to The Hague.
Kenya repeatedly failed to set up such tribunals and so the ICC indicted those it said bore the greatest responsibility for the violence.
The ICC on Monday said the two trials would not clash, after Mr Kenyatta warned that the constitution prevented the two men from being abroad at the same time.
The president is due to go on trial in November. He also denies charges of fuelling violence.
The judges said the two cases could be heard alternately - in blocks of four weeks.
On Thursday, Kenya's parliament passed a motion calling for the country to withdraw from the ICC.
The court said the cases would continue, even if Kenya withdrew.
In May, the African Union (AU) accused the ICC of "hunting" Africans because of their race and urged it to drop the Kenyan cases.
The ICC says it pursues justice impartially and will not allow perpetrators of violence to go unpunished.
The court was set up in 2002 to deal with genocide, crimes against humanity, war crimes and the crime of aggression.
It has been ratified by 122 countries, including 34 in Africa.
Daniel Levy: Football's [Soccer] toughest negotiator?
Gareth Bale may have been the big star of
Europe's summer transfer window, but behind the scenes it was his former
club chairman Daniel Levy who emerged as one of the most formidable
characters.
The Tottenham supremo has long been known as one of the toughest
negotiators in football, and he cemented that status with the manner in
which he handled the Bale sale. Not only did he demand a massive fee
– possibly even a world record – for a player largely untested at the
highest level, but he played the European transfer market with all the
strategic flair of a chess Grandmaster.Throughout the summer, I received plenty of messages from fans around the world, telling me that the Welsh winger wasn’t worth anything like the astronomical figures being quoted, and maybe he’s not. But in any market, the value of any commodity – be it a piece of real estate or a bale of hay – is only decided by the two negotiators around the table.
If you want it bad enough, you’ll pay what I say.
On Sunday, social media sites were alive with armchair micro-analysis of the trade and much of the comment was commending Levy’s role. With his business acumen he should take over as Britain’s finance minister, the narrative went, or with his negotiating skills he should represent terrorist organizations. Clubs who are struggling in the transfer market should just sign Levy ahead of any new players and – apparently – he never loses at monopoly, because anyone landing on his properties ends up having to pay three times what they’re worth.
Read: Spanish lessons for Gareth Bale
Bale was by far and away Tottenham’s best player last season, swaggering his way to three individual player awards and scoring 26 goals, none of which were tap-ins – many of which were 30-yard netbusters. Spurs didn’t have to sell their prize asset and nor did they particularly want to, but having just missed out on Champions League qualification for a third year in four, and with Bale already seduced by the idea of a dream move to Spain, the time was now right to make the most of an opportunity.
England’s top three teams changed their managers in the summer, a perfect time for Spurs to strike. Aided and abetted by his new director of football Franco Baldini, Levy identified several key targets early on, quickly sewing up deals for Paulinho, Roberto Soldado, Etienne Capoue and Nacer Chadli. While English Premier League rivals Arsenal and Manchester United were idling in the market, Spurs were organized and decisive, breaking their own transfer record – twice.
Levy wasn’t finished. Chelsea may have snatched Willian from under his nose, but he broke the club’s record transfer fee for a third time in just a matter of weeks by landing the Bale-esque Erik Lamela, and he also signed Christian Eriksen and Vlad Chiriches – all while Bale remained a Tottenham player.
A world record deal was "imminent" for the last fortnight of August, but it didn’t actually go through until the penultimate day of the window.
Naturally Tottenham wanted to have their own targets under contract, but in assessing the landscape around him, Levy was particularly shrewd. He knew that Real would unload several players to accommodate Bale’s arrival, but they couldn’t risk doing so until they knew he was coming for sure.
It just so happens that Arsenal wanted to sign one or both of Real's Angel di Maria and Mesut Ozil. By holding on until last Friday it meant they couldn’t get them before the North London derby against Spurs on Sunday, after which the Bale deal was finally confirmed.
Levy knows very well that Arsenal represent arguably the biggest threat to his club's aspirations of a top-four finish. In the end, the Gunners got Ozil on deadline day but we may never know if they could have had more.
I interviewed Levy for World Sport a few years ago; it was a rare chance to speak with the 51-year-old, who prefers to keep a low profile in the media. His record isn’t perfect, but he’s learned from his mistakes. He thoroughly frustrated Madrid when they last went after one of his players, making them pay through the nose for Luka Modric in late August 2012, and he had no hesitation in cutting manager Harry Redknapp adrift when he became too greedy in his contract negotiations.
Levy doesn’t take kindly to anyone who pushes him too hard on a deal. When Real had the arrogance to build a stage upon which they were going to parade Bale, Levy made them take it down – nothing had yet been signed.
Of course it all counts for naught if Spurs again fail to push on up the table before mixing with Europe’s elite in the Champions League. But there is only so much a chairman can do. It’s now up to manager Andre Villas Boas and the men on the field to follow their chairman’s example: don’t take any prisoners and make sure you’re not the first to blink.
Leicester fire deaths: Murder probe starts after family killed
The family lived in Wood Hill, Leicester
Police have launched a murder investigation after a mother and her three children were killed in a house fire in Leicester.
Detectives are investigating the possibility that the fire was linked to the murder of a man on Thursday.
The family's mosque said the mother who died was Shehnila Taufiq, her daughter was Zainab Taufiq, and her sons were Jamal Taufiq and Bilal Taufiq.
They were found dead in upstairs bedrooms at their house in Wood Hill.
The children's father, Dr Muhammad Taufiq Al Sattar, worked as a neurosurgeon at Beaumont Hospital in Dublin, and neighbours said the family had recently moved to Leicester.
Assistant Chief Constable Roger Bannister said Leicestershire Police was examining the possibility of the blaze being a revenge attack.
He said the murdered man was "in his 20s and lived locally".
He was assaulted in Kent Street, less than a mile away from the scene of the fire, at about 17:30.
"These are obviously both very serious incidents and investigations have begun to establish if there are any links between them," said Mr Bannister.
"I understand the level of concern there may be in the city and would ask things not to escalate.
"I invite people, that if they have any concerns, to speak to the officers at the scene or call the police."
Mr Bannister said the mother who died in the fire was thought to be in her late 40s, her daughter was 19, and her two sons were 17 and 15.
Neighbours said the family worshipped at the nearby mosque. They said the father was away in Ireland at the time of the fire.
Zeeshan Bawany, a family friend, said the father "couldn't believe what was being said to him" when he was told what had happened.
Mr Bawany said he was asked by the family to go to the house and check it was true.
A statement from Beaumont Hospital said: "The board and staff of Beaumont Hospital have learned, with shock, of the tragic loss suffered by our colleague Mr Taufiq Sattar.
"We wish to express our sincere condolences to Mr Sattar and assure him that our support and thoughts are with him at this terrible time."
'Family wiped out' Labour MP Keith Vaz, who represents Leicester East, met community members near the police cordon sealing off Wood Hill.
"The father is a doctor and is being comforted by members of the community - a community who are clearly in grief," Mr Vaz said.
"A whole family wiped out in this way, with only the father remaining, is a big shock and a real tragedy."
Leicester mayor Peter Soulsby said he had been briefed about the murder in Kent Street and described it as "a stabbing".
A post-mortem examination on the murdered man is due to take place later.
BBC Radio Leicester's Kamlesh Purohit was in the area shortly after the assault and saw a man lying on the floor.
"What I saw right next to my car was a car parked in the middle of the street and just in front of the car was a man lying on the floor," he said.
"He appeared to be of West Indian origin and at that stage I thought perhaps there had been a car accident."
Thousands warned to evacuate amid Colorado floods
Footage showed bridges, roads and cars washed away by floodwaters
Thousands of people have been warned to evacuate the Boulder area of Colorado and a mountain hamlet as flooding swells creeks to dangerous levels.
Storm rains have killed at least three people in the state and caused severe damage to property.
Water levels in the Boulder Canyon are reportedly rising rapidly because of debris and mud blocking its mouth.
President Barack Obama has signed an emergency order approving federal disaster aid for Boulder County.
Towns such as Jamestown, Lyons and Longmont are said to have been reduced to islands by the swirling floodwaters.
'Biblical' Officials set up road blocks to prevent residents fleeing in their vehicles on to flooded roads.
The raging torrent - dubbed a "100-year flood" by officials - has hampered rescue crews trying to reach communities stranded downstream.
Lyons resident Howard Wachtel joked to the Associated Press news agency: "This is more like something out of the Bible. I saw one of my neighbours building an ark."
Some 4,000 people living along Boulder Creek were sent notices to move to higher ground late on Thursday, reported Boulder's Daily Camera newspaper.
Another 500 inhabitants of Eldorado Springs were urged to leave due to a threat from South Boulder Creek, an official told the Associated Press early on Friday.
Low-lying areas beyond the Rocky Mountains are also at risk, with up to 3,000 people previously ordered to leave the Commerce City district of Denver.
'Staggering rainfall' Emergency notifications have been issued to 8,000 telephone numbers in areas along Boulder Creek.
Governor John Hickenlooper told local radio there had been "a staggering amount" of rainfall.
1/5
"Given the drought situation we've had, it was almost a year's worth of rain," he said on the KBCO radio station.
The rain was forecast to continue until midday on Friday (18:00 GMT).Emergency officials have reported at least three deaths: a man in Colorado Springs; one when a building collapsed in Jamestown; and a man in Boulder, who died after getting out of a car to help a woman who was swept away from the same vehicle. She was still missing.
"There is water everywhere," Andrew Barth, emergency management spokesman in Boulder County, told Reuters news agency. "We've had several structural collapses. There's mud and muck and debris everywhere. Cars are stranded all over the place."
National Guard troops have reportedly been dispatched north of Boulder to the cut-off town of Lyons, which is said to be without fresh water, power or phone lines.
A 20ft (6m) wall of water was reported in Left Hand Canyon, north of Boulder, according to National Weather Service meteorologist Bob Kleyla.
Two areas south-east of the town of Estes Park were ordered to evacuate after an earth dam gave way in the area.
Classes at the University of Colorado, Boulder, were cancelled until Friday at least, while schools in the area are also closed.
Standing water on a road caused some traffic delays into Denver International Airport, but not to flights.
Officials told NBC that water reached as high as first-floor windows in some parts of Boulder, while cars were seen floating in the streets.
The prolonged rain has been blamed on a low-pressure system stationed over Nevada, which is drawing moist air out of Mexico into the Rockies' foothills.
Brazil protests disrupt Independence Day celebrations
Protesters in Brazil have disrupted Independence Day celebrations, demanding better public services and an end to corruption.
n Rio de Janeiro, some 200 protesters interrupted the traditional Seventh of September military parade, shouting anti-government slogans.
They clashed with police, who threw tear gas and arrested dozens of people.
There were further clashes in the capital, Brasilia, where President Dilma Rousseff was giving a speech.
She said there was "still a lot to be done" in Brazil and that there were "urgent problems to be addressed and the population has the right to demand changes".
But she said the country had "progressed as never before in the last few years".
The official ceremony went ahead without incident, but hundreds of demonstrators later clashed with police outside the Congress building.
Demonstrators also attempted to make their voices heard outside the Mane Garrincha stadium ahead of a friendly match between the Brazilian football team and Australia.
Police stopped the march, which degenerated into violence. Some 50 arrests were made.
Many demonstrators accused the police of using excessive force.
"They never spoke to us. They came in in great numbers and began throwing tear gas canisters," student Leticia Hellen told Agencia Brasil.
Tear gas In Rio, people who had gone to the parade with their families were caught up in the violence.
"I never thought I would go through this. My God! In such a beautiful country," said 63-year-old Josefa da Silva, who had been affected by tear gas.
The protests continued into the evening near the Rio de Janeiro state governor's palace.
Police stopped demonstrators from approaching the building, in the Laranjeiras district, arresting some 50 people.
Streets were blocked off for several hours and a metro station was closed due to the violence.
Activists had used social media to call for protests in more than 150 cities.
Most of them went ahead peacefully, but there were clashes in a number of other protests, including those in Fortaleza and Curitiba.
In Brazil's largest city, Sao Paulo, police said around 2,000 people took part in a march calling for social justice.
The demonstration were largely peaceful, but towards the end activists attacked police officers and vandalised shops and bank branches.
Brazil saw a big wave of protests in June, as the country prepared to host the football Confederations Cup.
Initially, demonstrators demanded that a hike in bus and underground fares be revoked.
But the demonstrations grew into a much larger movement against corruption and excessive spending in preparations for next year's World Cup and the 2016 Olympics, which Rio will host.
n Rio de Janeiro, some 200 protesters interrupted the traditional Seventh of September military parade, shouting anti-government slogans.
They clashed with police, who threw tear gas and arrested dozens of people.
There were further clashes in the capital, Brasilia, where President Dilma Rousseff was giving a speech.
She said there was "still a lot to be done" in Brazil and that there were "urgent problems to be addressed and the population has the right to demand changes".
But she said the country had "progressed as never before in the last few years".
The official ceremony went ahead without incident, but hundreds of demonstrators later clashed with police outside the Congress building.
Demonstrators also attempted to make their voices heard outside the Mane Garrincha stadium ahead of a friendly match between the Brazilian football team and Australia.
Police stopped the march, which degenerated into violence. Some 50 arrests were made.
Many demonstrators accused the police of using excessive force.
"They never spoke to us. They came in in great numbers and began throwing tear gas canisters," student Leticia Hellen told Agencia Brasil.
Tear gas In Rio, people who had gone to the parade with their families were caught up in the violence.
"I never thought I would go through this. My God! In such a beautiful country," said 63-year-old Josefa da Silva, who had been affected by tear gas.
The protests continued into the evening near the Rio de Janeiro state governor's palace.
Police stopped demonstrators from approaching the building, in the Laranjeiras district, arresting some 50 people.
Streets were blocked off for several hours and a metro station was closed due to the violence.
Activists had used social media to call for protests in more than 150 cities.
Most of them went ahead peacefully, but there were clashes in a number of other protests, including those in Fortaleza and Curitiba.
In Brazil's largest city, Sao Paulo, police said around 2,000 people took part in a march calling for social justice.
The demonstration were largely peaceful, but towards the end activists attacked police officers and vandalised shops and bank branches.
Brazil saw a big wave of protests in June, as the country prepared to host the football Confederations Cup.
Initially, demonstrators demanded that a hike in bus and underground fares be revoked.
But the demonstrations grew into a much larger movement against corruption and excessive spending in preparations for next year's World Cup and the 2016 Olympics, which Rio will host.
Mario Balotelli winner secures Italy's passage to World Cup finals
Italy and the Netherlands sealed their places in the World Cup finals
in Brazil next year while England survived an uncomfortable night in
Kiev against Ukraine in key qualifying matches Tuesday.
Mario Balotelli scored
the winner as Italy came from behind to beat the Czech Republic 2-1 to
seal Group B, while the Dutch had a pair of Robin van Persie goals to
thank for a 2-0 win in Andorra to wrap up Group D of European
qualifying.
Roy Hodgson's England
battled to a goalless draw to maintain their leadership of Group H, one
point clear of Ukraine and Montenegro with two rounds of matches
remaining.
It was an unconvincing
performance and visiting goalkeeper Joe Hart was the busier goalkeeper
in a match of few clear cut chances, but Frank Lampard, making his 100th
appearance for England nearly grabbed the winner with a headed effort
in injury time.
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Italy fell behind to a
19th minute Libor Kozak volleyed strike in Turin, but the Azzurri struck
back through Giorgio Chiellini in the 51st minute before Balotelli
stepped up to hit the winner past Petr Cech from the spot three minutes
later to set the four-time champions on the road to Brazil.
Milan's Balotelli had a
mixed night, wasting several chances to put his side firmly in control,
before winning the penalty as he was crudely fouled by Theodor Gebre
Selassie.
To complete an ultimately disappointing night for the Czechs, Daniel Kolar was given his marching orders near the end.
"We've qualified and we're really satisfied," said Italy coach Cesare Prandelli.
"Tonight there were
spells in which we suffered physically but we also played some quality
football. This squad has a lot of quality," he told AFP.
Fellow powerhouses Germany need
just a single point from their final two matches to join them after a
3-0 win in the Faroe Islands, with Per Mertesacker, Arsenal new boy
Mesut Ozil and Thomas Muller scoring the goals.
Sweden
still have a mathematical chance of overhauling the Group C leaders
after Zlatan Ibrahimovic's first minute goal in the 1-0 win in
Kazakhstan, but the Germans can seal qualification next month when they
play the Republic of Ireland.
Switzerland
are also all but assured of a finals place, five points clear of
Iceland in Group E as a pair of Fabian Schar goals saw off Norway 2-0.
France revived their hopes by breaking a scoring drought which had lasted 526 minutes in a fighting 4-2 win in the Belarus.
Franck Ribery canceled
out a Egor Filipenko opener for the hosts and then equalized for the
second time after Timofei Kalachev's effort.
Samir Nasri and Paul
Pogba grabbed vital late goals to clinch victory for the French, who
draw level with world champions Spain on points in Group I.
Spain,
who have played a game less, were salvaging a 2-2 draw with Chile in a
friendly in Geneva, equalizing for the second time in added time through
Jesus Navas.
Eduardo Vargas netted twice for the South Americans, with Tottenham striker Roberto Soldado canceling out his first effort.
Wales' 3-0 home defeat to Serbia in Group A was notable for the appearance of Real Madrid's new world record signing Gareth Bale, who played for half an hour as a second half substitute and almost scored with a late free kick.
Bale has not played since a pre season friendly for his former side Tottenham, nursing a foot injury.
Earlier, Jordan
won a marathon penalty shootout 9-8 with hosts Uzbekistan to qualify
for an intercontinental playoff, with the winners reaching next year's
finals.
They will play South America's fifth placed team after a topsy turvy contest in Tashkent.
The home side went ahead
through Anzur Ismailov and dominated much of the first half, only for
Saeed Murjan to level with a stunning half volley strike just before the
interval.
Despite several chances
for either side, the match went into extra time, which was delayed for
18 minutes by a floodlight failure.
The penalty drama was intense until the unfortunate Ismailov failed to convert his effort to leave the visitors celebrating.
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