HEALTH

Why Primary Care Practices Need Pediatric Physician Assistants

Published

5 months ago

July 18, 2025

John

Across the United States, primary care practices are encountering unprecedented challenges in delivering timely, high-quality pediatric care. An expanding pediatric population, combined with more complex medical needs and chronic conditions, has made it increasingly difficult for primary care physicians to meet expectations alone. Parents now expect not only accessibility but also specialized expertise in childhood development, preventive health, and acute care. This rising demand underscores the urgency for practices to integrate dedicated pediatric professionals into their teams.

Pediatric physician assistants (PAs) offer a compelling solution to this gap. Trained extensively in child health and disease prevention, these clinicians have the capacity to deliver comprehensive services without compromising the continuity of care. Their skill sets align closely with the evolving expectations of family-centered practices that must balance efficiency with individualized attention. The shortage of pediatricians in many regions makes their contribution even more critical, especially in underserved communities where families face long wait times and limited options.

Incorporating pediatric PAs into primary care workflows also enhances the practice’s ability to keep up with rapidly advancing treatment protocols and vaccination schedules. These professionals remain current on guidelines issued by organizations such as the American Academy of Pediatrics. Their familiarity with emerging therapies and evolving standards allows practices to deliver care that meets the highest clinical benchmarks. As a result, practices can more effectively bridge gaps in service while ensuring that young patients receive the most current treatments available.

Enhancing Access and Reducing Wait Times for Families

For many families, securing a timely appointment with a pediatrician can prove daunting. Long wait times often result in delayed diagnosis and treatment, which may worsen outcomes for children. Pediatric physician assistants alleviate these bottlenecks by expanding appointment availability and enabling same-day visits for acute illnesses or injuries. Their presence means parents do not have to sacrifice timely care, even during high-demand seasons such as flu outbreaks or school physical deadlines.

In practices that employ pediatric PAs, workflows are streamlined and more responsive to patient needs. Physician assistants can manage routine visits, developmental screenings, and follow-up appointments while physicians focus on more complex cases. This team-based approach minimizes inefficiencies that commonly frustrate families and improves overall patient satisfaction. Over time, these enhancements can significantly bolster a practice’s reputation and attract new patients.

Moreover, increased access can have a measurable impact on community health. When children receive prompt, appropriate care, they are less likely to visit urgent care centers or emergency departments for conditions that could have been addressed earlier. By supporting preventive care and early intervention, pediatric PAs help reduce unnecessary utilization of high-cost services. This contributes to more sustainable healthcare delivery and ultimately benefits insurers, practices, and families alike.

Improving Quality of Care Through Specialized Training

Pediatric physician assistants bring a depth of training specifically tailored to the unique physiological and psychological needs of children. Unlike generalist clinicians, they undergo focused education in pediatric pharmacology, growth and development milestones, and management of chronic childhood illnesses. This specialization allows them to recognize subtle warning signs and tailor interventions that are age-appropriate and evidence-based.

Their advanced competencies also translate into better patient outcomes across a range of conditions. For example, pediatric PAs are equipped to identify developmental delays and behavioral issues early, when interventions are most effective. They can also counsel families on preventive measures, such as nutrition and immunizations, with a level of detail that builds trust and empowers parents to make informed decisions. These contributions extend far beyond routine sick visits and help create a proactive culture of wellness.

Practices that incorporate pediatric PAs often report measurable improvements in clinical quality metrics, as their responsibilities include thorough preventive care and patient engagement. In many practices, the way pediatric PAs manage preventive care, developmental assessments, and acute visits illustrates how their role elevates care delivery and builds confidence among parents who rely on consistent, knowledgeable support. This added expertise fortifies the entire care team and ensures that young patients receive comprehensive, dependable guidance throughout every stage of development.

Supporting Physicians and Preventing Burnout

The workload facing primary care physicians has expanded significantly in recent years. Administrative responsibilities, chronic disease management, and an ever-increasing patient volume create a perfect storm of stress and fatigue. Pediatric physician assistants help offset this burden by sharing the clinical workload, enabling physicians to focus on complex diagnostic challenges and higher-acuity cases. This support not only safeguards patient care but also protects physician well-being.

By delegating routine visits and follow-up care to pediatric PAs, practices can reduce scheduling pressures that often lead to overbooked calendars and rushed appointments. Physicians can devote more time to care planning and professional development, which strengthens the entire practice’s capabilities. Moreover, patients benefit from longer, more meaningful interactions when clinicians are not overwhelmed by unsustainable caseloads.

Preventing physician burnout has become a strategic priority for many healthcare organizations. High turnover rates and early retirements among primary care doctors threaten the continuity of care and exacerbate access issues. Incorporating pediatric PAs into care teams helps mitigate these risks by distributing the workload more evenly and preserving the satisfaction and engagement of all providers. Over the long term, this model creates a healthier, more resilient workforce.

Advancing Preventive Care and Early Intervention

Preventive care is the cornerstone of pediatric health, yet many practices struggle to devote adequate time to counseling and anticipatory guidance. Pediatric physician assistants are uniquely positioned to fill this gap by providing in-depth education and monitoring for families. They can develop individualized wellness plans that address nutrition, safety, mental health, and developmental milestones, all of which contribute to healthier outcomes.

Early intervention is equally critical in pediatric care, particularly when developmental or behavioral concerns arise. Pediatric PAs have the training to screen for conditions such as autism spectrum disorder, attention deficit hyperactivity disorder, and learning disabilities. By identifying these issues early, they help ensure that children receive timely referrals and interventions that can significantly improve long-term functioning. This proactive approach is especially valuable in practices serving diverse populations with varied access to specialist care.

The impact of these preventive and early intervention efforts is profound. Children who receive consistent monitoring and tailored guidance are more likely to thrive academically, socially, and physically. Their families gain confidence in managing health challenges, and the broader community benefits from reduced reliance on emergency care. Pediatric PAs drive these outcomes by combining clinical expertise with a patient-centered approach that prioritizes early action.

Strengthening Patient Relationships and Continuity of Care

Trust and familiarity are foundational to effective pediatric care. Parents often feel more comfortable discussing sensitive issues and following treatment plans when they have an ongoing relationship with a clinician who knows their family’s history. Pediatric physician assistants are well-suited to establish and nurture these connections over time. Their regular presence in the practice creates continuity that is critical for managing chronic conditions and promoting preventive health.

Continuity of care also translates into fewer gaps in treatment and fewer unnecessary duplications of services. When pediatric PAs collaborate closely with physicians, they can track progress, update care plans, and ensure that families receive clear, consistent information. This coordination minimizes confusion and empowers parents to be active participants in their child’s health journey. It also helps practices maintain accurate records and comply with quality reporting requirements.

Over time, these strong relationships build loyalty and enhance the reputation of the practice. Families are more likely to recommend providers who demonstrate attentiveness, consistency, and genuine care for their children. Pediatric PAs play a pivotal role in establishing this rapport, creating an environment where families feel valued and supported.

Financial Benefits and Operational Efficiency

While the clinical advantages of pediatric PAs are clear, their impact on the financial health of a primary care practice is equally important. Employing physician assistants can improve productivity by increasing the number of patients seen each day. This higher throughput generates additional revenue without compromising the quality of care. Practices also benefit from more efficient use of physician time, reserving higher reimbursement appointments for complex cases.

Pediatric PAs contribute to cost savings in other ways as well. Their preventive care efforts reduce unnecessary hospital admissions and emergency department visits, which can be costly for both practices and insurers. Over time, these efficiencies can translate into stronger financial performance and greater stability in an increasingly competitive healthcare marketplace.

Additionally, the operational flexibility provided by pediatric PAs helps practices adapt to fluctuations in patient volume and staffing needs. Whether covering during physician absences or managing seasonal surges in demand, they enable practices to maintain consistent service levels. This adaptability enhances patient satisfaction and preserves revenue streams that could otherwise be disrupted.

The Strategic Imperative to Embrace Pediatric PAs

As healthcare delivery continues to evolve, the integration of pediatric physician assistants has emerged as a strategic imperative for primary care practices. Their specialized training, commitment to preventive care, and ability to strengthen patient relationships address many of the most pressing challenges in modern pediatric care. Practices that embrace this model are better equipped to deliver high-quality, accessible services that meet the expectations of today’s families.

The benefits extend far beyond clinical outcomes. Pediatric PAs help create sustainable workflows, protect the well-being of physicians, and improve the overall financial health of practices. Their contributions support a more resilient healthcare system that can adapt to rising demands without compromising standards of care.

In an environment defined by rapid change and growing complexity, practices must leverage every available resource to deliver exceptional pediatric services. Pediatric physician assistants are not simply an optional enhancement but a vital asset in building the future of primary care. Their integration represents a decisive step toward a more effective, patient-centered model of care that prioritizes the needs of children and families alike.

HEALTH

Winter Care for Women: Preventing UTIs and Vaginal Infections

Published

2 weeks ago

December 9, 2025

John

Introduction

Winter and high pollution periods can influence daily habits and natural immunity, increasing the risk of urinary tract and vaginal infections in women. Colder temperatures often lead to reduced water intake, layered clothing, prolonged indoor stays and changes in hygiene practices, all of which may affect urogenital health. At the same time, seasonal stress, lack of sunlight and lowered immunity can make the body more susceptible to bacterial and fungal infections.

Why Does Winter Raise UTI and Vaginal Infection Risk?

Winter can affect daily habits and body defences, increasing infection risk. The following factors contribute to this rise.

Behavioural Drivers: People may drink less water in cold weather and delay urination, increasing bacterial concentration in urine. Tight, non-breathable clothing and dampness after exercise trap moisture and encourage microbial growth.
Physiological Factors: Seasonal viral infections, poor sleep and stress may reduce immune strength in the urogenital tract. Reduced indoor humidity may cause dryness and micro-abrasions that allow infection.
Environmental Contributors: Pollution may increase inflammation and weaken mucosal defence. Together, these factors explain the seasonal rise in cystitis and vaginal infections.

Common Conditions and What They Mean

Understanding common winter-related infections helps in early detection and treatment.

Uncomplicated Lower UTI (Cystitis): Sudden urinary frequency, urgency, burning sensation and cloudy or strong-smelling urine. Needs timely care to prevent spread to kidneys.
Pyelonephritis (Upper UTI): Fever, flank pain and nausea suggest kidney involvement and require urgent attention.
Vulvovaginal Candidiasis: Itching, thick white discharge and discomfort; often linked to moisture, antibiotic use or diabetes.
Bacterial Vaginosis: Thin grey discharge with a fishy odour, caused by an imbalance of vaginal bacteria.
Sexually Transmitted Infections (STIs): May present with abnormal discharge and require targeted testing and partner treatment.

Prevention Checklist – Practical Winter Measures That Work

Before implementing preventive steps, it is important to understand how daily habits can influence infection risk.

Hydration and Regular Voiding: Sip fluids throughout the day and avoid holding urine for long periods.
Clothing and Hygiene: Wear breathable cotton underwear, avoid tight synthetic garments for long hours and change damp clothes promptly.
Toilet Care: Wipe front to back and avoid douching or scented products that disturb natural flora.
Post-Sex Habits: Urinate after intercourse, avoid irritants and use barrier protection when required.
Manage Comorbidities: Maintain blood sugar if diabetic and complete full antibiotic courses when prescribed.
Environmental Measures: Use indoor humidifiers to prevent dryness and shower after exposure to pollution.
Proactive Health Behaviours: If infections recur, speak with a gynaecologist or women’s health specialist about preventive options.

When to Consult a Gynaecologist or Seek Urgent Care?

You should book a gynaecologist near me or women’s health specialist near me via Apollo 24|7 if you have fever with urinary symptoms, flank pain, persistent symptoms despite initial treatment, recurrent UTIs, severe vaginal discomfort or symptoms of an STI. Seek urgent care for high fever, severe flank pain, vomiting, dizziness or signs of sepsis. Teleconsultation may help with early guidance and referral if needed.

You may also consult a gynaecologist in Kolkata through Apollo 24|7 when symptoms persist or worsen.

What a Specialist Will Do – Diagnostic and Management Approach

During consultation, the specialist follows a stepwise evaluation and treatment process.

Initial Tests: Urine dipstick, microscopy, urine culture if needed and vaginal swabs for candida, BV or STIs.
Further Evaluation: Renal ultrasound or CT for suspected complicated infections; bladder scan or urodynamics for voiding issues.
Treatment Approach: Simple cystitis may need empirical treatment. Vaginal infections like candidiasis and BV receive topical or oral medication. Recurrent cases require tailored therapy and sometimes multidisciplinary care.
Follow-Up: Symptom review, advice on prevention and referral to urology if structural issues are suspected.

Preparing for Your Appointment on Apollo 24|7

Before your consultation, be ready with your medical details.

Have Ready: Symptom timeline, recent test reports, current medications, allergies, pregnancy status and any imaging results.
Booking Tips: Search terms such as gynaecologist near me, best gynaecologist near me, gynaecologists near me, best gynaecologists near me or women’s health specialist near me can help find suitable options.
What to Expect: A clear diagnosis plan, treatment if required and personalised prevention advice. The specialist will guide if in-person tests are necessary.

Conclusion

Winter may increase the risk of UTIs and vaginal infections due to lower immunity, reduced hydration and lifestyle changes. Most infections are preventable with simple habits like staying hydrated, maintaining hygiene and wearing breathable clothing. If symptoms recur or do not improve, consulting a gynaecologist near me via Apollo 24|7 ensures timely diagnosis and proper care. Early medical attention helps avoid complications and supports better comfort and health during the colder months.

HEALTH

Minimally Invasive Thyroid Nodule Treatments Available in Singapore

Published

3 weeks ago

December 2, 2025

John

Thyroid nodules are a common clinical finding, and while most are benign, they can cause discomfort, aesthetic concerns, or, in rare cases, indicate malignancy. In Singapore, the rise of routine health screenings has led to increased detection of thyroid nodules, and patients are often concerned about invasive surgery, scarring, and recovery time. Fortunately, minimally invasive thyroid nodule treatments offer effective alternatives that reduce downtime while delivering precise outcomes.

As an endocrinologist practicing in Singapore, I frequently see patients seeking guidance on safe and efficient nodule management. Understanding the range of treatment options, their benefits, and limitations is crucial for making informed decisions.

Understanding Thyroid Nodules

A thyroid nodule is a growth or lump in the thyroid gland, located in the neck just below the Adam’s apple. Nodules vary in size, composition, and clinical significance. They may be solid or fluid-filled (cystic) and can present as a single nodule or multiple nodules. While the majority are benign, features such as rapid growth, suspicious ultrasound characteristics, or abnormal lab results warrant further investigation.

Patients often experience anxiety upon discovery of a nodule. The first step is a thorough evaluation, including physical examination, thyroid function tests, and imaging studies such as ultrasound. This assessment guides the choice of treatment, from observation to minimally invasive interventions.

For patients seeking thyroid nodule treatment Singapore, it’s important to understand that not all nodules require surgery. Many can be managed effectively with targeted, minimally invasive procedures that preserve thyroid function and minimize complications.

When Minimally Invasive Treatments Are Appropriate

Minimally invasive interventions are typically recommended for:

Symptomatic benign nodules causing discomfort, difficulty swallowing, or breathing issues.
Cystic or predominantly cystic nodules that recur after aspiration.
Nodules with cosmetic concerns, particularly when located in the visible areas of the neck.
Patients wishing to avoid conventional surgery or those unsuitable for general anesthesia.

The decision depends on nodule size, type, symptoms, and patient preference. In Singapore, advanced imaging and procedural techniques allow endocrinologists to tailor treatment plans safely and effectively.

Common Minimally Invasive Treatments

1. Ultrasound-Guided Fine Needle Aspiration (FNA)

FNA is both a diagnostic and therapeutic tool. A thin needle is used under ultrasound guidance to extract cells from the nodule for cytological examination. While primarily diagnostic, FNA can also provide temporary relief for cystic nodules by aspirating fluid, reducing nodule size and pressure symptoms.

2. Radiofrequency Ablation (RFA)

Radiofrequency ablation is a cutting-edge technique widely used in Singapore. RFA delivers thermal energy through a thin electrode inserted into the nodule under ultrasound guidance, causing controlled tissue destruction. Over weeks to months, the treated nodule shrinks significantly, alleviating symptoms without the need for surgical removal.

RFA is particularly effective for solid and mixed nodules. Advantages include:

Preservation of normal thyroid tissue.
Minimal scarring, as the procedure is performed percutaneously.
Short recovery time, often allowing patients to resume daily activities immediately.

3. Laser Ablation

Laser ablation uses focused light energy to coagulate nodule tissue. Similar to RFA, it is performed under ultrasound guidance and is suitable for nodules causing cosmetic or functional concerns. Laser ablation provides precise control over the treated area, minimizing damage to surrounding tissue.

4. Ethanol Ablation (Ethanol Injection)

Ethanol ablation involves injecting concentrated alcohol into cystic or predominantly cystic nodules, inducing fibrosis and shrinkage. This approach is highly effective for recurrent cysts and is minimally invasive, performed under local anesthesia in an outpatient setting.

5. High-Intensity Focused Ultrasound (HIFU)

HIFU is an emerging non-invasive technique that uses focused ultrasound energy to heat and destroy nodule tissue without any needle puncture. While still less common than RFA or laser ablation, HIFU is ideal for patients who prefer completely non-invasive treatment.

Advantages of Minimally Invasive Treatments

Minimally invasive interventions offer several benefits over conventional surgery:

Reduced Recovery Time: Most patients can return to normal activities within a day or two.
Preservation of Thyroid Function: Unlike surgery, which may require partial or total thyroid removal, these treatments preserve healthy tissue.
Minimal Scarring: Small puncture sites or no incisions reduce visible scarring.
Lower Risk of Complications: There is reduced risk of nerve injury, infection, and bleeding compared to open surgery.

Patient Considerations and Follow-Up

Although minimally invasive procedures are highly effective, patients should understand that results may vary depending on nodule size and type. Repeat treatments may occasionally be required, especially for larger nodules.

Regular follow-up includes ultrasound monitoring and thyroid function tests to ensure the nodule shrinks appropriately and to detect any new growth. In Singapore, clinics offering these treatments often provide comprehensive follow-up care, ensuring patient safety and long-term outcomes.

Lifestyle and Supportive Measures

While medical intervention is the cornerstone of treatment, supportive measures can enhance outcomes:

Maintaining a balanced diet rich in iodine, vitamins, and minerals to support thyroid health.
Avoiding excessive neck trauma or strain.
Monitoring for symptoms such as neck swelling, voice changes, or difficulty swallowing.

Educating patients about their condition and providing reassurance are integral to successful management. Many patients experience anxiety upon nodule detection, and clear communication about treatment options, benefits, and risks can alleviate concerns.

Choosing a Specialist in Singapore

Selecting an experienced endocrinologist or thyroid specialist is critical. Clinics that specialize in thyroid care offer advanced diagnostic tools, procedural expertise, and personalized treatment plans.

For patients seeking thyroid nodule treatment in Singapore, it’s important to choose a provider who can assess whether minimally invasive techniques are appropriate and who can guide you through every step of the process.

Conclusion

Minimally invasive thyroid nodule treatments provide effective, safe, and cosmetically favorable alternatives to conventional surgery. In Singapore, advancements such as RFA, laser ablation, ethanol injection, and HIFU have revolutionized care, allowing patients to address nodules efficiently while minimizing downtime and preserving thyroid function.

Ultimately, early detection, proper evaluation, and individualized treatment planning are key to optimal outcomes. With expert guidance and minimally invasive interventions, patients can manage thyroid nodules confidently, achieving both functional and aesthetic satisfaction.

HEALTH

My Experience with Eczedone: A Personal Journey to Relief

Published

4 weeks ago

November 26, 2025

John

Introduction to Eczema and its Impact on Daily Life

Eczema is more than just a skin condition; it can feel like an unwelcome companion that follows you everywhere. The relentless itch, the dry patches, and the constant need to apply creams can overshadow daily life. It’s a struggle that many people face, often leading to frustration and self-consciousness. As someone who has battled eczema for years, I know how challenging it can be to find relief.

Traditional treatments often come with their own set of challenges—side effects or limited effectiveness left me feeling disheartened. That’s when I stumbled upon something different: Eczedone. This innovative solution promised not only relief but also hope—a chance to reclaim my skin and my confidence.

Join me on this personal journey as I share my experience with Eczedone, exploring its impact on treating eczema and what it means for those seeking comfort from this persistent condition.

My Struggle with Eczema and Traditional Treatment Options

Living with eczema felt like an endless battle. My skin often itched and burned, making daily life a challenge. I tried everything from over-the-counter creams to prescription medications. Each attempt brought temporary relief but never lasting results.

Doctors recommended steroid creams, which helped at times but left me feeling uneasy about their long-term effects. The side effects were daunting; thinning skin and other complications lingered in the back of my mind.

I also explored natural remedies like coconut oil and oatmeal baths, hoping for something gentle yet effective. While soothing in the moment, these approaches didn’t address the underlying issues.

The frustration grew as flare-ups continued to disrupt my routine. It was disheartening to feel trapped in this cycle without a clear solution on the horizon.

Discovering Eczedone: What It Is and How It Works

Eczedone is a game-changer in the world of eczema treatment. Unlike traditional options that often focus on temporary relief, Eczedone targets the root causes of inflammation and irritation.

This innovative product combines natural ingredients known for their soothing properties. It works by penetrating deep into the skin to promote healing from within. Users can expect reduced redness and itching with regular application.

Many have praised its lightweight texture, making it easy to incorporate into daily skincare routines. Plus, it’s free from harsh chemicals that can aggravate sensitive skin.

Understanding how Eczedone functions gives hope to those struggling with eczema. By addressing both symptoms and triggers, it paves a new path toward healthier skin and improved quality of life.

My Personal Experience with Using Eczedone

When I first started using Eczedone, I felt a mix of hope and skepticism. My skin had been through so much. The relentless itchiness and redness were exhausting.

Applying the cream was simple. It absorbed quickly, leaving no greasy residue behind. After just a few days, I noticed my flare-ups becoming less intense.

What surprised me most was how soothing it felt on application. No burning sensation—just relief washing over my skin.

As the weeks went by, my confidence grew alongside the improvement in my condition. Wearing short sleeves didn’t feel daunting anymore; instead, it became an option again.

The transformation wasn’t just physical; emotionally, I began to reconnect with activities that eczema had previously sidelined me from enjoying fully.

The Benefits of Eczedone and its Effectiveness in Treating Eczema

Eczedone has emerged as a game-changer for many dealing with the discomfort of eczema. Its innovative formulation targets inflammation and helps restore the skin’s natural barrier.

One significant benefit is its fast-acting relief. Users often report reduced itching and redness within days, allowing them to regain comfort in their daily lives. This rapid response can be life-changing for those who struggle with flare-ups.

Additionally, Eczedone contains natural ingredients that are gentle on sensitive skin. Unlike some harsh treatments, it minimizes irritation while effectively combating symptoms.

Many have also noted an improvement in overall skin hydration after consistent use. This added moisture supports healing and reduces recurrence of dry patches common with eczema.

With regular application, Eczedone promotes resilience against triggers, helping users feel more empowered in managing their condition effortlessly.

Tips for Managing Eczema Symptoms Alongside Eczedone

Managing eczema symptoms requires a multifaceted approach, even while using Eczedone. Hydration is key. Drinking plenty of water can help keep your skin moisturized from the inside out.

Incorporate gentle skincare routines into your daily life. Opt for fragrance-free products that won’t irritate your sensitive skin. Look for emollients and ointments that provide lasting hydration.

Pay attention to your triggers. Stress, certain foods, and environmental changes can exacerbate flare-ups. Keeping a journal may help identify these patterns.

Consider incorporating anti-inflammatory foods into your diet as well. Foods rich in omega-3 fatty acids, like salmon or flaxseeds, might support overall skin health.

Don’t underestimate the power of relaxation techniques such as yoga or meditation to manage stress levels effectively; they can indirectly contribute to fewer eczema outbreaks over time.

Conclusion: Empowerment through finding

Finding relief from eczema can feel like a never-ending battle. For many, traditional treatments often leave much to be desired, leading to frustration and disappointment. However, my journey took an unexpected turn with the discovery of Eczedone.

Eczedone has not only transformed my skincare routine but also given me hope. Its effectiveness in soothing my skin made a significant difference in managing symptoms that once consumed my daily life. The natural ingredients work harmoniously to calm irritation while providing lasting hydration.

Throughout this experience, I’ve learned that empowerment comes from being proactive about our health choices. With Eczedone by my side, I’ve found renewed confidence and comfort in living with eczema. It’s essential for anyone struggling with this condition to explore options like Eczedone and discover what works best for them.

Taking charge of your skincare journey may require some trial and error, but finding solutions that resonate personally is incredibly rewarding. Remember, you are not alone on this path; support exists within communities of those who understand what you’re going through.

Embracing new possibilities can lead us toward relief we never thought possible—just as I experienced firsthand with Eczedone.