Endometriosis – Causes, Symptoms And Treatment

Endometriosis is the growth of cells similar to those that form the inside of the uterus (endometrial cells), but in a location outside of the uterus. Endometrial cells are the same cells that are shed each month during menstruation. Endometriosis is a common health problem in women. In women with this problem, tissue that looks and acts like the lining of the uterus grows outside of the uterus in other areas. These areas can be called growths, tumors, implants, lesions, or nodulesIt facilitates collaboration and information sharing between women with endometriosis. Endometriosis is estimated to affect over one million women (estimates range from 3% to 18% of women) in the United States.

It is one of the leading causes of pelvic pain and reasons for laparoscopic surgery and hysterectomy in this country. While the mean age at diagnosis is around 25-30 years, endometriosis has been reported in girls as young as 11 years of age. Endometriosis is rare in postmenopausal women. Endometrial cells (loosened during menstruation) may “back up” through the fallopian tubes into the pelvis, where they implant and grow in the pelvic or abdominal cavities. This is called retrograde-menstruation. When endometrial tissue is located elsewhere in your body, it continues to act in its normal way: It thickens, breaks down and bleeds each month as your hormone levels rise and fall. Because there’s nowhere for the blood from this displaced tissue to exit your body.

It becomes trapped.Trapped blood may lead to the growth of cysts. Cysts, in turn, may form scar tissue and adhesions abnormal tissue that binds organs together. This process can cause pain in the area of misplaced tissue, often the pelvis, especially during your period. Scars and adhesions related to endometriosis also can cause fertility problems. Pain is one of the most common symptoms of endometriosis. Usually the pain is in the abdomen, lower back, and pelvis. Some women have no pain, even though their disease affects large areas. Other women with endometriosis have severe pain even though they have only a few small growths. Women with endometriosis may also have gastrointestinal problems such as diarrhea, constipation, or bloating, especially during their periods.

Causes of Endometriosis

1.Estrogen harmones

2.Retrograde menstruation.

3.Immune system

4.Allergic reactions.

5.Impact of toxins.

Symptoms of Endometriosis

1.Pain with sex.

2.Infertility.

3.Fatigue.

4.Painful urination during periods.

5.Infertility.

Treatment of Endometriosis

Progesterone counteracts estrogen and inhibits the growth of the endometrium. Such therapy can reduce or eliminate menstruation in a controlled and reversible fashion. Progestins are chemical variants of natural progesterone. Gonadotropin releasing hormone agonists (GnRH agonists) induce a profound hypoestrogenism by decreasing FSH and LH levels. While quite effective, they induce unpleasant menopausal symptoms, and over time may lead to osteoporosis. Laparotomy can be used for more extensive surgery either in attempt to restore normal anatomy, or at least preserve reproductive potential. Danazol (Danocrine) and gestrinone are suppressive steroids with some androgenic activity. Both agents inhibit the growth of endometriosis but their use remains limited as they may cause hirsutism. There has been some research done at Case Western Reserve University on a topical Danocrine, applied locally, which has not produced the hirsutism characteristics. Pseudopregnancy can be created using oral contraceptives containing estrogen and progesterone. Women take the medicine consistently for 6 to 9 months. This type of therapy relieves most of the symptoms, but does not prevent scarring from the disease.

Avoid coffee and alcohol. Conservative surgery removes endometrial growths, scar tissue and adhesions without removing your reproductive organs. In laparoscopic surgery, a slender viewing instrument (laparoscope) is inserted through a small incision near your navel. The laparoscope is equipped with a laser, a cautery an instrument that destroys tissue with heat or small surgical instruments. Melatonin and serotonin are increased by meditation, and the stress hormone cortisol is decreased. Oral contraceptive pills (estrogen and progesterone in combination) are also sometimes used to treat endometriosis. The most common combination used is in the form of the oral contraceptive pill (OCP). Treatment of endometriosis has involved the administration of drugs known as aromatase inhibitors (anastrozole [Arimidex] and letrozole [Femara] are examples). These drugs act by interrupting local estrogen formation within the endometriosis implants themselves. They also inhibit estrogen production in the ovary, brain, and other sources, such as adipose tissue.

How To Find Top Financial Services

Finding top financial services may sometimes feel like a daunting task. When it comes to your money, you want to be sure that you’re working with a company or an individual that you trust. There’s nothing worse than realizing that you’ve been placing your money in the wrong hands. Since there are many different types of financial services, there are many ways to find the top financial services. Before you start looking, you should educate yourself on the area of financial services that you are looking for. If you can figure out what you should be looking for it will be easier to find it. Self education is the best step that you can take in your own financial management.One of the most important types of financial services that most people will use is their bank or credit union. Since a bank or credit union will provide a wide variety of services, from checking and savings accounts to loans, it makes sense to take some time to choose the right institution for your needs. A lot of people choose their bank based on their commercials or a small piece of the puzzle, like free checking.For an accurate review of the aspects of a particular bank, you can search online for reviews. People aren’t afraid to share their opinions on a bank that has mismanaged their money. These days, thanks to the internet, you can see how a bank really treats its customers and make an informed decision.A good resource for evaluating your financial services options is Bankrate.com. This website has detailed information on the interest rates of checking and savings accounts from a variety of different banks. It’s also a good place to find out about mortgage loans, auto loans, CDs, investments and credit cards. You can use this resource to thoroughly investigate your options before making a decision. It will make it easy to find the top financial services.Besides banks, loans and investments, there are many other types of financial services. If you are going to be investing in the stock market, you’ll need a broker. If you want an expert to do your taxes, you’ll need an accountant. Some people even opt to talk with a financial advisor to help them with a wide variety of financial needs.These types of professionals can be found in your local community or online. Since they work directly with you and your money, you’ll want to take some time to find the right option for you. The best way to start finding these types of financial service professionals is to ask for referrals. Talk to your friends an family about what you are looking for. Many of them may use the type of financial professional that you are looking for.In addition to referrals, you can also use the Better Business Bureau’s website to find reputable professionals in your area. If a company or individual professional has complaints against them, the BBB’s website will let you know. The site is located at www.bbb.org. It is a fast and easy way to find top financial services in your area.

Juggernaut Or Not: Card Games To Select From

Cards is an ancient pastime that over the ages has only picked up popularity and fans. During childhood simple games such as War are explained and then used as a learning tools for helping totters appreciate the world of numbers. As people grow up they begin to play more complicated games that rely on strategy and skill to determine outcome. I have surveyed some of the more popular ones and compiled a list of the toughest and the easiest to learn.

Snap Your Fingers, Soak Them Up:
1) Full and Complete Attack
Based on simple arithmetic, this game using all the 52 cards (including as many jokers as you wish), is one of the all time favorites of children. Neither does it need any strategy nor does it require any particular skill! Full and Complete Attack is generally the first game that children are taught because it not only improves their numerical skills, but adds enjoyment and action to this process.

2) Liar:
Here, all cards lower than eight are removed from the deck, and then seven cards are dealt. The remainder is placed down and one card is placed face-up. According to that card, the player in turn places cards facing down on top of that card. He has to state what card it is, but he can lie. If someone thinks is has lied, they can challenge him and reveal the card. If the player lied, he has to pick up all the cards, if not the challenger does the honors. The goal is to finish all the cards in your hand.

3) Johnny 5:
Johnny 5 is a little more difficult then the first to games but still is very simple to learn. Each player is dealt 5 cards. The left over cards are placed in the center of the table face down the player to the dealers left the may put down a pair of cards or a r 3 card run of cards. If you do not have any the player must take a card. The object of the game is to get rid of all your cards and to have you last one or 2 cards total 5.

4) Joining the Fray:
One of the more entertaining games (especially for children), it requires basic colour and number combinatory skills only. You have to match numbers such as by collecting all fours and all aces, and then release all your cards onto the game deck. The focus of this game is not that much on winning, but on not losing and that is what adds the extra spice to it. It does not matter who throws his cards down first, but the player who notices it last and his cards are the last to hit the table: loses.

List of Most Difficult Games to Learn
1) Bridge:
An old but still popular game, here, you partner with someone and decide before playing how many hands you will win. The complexity of bridge lies not in the rules, which are relatively easy to pick up, but in the intricate game plans and maneuvers one has to master to play well.

2) Dragon Poker:
Dragon Poker is not totally unlike poker. Any of the different variations of poker can be used as the base for the game, but the general rules are very different. There are no official rules for dragon poker, they must be thought up and written down by the group of people you are playing with, and it is the duty of each player to memorize the rules, if you forget a rule it goes against you and if someone else does not remember a rule that can hurt you, do not worry you do not have to remind them. The best games have the most rules. An example of a rule can be if the date ends in an odd number and the dealer is wearing a shirt that the color of the shits spelling is an even number, then each player must pay the dealer 100 dollars. This rule can only be used once and whoever is the first to call out the rule during their deal gets it.

3) Baccarat:
Just like in poker, you have to study and memorize the value of certain cards such as that tens and face cards (Jack to King including Ace) are zero. In addition, you need to learn specific rules such as that if you get an eight or nine no more cards are dealt. To conclude, this game is not for beginners.

Tips And Ideas For Better Home Improvement

The time often comes in your life when it is necessary to attempt a home improvement job. You may have purchased a new house and it needs a little facelift or it could be that niggling house job you keep putting off. Follow some simple rules and the task can become a little easier, even enjoyable.

Always take time to prepare. Have a plan of action in the form of a manual or instruction leaflet and do the necessary preparations for the job. Do not forget to protect or shield any expensive items, furniture and flooring that might get damaged or accidentally stained in the home improvement process.

Always make sure that you have good ventilation when doing any home improvement project especially when using paints and some glues. Use your electrical devices with adequate safety protection and keep your tools away from children. If you plan to do any outside home improvements like varnishing or painting check the weather forecast to make sure it is not going to rain.

Although all the previous suggestions are extremely relevant the most important measure for you to take before starting a job is to make sure you have the right tools, and the best quality of tool you can afford. This suggestion should not be ignored. Reference your manuals to get the necessary tools for the job beforehand.

If you just fancy having a go at a home improvement activity begin with a renovation type job. Take a room, for instance the living room, and see what could be done to enhance the beauty or functionality of the room. It may need wallpapering or you may want to change the floor from carpet to wooden floorboards. The furniture may need to be reupholstered or a stray crack in the wall may need to be filled in. In the kitchen a table may need re-varnishing or a cupboard handle replacing. But a word of warning, if you are unsure ask the advice of a trained contractor. Also when you are deciding what home improvement to do think carefully if the alterations would fit into the theme or color scheme of your house.

After you have attempted some minor renovations and repairs this should give you more confidence to try a bigger project, for instance an outdoor patio or decking job. Remember to plan and prepare your home improvement jobs, use the right tools and give yourself plenty of time to get the job done.

Loads Of Enjoyment With Online Games

The internet has become a major source of gaming content with the passage of time. Just like the games that can be installed and played on the computer, the online games also need a computer to run. The main reason why online games are now taking over the local computer games includes their wider range and easier availability. It is possible to enjoy racing games like truck games and car games to even bike games and unicycle racing games. Then there are traditional classics like card games, casino games and highly popular arcade games which give a hint of the days of gaming long gone by.

The thing that is important to know about online games is that online games are not just about playing. There are complete communities built around these games. You can find blogs and discussion forums about online games which are extremely helpful in enjoying the game to the max. In case you are stuck somewhere and need some help or if you have developed some nice trick or strategy that you want to share, these forums and blogs are just the place. Above all, you can find reviews about the games that you should play and the games that you should avoid.

Playing online games is extremely exciting and at the same time, extremely challenging. The adrenaline pumping that you can receive by playing online games can not be paralleled by anything else. There are a number of people who are involved in playing games online. You can easily find competition and you can also find allies for your games.

The best thing about online games is that you can find free online games. You have to look for them though. Most of the online gaming sites provide you a subscription model. In this case, you would get a free trial membership that would last for anywhere between a week to a month. After this, you would have to cough up money to keep on playing games online. Creating a new account would not help because you would not be able to transfer your game levels and statistics from the old user account to the new user account. The thing is that free online games are available. While they are not exactly free because they are being sponsored by advertising on the site. You would have to look for the games that are completely free and not just a ‘free trial’.

There is an endless variety of online games that you can play – from games as simple as Texas Hold’em Up Poker that allows you to gamble against other players to games like Chess where you pitch you gray cells against the power of a computer or the brains of other people. After you have finished a long and tiring day of work, online games can be the perfect way to vent your frustration and make yourself fit and free for another day at work. With online games, you can easily get fast track entertainment at almost no cost.

Black Jack In The Casino

Whether you’re new to casino gaming or a casino veteran, blackjack is one of the simplest and most fun card games casinos have to offer. The objective in blackjack is to beat the dealer by getting a hand as close to 21 as possible without going over. To play casino blackjack, you need only a basic understanding of the rules and a desire to have fun.

So how do you reach 21? In blackjack, the cards have values. Number cards two through ten are counted at face value, while all face cards (King, Queen and Jack) are worth ten points. The ace is a special card in blackjack: you decide whether it’s worth one or eleven points. Since casino players are dealt two cards to start, if you get an ace and a face card or ten, you have 21, an instant win, as long as the dealer doesn’t get 21 as well. This two-card winning hand is called a blackjack hence the name of the game!

Casino rules for blackjack are basically the same at all casinos. After you get your first two cards, your options are to hit, stand, double down, split, or sometimes surrender. Hit means to take another card; stand means to keep what you have. A double down means you will double your bet in exchange for taking only one more card (you can draw up to five cards in blackjack). If your first two cards are the same value, you can split, or separate them and play each card as a different hand. Not all casinos offer the option to surrender, which means you would withdraw from the hand and receive half your bet back.

When you play blackjack at a casino, be sure to know which table to choose. Most casinos have color coded blackjack tables according to the minimum bet the table accepts, usually $3, $5, $25 or $100. In any casino, it’s a given the $3 and $5 tables will be crowded, but they’re great for beginners at casino games because all of the cards are dealt face-up, as opposed to the one-up, one-down method at higher tables. So the next time or the first time you visit a casino, make a stop at the blackjack tables and aim for 21!

However you have to realise that you can loose alot of money in a casino if you are not careful, always warm up on a low betting table befor joining a big game. you have to see if lady luck is on your side. also give your self an ammount limit and do not exceed that limit, buy your chips once there gone leave! gambaling can be addictive and cause you many problems.

Ectopic Pregnancy – Defination, Causes, Symptoms And Treatment

Ectopic pregnancy is a condition in which a fertilized egg settles and grows in any location other than the inner lining of the uterus . About 1% of pregnancies are in an ectopic location with implantation not occurring inside of the womb, and of these 98% occur in the Fallopian tubes. In a typical ectopic pregnancy, the embryo does not reach the uterus, but instead adheres to the lining of the Fallopian tube. The implanted embryo burrows actively into the tubal lining. Most commonly this invades vessels and will cause bleeding. This bleeding expels the implantation out of the tubal end as a tubal abortion. Some women thinking they are having a miscarriage are actually having a tubal abortion. There is no inflammation of the tube in ectopic pregnancy. The pain is caused by prostaglandins released at the implantation site, and by free blood in the peritoneal cavity, which is locally irritant. Sometimes the bleeding might be heavy enough to threaten the health or life of the woman. Usually this degree of bleeding is due to delay in diagnosis, but sometimes, especially if the implantation is in the proximal tube it may invade into Sampson artery , causing heavy bleeding earlier than usual. An ectopic pregnancy can’t proceed normally. The developing embryo can’t survive, and the growing placental tissue may destroy important maternal structures. Without treatment, life-threatening blood loss is possible. About one in every 40 to 100 pregnancies is ectopic. Thanks to earlier diagnosis and treatment, the chance for future healthy pregnancies is better than ever before.

Ectopic means “out of place.” An ectopic pregnancy is a pregnancy where the fetus is not growing in the usual location (the uterine cavity or the womb). Ectopic pregnancies can occur in a number of unusual locations, each with different characteristic growth patterns. Almost all ectopic pregnancies occur in fallopian tubes (tubes from uterus), so this is also known as “Tubal Pregnancy”. Since the fallopian tubes are not large enough to accommodate a growing embryo, the pregnancy cannot continue normally. If identified early, the embryo is removed. In some cases, the embryo grows until the fallopian tube is stretched so much that the tube ruptures. Rupture of the tube is a medical emergency that requires immediate medical attention because it can result in severe hemorrhaging. An ectopic pregnancy is a potentially life-threatening condition.

Causes of Ectopic pregnancy

An ectopic pregnancy is caused by a disruption in a woman’s reproductive anatomy or the timing of specific reproductive events. Ectopic pregnancy is common in women age 20 to 29, but the cause is not always known. However, previous damage to one of the two fallopian tubes may obstruct the passage of the fertilized egg along the tube to the uterus. The egg then implants in the wall of the tube instead of in the uterus. This prior damage may have been caused by an unsuccessful or a reversed sterilization procedure or a fallopian tube infection. Ectopic pregnancies are more common in women using an intrauterine contraceptive device, partly because these devices increase the risk of a pelvic infection in women who exposed to sexually transmitted diseases.

Symptoms of Ectopic pregnancy

1. Nausea, vomiting.

2. Dizziness.

3. Low blood pressure.

4. Breast tenderness.

5. Frequent urination.

Treatment of Ectopic pregnancy

Medicine, surgery, or a combination of the two are usually used to end an ectopic pregnancy before it endangers the mother. In a few cases, very early ectopic pregnancies can be watched closely to see whether the pregnancy will miscarry on its own. Emergency medical help is needed if the area of the ectopic pregnancy ruptured. (Shock is an emergency condition.) Treatment for shock may include keeping the woman warm, raising her legs, and giving oxygen. Fluids by IV and a blood transfusion may be needed. Surgery (laparotomy) is done to stop blood loss (in the event of a rupture). This surgery is also done to confirm the diagnosis of ectopic pregnancy, remove the abnormal pregnancy, and repair any tissue damage. In some cases, removal of the fallopian tube may be necessary. A mini-laparotomy and laparoscopy are the most common surgical treatments for an ectopic pregnancy that has not ruptured.

Easy Card Games To Entertain

My own experience makes me feel that every child will benefit from playing card games.

It is a healthy experience for a child to play with grownups as an equal; and to play with other children without noticing difference in age.

It is good for the child’s character to get practice in losing without squawking and in winning without crowing. (Many adults could use some of this practice too!)

A young child can learn about numbers and easy arithmetic from a simple card game. A child of any age can exercise his brain by the logical thinking that is needed in the more advanced games.

Moreover, card games are fun. And this is the best of all reasons for teaching them to children.

These games are for children who are too young to think… and for grownups who would rather not think! Sometimes it’s hard to tell whether the children or the grownups laugh harder!

PIG

This is a very hilarious game for children or for adults to play with children. Anybody can learn the game in two or three minutes, and one extra minute makes you an expert!

Number of Players: 3 to 13. Five or 6 make the best game.

Cards: Four of a kind for each player in the game. For example, 5 players would use 20 cards: 4 Aces, 4 Kings, 4 Queens, 4 Jacks, and 4 10′s. For 6 players you would add the four 9′s.

The Deal: Any player shuffles and deals 4 cards to each player.

Object: To get 4 of a kind in your own hand, or to be quick to notice it when somebody else gets 4 of a kind.

The Play: Each player looks at his hand to see if he was dealt 4 of a kind. If nobody has 4 of a kind, each player puts some unwanted card face down on the table and passes it to the player at his left, receiving a card at the same time from the player at his right.

Each player looks at his hand as it appears with the newly-received card. If, still, nobody has 4 of a kind, each player once again passes a card to the left and gets a new card from the right.

The play is continued in this way until some player has 4 of a kind in his hand. That player stops passing or receiving cards since he is satisfied with his hand as it is. Instead of playing on, he puts his finger to his nose.

The other players must be quick to notice this, and each of them must stop passing in order to put a finger to his nose. The last player to put a finger to his nose is the Pig.

DONKEY

This is the same game as Pig, except that when a player gets 4 of a kind he puts his hand face down on the table quietly instead of putting his finger to his nose. He still gets a card from his right and just passes that along to the left, leaving his 4 of a kind untouched on the table.

As each player sees what has happened, he likewise puts his hand down quietly. The idea is to keep up the passing and the conversation while some player plays on without realizing that the hand has really ended.

The last player to put his cards down loses the hand. This makes him a D. The next time he loses, he becomes a D-O. The third time, he becomes a D-O-N. This keeps on, until finally some player becomes a D-O-N-K-E-Y.

How To Find The Best Free Online Games

Online games are very interesting to play. When they are available for free, no one can resist playing them. Many people encounter the problem of finding sources for the best free online games. Even so, it is not very tough. Those who regularly play online games don’t have a problem finding interesting and suitable games.

There are free online games available on almost every game website. Certain websites are especially geared towards the game maniacs, and on these websites, many can easily log in and search for their favorite games. If you are looking for a specific game, you can type the name of the game in the search box, and then you will have it right in front of you. For example, if you are interested in a special kind of game, like war games, simply click on that option, or type “war games” in the search box. All of these sources for the best free online games are loaded with games for all kinds of players from kids to adults.

There are even certain websites particularly designed that specially serve specific groups of players. For kids of a very young age, the games have a very colorful design, and they rules are not difficult to follow. There is usually less competition and stress involved with these games.

The sources for the best free online games for teenagers and adults will tend to have games that are more complex, romantic in nature, fast, and tricky. There is more alertness required of the players of these games. Some of these online games charge for playing, while some of them are completely free. Therefore, one should keep in mind that it is a benefit to be able to play these games without spending a penny. The sources for free online games are visited and used the most.

You can find a variety of websites that are regarded the best websites for buying and selling video and computer games. On some of these websites, you can find things that are generally related to video games. They offer video game based greeting cards, video games wallpaper, and other things. There are many free online games that are available, and they can be shooting games, adventure games, sports, animated games, 3D games, cool games, hot games, fast games, flashing games, dragon games, war games, street racer, make up games, fear factor games, heart breaker games and more. Accessing these games is simple. All it takes is one click of a mouse.

Taking Your Personal Finance Situation Online!

In modern times, society has reached a point where money represents the number one force and everyone is interested in providing for himself. That has always been the law of nature but it seems that the more we struggle to lead an existence, the more credit we give to money. In the end, we are left with just one question: how can we understand better our personal finance situation? Where should we resort for help? The answer is more obvious than we imagine: the Internet!

The advent of the World Wide Web has brought numerous advantages and that includes the personal finance sector as well. Fortunately, we have a multitude of resources to help us out, providing all the information we need to know about financing, cheap loans, mortgages and other similar subjects. In fact, one single website can represent our portal into the entire financial world. We have access to multiple subjects related to personal finance and we are sure to find some of the best experts to provide us with the much-needed assistance, imparting valuable knowledge.

When you say personal finance, you automatically think about finding a reliable and experienced accountant. With the help of the Internet, not only you can discover some of the best accountants out there but plenty of other experts working in the field of accountancy. If you are in need of professional auditors, you can make good use of such services by getting their contact details. Also you can get in touch with one of those specialists that can provide you taxation-related services and an extensive analysis of the banking field.

If you are need in some professional advice for your personal finance situation, then you can go ahead and search for consulting experts. They can highlight the best investments for you to make, along with perspective risks and risk management strategies. Finance consultants are just the specialists you need to make it into the tough business world, knowing all the trends of the market and how to avoid potential pitfalls. They can provide an appropriate course of action in case you find yourself in debt, suggesting cheap loans and other procedures that are beneficial for you.

As for banks, the World Wide Web contains an incredible selection of the best and most reputable banks in London. You can easily access them and discover their offers for mortgages, cheap loans and other banking services. Most of these banks have just released Internet banking services, with great plans for savings and potential investments, so you can definitely check them out. With them, you will get a clear picture of where you stand when it comes to personal finance, versus the current market and get experts advice, particularly when it comes to managing your finances. If you want to be knowledgeable in the field of interest savings and financial planning, then these are the online resources you should look for.

The Internet is the perfect tool to discover a lot of interested things about today’s business world. As an example, if you are interested in cheap loans, you can certainly take advantage of the specialized resources offered online and compare a multitude of existing offers. No matter if you are interested in homeowner loans, unsecured loans or car financing, it is guaranteed that you will find a specialist to help you out and also get you the best possible deal. Also, most of these portals offer what is known as a loan calculator, the most essential thing you need to compare loans. As you are probably interested in cheap loans, this resource is perfect, taking into account the sum you want to borrow and providing you with set answers.

Many people are afraid to take up a loan because they fear they will go even deeper in debt. While that may be true for a few cases, most people are actually satisfied with the cheap loans they find online and consider that they were exactly what they needed. In order for the loan calculator to provide you the cheapest loan, you will have to mention the loan amount, the loan period (from 6 months to 25 years) and your residential status. You can also use the Internet to find out the best selling loans, the APR rate and also how you can use one of these cheap loans for debt consolidation. As you can see, when it comes to finance, the Internet is just what you need!