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Poor fiscal capacity of the govt due to tax evasion and avoidance versus large population → Public healthcare, education, housing, water & sanitation infra is poor → a. To provide recommendations of levels of PA needed to decrease ED for men with physical inactivity, obesity, hypertension, metabolic syndrome, and/or cardiovascular diseases. This systematic review estimated the levels of PA needed to decrease ED for men with physical inactivity, obesity, hypertension, metabolic syndrome, and/or manifest cardiovascular diseases. Therefore, ED is typically linked to a web of closely interrelated cardiovascular risk factors such as physical inactivity, obesity, hypertension, and metabolic syndrome. "The endothelial cells that line your coronary arteries line all the arteries in your body, including the arteries that go to the penis." 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Many potential patients have questions regarding the Max X procedure, ranging from its effectiveness to safety concerns. Unfortunately, patient took several different brands of ED pills at the same time, assuming its “safe” as proclaimed on the packaging. Per patient “I was not aware of the contents in neither the ED pills nor the substances contained within it”. Later patient called his friend and request to take him to nearby healthcare facility Patient reported right hemiparesis, unstable gait and imbalance. Individuals with PDD experience intense distress over a perceived flaw in their penile size or appearance, even when it is medically normal. This procedure, known as ligamentolysis, does not increase the actual length of the erect penis, as the erectile tissue remains the same size. Consistent, long-term use of VEDs is sometimes medically prescribed for erectile dysfunction or rehabilitation after prostate surgery, but not for cosmetic enlargement. Currently, evidence suggests that ED is not only correlated with cardiovascular disease due to shared medical comorbidities, but is, in fact, an independent risk factor for cardiovascular disease. The Second Princeton Consensus on sexual dysfunction and cardiac risk stated that all men with ED, even in the absence of manifesting cardiac symptoms should be regarded as having potential risks for cardiovascular disease (24). Many of these side effects occur because there is cross-reaction with other phosphodiesterase types located throughout the body (18,22). Other side effects include headache, dyspepsia, flushing, myalgia/back pain, visual disturbances, and nasal congestion. 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