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Weight gain and prostate cancerOne of the hormone therapies involves increasing the production of LH-RH. Luteinizing Hormone-Releasing Hormone (LH-RH) is a hormone which is produced by your body. This lessens the production of testosterone. The drug given induces the generation of this hormone. One of the side effects of this therapy is weight gain. Along with this, breast pain, hot flashes, nausea, and growth of male breast tissue might occur. Apart from hormone therapy side effects, the presence of fatigue can also stop a patient from regularly exercising, thus, resulting in gaining weight. However, it is important that this weight gain is averted as the chance of cancer returning is a possibility. You can keep your weight in check by following these tips: Ask your doctor if your hormone therapy can lead to weight gain. If you receive an affirmative answer, then ask for a diet chart to be followed. You can also keep a food and activity journal to get an idea of how your body is reacting to the treatment. Inculcate physical activity in your schedule. This will not only help to reduce fatigue, but also keep at bay the chances of becoming constipated or feeling nauseous. Medical studies have shown that cancer patients must have at least 2-1/2 hours of moderate physical exercise per week. Have about 2.5 cups of fruits and vegetables every day. Also, shift to whole grain food items. You should also consume at least a cup of legumes, for example, beans, to keep up your protein levels. It is best to opt for lean protein snacks like yogurt and chicken. You must stay adequately hydrated during your treatment. Drink about 10 to 12 glasses of water everyday. Do not consume excessive amount of sweetened beverages like coffee and cola. Have a small portion of nut and nut seeds. If you feel distressed due to the therapy, go for a massage. These have been proved to reduce anxiety and stress caused during the treatment of cancer. Most importantly, keep up with your appointments with the doctor and convey the bodily changes that you may notice. Have an optimistic outlook towards the treatment and do not repress any emotional disturbance. Weight gain in men who had been previously healthy often leads to depression regarding weight issues. Being proactive and focusing on keeping your weight under check is the key here. You could also approach a psychologist if you have been feeling low. The LH-RH therapy is also known as Androgen Deprivation Therapy (ADT). This therapy leads to a weight gain of around 9 pounds within a year of starting treatment. You can make sure that your weight is controlled by altering your lifestyle and getting adequate physical exercise everyday.
Mother can pass stress patterns to childThe stress patterns in the mother have shown to affect the mental development of children and have been found to play a role in autism and even schizophrenia. "Pressure and stress is the common cold of the psyche." - Andrew Denton There are several studies conducted in this area of research. The results are varied and present a set of multiple issues that children can face if their mothers have been under stress when they were in the womb. In later years, these babies grow into children who have a weak mental state. They cry easily, pick the escape route in conflicts and difficult situations, are anxiety prone and may get easily bullied in social environments. Their social adjustment gets hampered due to emotional weakness. These children are not good at handling weak moments and end up being rubbed off the wrong way, time and again. It pushes them into a vicious cycle. The incapability to tackle socially stressful situations further scares them. They get bullied and become even more vulnerable. What to do? The approach is twofold. Curb the problem in the beginning. Yes, it is natural to be stressed. Pregnancy can be tough, physically as well as mentally. With the modern life, the stressors have increased and there is always so much to do in such little time. Relationships, work, food, health, hormones - there is ample to trouble you. Find a release for the tensions. The one growing inside you needs you to be happy and healthy. Do things that make you happy, keep your happiness at the top priority. Everyone around you needs to understand that. Reader, if you are the husband, parent, sibling or friend of a pregnant lady - support her, understand her and do all you can to make her smile. Do not be the one who reprimands if she is worried, be the one who takes away her worries. Pave way for a baby who is happy and ready to start a new life. Second, do what you can at the given time. The child is already here and is facing emotional adjustment issues - extend your support to him/her. Give the kid the ground to grow strong roots and stand tall, without being disturbed easily by gushes of the wind. While it is difficult to avoid stress, you can always try to handle it better, for the sake of your child.Soon-to-be mothers who go through stressful situations may be passing on the stress patterns to their babies.
Dehydration: Prevention and curePlaying outside is great for the child's physical as well mental development. But if your child has spent the entire day outside and comes back with fever, diarrhea, or vomiting, and is sweating a lot, then watch out for the signs of dehydration. What is dehydration? Dehydration means abnormal loss of water from the body, especially from illness or physical exertion. Under normal conditions we all lose some body water through sweat, urine, and tears. Kids lose large amount of water and salt from body during fever, diarrhoea, vomiting, or long hours of physical activity or exercise without any water intake. How do I know it is dehydration? If your child has any of the fever, diarrhoea, vomiting or is sweating a lot on hot days then watch for these signs: Sunken eyes Dry or sticky mouth Dark urine or lack of urine output Tiredness, lethargy, irritability or fatigue How can I prevent dehydration? The best way to prevent dehydration is to ensure the child drinks plenty of fluids when they are sick or physically active. Get your kid in the habit of drinking enough water before he/she even feels thirsty.If it is very hot, explain to the kids the benefits of drinking water frequently. If possible, avoid going out in the sun. Give your kids a well-balanced meal to be sure that they are getting all the adequate nutrients. What if my kid gets dehydrated? If the kid is below 1 year, care should be taken to breast feed the baby often. If the dehydration is due to vomiting, feed small amounts frequently for it to absorb in between the vomiting episodes. Give a spoonful of ORS solution every 10 minutes to replace the lost fluids. For kids above 1 year, start with plain water initially when the kid complains of thirst. Later the kids may need drinks containing sugar and electrolytes. Also, the child should be made to rest at home in a cool environment until the lost fluid has been replaced. Once the child is rehydrated, resume to normal routine and diet.
Bow legsCauses: Physiological - As mentioned before, bow legs are normal below 18 months of age. Thereafter as the child continues to grow the bowing begins to improve slowly. By the age of 3 to 4 the deformity usually gets corrected. Blount’s disease - This disease results in bowing of legs due to abnormality of the growth plate of the upper part of shinbone known as tibia. Growth plates are the growing end of the bones. It is diagnosed after the child is 3 to 4 years old. Rickets - Rickets is a group of diseases that occurs due to deficiency of vitamin D. Rickets is characterized by bow legs and other bony deformities. Most commonly rickets occurs in children due to deficient intake of vitamin D. Signs and symptoms: The bony deformity becomes visible when the affected child walks or stands. The uncommon walking pattern of the child is the commonest symptom. Bow legs usually do not cause any pain. However, persistent and severe bow legs cause discomfort to other bony structures like spine and hip. Test and diagnosis: The doctor at first asks questions to the parents regarding the development of the child. This is followed by physical examination of the child. Physical examination often suggests bow legs. If the doctor suspects an underlying disease, necessary laboratory tests are done. The doctor always asks for an x-ray of the affected legs to evaluate the severity and extent of bowing. Treatment: If the bow legs persist after 3 to 4 years or an underlying disease is detected, treatment is undertaken. Medical and non-surgical treatment- In cases of physiological bow legs, no treatment is required. The parents are reassured by the doctor and spontaneous resolution takes place by the age of 2 years. Continuous followup is advised for borderline cases. Children with Blount’s disease need treatment with a brace. Children with rickets need medical management by a specialist doctor. Additionally, they need advice and regular followup by an Orthopedic surgeon. Surgical treatment  - If the bony defects persist in children with bow legs even after medical and nonsurgical treatment, surgery is required to correct the bowing. Two types of surgery is advocated to correct bony deformity of the legs. Guided growth:  Growth of the healthy part of the growth plate is stopped and that of the abnormal part is promoted. This allows straightening of the legs. Tibial osteotomy: The shinbone (tibia) is cut and reshaped to correct the deformity. Then bone is fixed with screws and plate. In both surgeries a cast is applied to promote healing of the bone. Crutches may be required for a few weeks to prevent weight bearing on the limb. Later, physical therapies are advised for complete recovery of range of movements and regular activities. Prevention The parents need to be vigilant about appearance of any bony deformity in legs of their child. The child must be given adequate amount of vitamin D in diet or vitamin D supplementation to prevent development of rickets.
Crave for non-food substances to put in your mouth? Go ahead take your pica!We all have strong cravings in some form or the other, especially for food. Just thinking of a chocolate cake or ice cream can set the mouth watering and the hand creeping to open the refrigerator. However, some people have an unusual craving and it is to consume non-food items. Everyone knows that children are known to eat chalk, dirt or lick walls but at times, even adults have this unusual craving for non-food items. This condition is termed as 'Pica'. One can understand a child popping something into its mouth as it's discriminatory skills are not developed, but what about fully grown adults who have this habit? Is it a mental ailment? One can't really call it a full blown mental condition as it occurs commonly in pregnant women. The cravings are as strong as any other food craving and sometimes these people go out of the way to satiate their cravings. So, right from paint thinner, to chalk to ink, ice, plaster, paint, linoleum to plastic bits can form the obsession or craving. Pica is a combination of psychological and biochemical processes and is generally a deficiency which sets about these intense cravings.  When pica strikes pregnant women, then it could be a cause for much concern and the doctor should be kept informed. While it is easier to indulge a pregnant woman's ice cream cravings if she also develops a thing for iron fillings on top of her ice cream, then obviously it can be a rather dangerous thing to do. Ice and chalk are comparatively harmless and other than affecting the teeth and the taste, do nothing much else, but what about turpentine and toxic materials? They can definitely interfere with the body's digestive processes and can even spread harmful toxins in the body to cause blood poisoning, intestinal infections, bowel blockages and lead poisoning or arsenic poisoning.  If you have such strong non-food cravings then before you give in to them talk about it to a medical practitioner. It could well be an iron deficiency or perhaps even anemia which is attracting you to chew pencils up or making you pop dirt in your mouth. If you are pregnant then certainly the doctor will need to address the underlying issue and ensure that the pica goes away before you deliver. Wouldn't want you chewing up the baby's soother now would we?
Where does your happiness lie? - Importance of emotional well-beingAn emotionally well person is characterized by ability to handle and adapt to changes, to efficiently deal with stress, has a positive self-image and can take decisions independently to cater to his needs. Striving forward with a sense of purpose, an emotionally strong person has the capacity to build and sustain fruitful relationships without over-dependence. Being emotionally well does not imply that you do not experience pain and suffering. Pain and suffering is an essential part of every person's life. The strength of your emotional well-being is determined by how you look at and react to them. Those who are emotionally well can treat their adversities as opportunities to change and move ahead with greater strength. Signs of an emotionally ill person include stress, frustration, discomfort with changes, negativity in thoughts, and unreasonable paranoia about the intention of other's actions, discontent, and depression. There is also the feeling of guilt over inability to hold relationships and of not being able to keep others happy. You may also find yourself unworthy and feel that you do not deserve to be happy. Such sensation of low self-worth fuels the need to look for other ways to feel relaxed - thus, resulting in substance dependence. In cases of severe emotional ill-being, one could experience sleeplessness, hopelessness, suicidal, and uncontrollable negative thoughts. Relation between emotional and physical well-being: Emotional well-being is closely related to your physical body. They share a symbiotic relation with one another.By taking care of your body, you allow balanced production of hormones and smooth functioning of the other body parts - allowing them to respond efficiently during tough situations and also assisting the body to cope with physically challenging conditions. By being emotionally strong, you will also contribute towards faster and effective treatment of your body from illnesses. Your emotional well-being is determined by the following factors: family background, companionships, past history of relationships, sensitivity to nature and genetic dispositions. Those who come from troubled family background find it harder to associate in a healthy way with others during their adulthood. In many cases genetically, a person has greater propensity towards being emotionally weak - though this can be controlled and molded into strength by one's own actions. Depending on the type of educational institutions you attended, your companionships could be those which built your self-image positively or which hindered your capacity to take care of yourself (due to instances of bullying and teasing). Past romantic relationships also determine how you deal with your emotions in the present. Those who are sensitive to nature have been found to have greater consideration for human beings as well as non-human beings around them. Every factor is a condition which can be shaped by the efforts of the individual. Emotional well-being is primarily built on the belief that you can create your own reality by choosing your actions. How to promote your emotional well-being? Be optimistic :  Emotional and mental well-being is majorly decided by how you look at your life. Even though you have many sufferings, are you able to accept them and find ways to get through them, knowing that the good is yet to come? Flip through the inspiring stories of people around you to motivate optimism. Find your beauty : Listen to the needs of your body and do not impose your mental ideas of beauty on it. Beauty of each person is determined by their unique characteristics. Do not let the conventional standards of beauty pull you down. Know that you are unique and beauty is not necessarily an external but an inner state of mind. Stay with those who care for you : You might see the need to sacrifice your happiness for others in some instances. However, if you find yourself doing that 8 out of 10 times in any relationship, it is time to seriously reconsider how you wish to live. Is your happiness being taken for granted? Are you running this relationship because you are afraid of being alone, knowing that it is going nowhere in the future? Those who care for you will show it through their actions. The best way to love yourself is by being able to see yourself through their eyes. Take care of your body :  Get adequate sleep daily and make sure your body gets lots of nutritious food. Don't let the advertisements decide the needs of your body. Try out different cuisines and let your body tell you which one it feels is most suitable. Exercise moderately everyday by taking a walk in a green area with your loved one (Remember that the point of exercising is not only to lose weight, but to sweat away your stress daily in fun ways!) Follow your heart : Do what you love. There is nothing that could harm your emotional well-being more than doing something which you know is not right and which you do not want to do. Confucius has dropped us a fortune cookie of happiness when he said that in choosing a job you love, you will never have to work a single day of your life. Get a pet companion :  Adopt an animal and take care of it. In taking care of the pet, you will realize and gradually get in touch with yourself, becoming aware of who you are as a human being. This could be the starting point of discovering your true potentials. Volunteer at social services : Let your creativity and emotions flow by connecting to those around you. Depending on your interests, choose a type of social service - old age home, orphanage, animal shelter, being with terminally ill people, and so on. Such activities will help to positively channelize your emotions.
Benefits of meditation: How daily meditation helps you lead a wholesome life Sharper memory: One of the most important cognitive capacities we use daily is our memory. With higher amount of stress on your brain and body due to demands at workplace and home, there is high probability of negative effect on your memory. This can be countered by mindfulness meditation where the focus of attention is a particular physical sensation. This lets you quiet your mind and learn to be attentive solely to the matter at hand, thus allowing your brain to be able to remember more sharply and quickly. Dealing with stress: Stress is the buzzword for anyone who is leading their life in busy cities. Starting from the hurried walk into the office to the pressure of meeting deadlines and reaching home exhausted only to find oneself engrossed in another set of tedious jobs is the condition of daily life for most people. Meditation will allow you to cope with stress in a stronger way by bringing the energies of your body under your control, thus giving you the power to channelize them effectively. Giving up painkillers: Recent medical studies, especially ones conducted in Montreal in 2010, showed how the practice of Zen meditation structures the brain in such a manner that its capacity to sense and deal with pain increases. Primarily practiced by Buddhist monks, Zen is the form of meditation where you focus on your breathing and posture while watching and letting your mind gradually turn quiet. In this way, you can put those pain killers away and increase your innate capacity to deal with pain. Happiness quotient: Prefrontal cortex is the part of brain concerned with positive emotions and feelings. Those who meditate have been seen to have greater activity in this area. Major journals and research institutions focusing on depression and role of meditation in reducing it have found that meditation helps the person to feel in control of their life by subtly changing the working of their brains and thus, resulting in greater capacity to cope with depression and negative feelings. Good for your heart: Two kinds of meditation which are greatly beneficial for smooth working of your heart are Zen and Transcendental meditation. Transcendental meditation, taking after its name, helps you to transcend your worries through attention on chanting. It has been found that meditating daily helps to reduce the chances of stroke and heart attacks by over 40%.
5 Muscle building smoothiesProtein is highly important for muscle building as it repairs the muscles and help in their rapid recovery after a workout. That is why most of the trainers recommend taking protein smoothies after workouts. Generally, banana and peanut butter alternatively, are used to add the protein content to the smoothies. Apart from these, Chocolate is a hot favourite as well. But if these do get boring, here are some smoothie ideas, only for you. Hot Cocoa (bed-time and post workout) Ingredients: 1-cup milk (fat-free), 1 scoop whey protein chocolate, 1 packet Swiss Miss Diet hot Cocoa and ½-cup cottage cheese (low fat). Recipe Heat the milk and just when it gets to the boiling point, blend it in the blender with the protein, cottage cheese and cocoa until smooth. Ensure that the mixture has mixed well. This protein smoothie can be taken just before bedtime as well, because the cottage cheese contains slow digesting proteins that are great for overnight muscle repairing. Each glass of the Hot Cocoa smoothie contains: Calories-275 Protein-44 gms Carbs-20 gms Fat-1 gm Fiber-0gm Root Beer Float (post-workout) Ingredients: 1 scoop vanilla flavored whey protein, ½ cup vanilla yoghurt (fat free(, 1 scoop vanilla casein protein and 1 ½ cup root beer Recipe In a bowl mix all the protein powders into the yogurt slowly and stir well to avoid clumps. Now, pour the root beer in a large beer glass and add this mixture of yoghurt carefully, without stirring. Since the root beer starts carbonation process, the shake becomes quite frothy without having to use a blender for mixing. Each large glass of the Root Beer Float smoothie contains: Calories-443 Protein-48gms Carbs-61 gms Fat-1 gm Fiber-1 gm Post workout or pre-workout smoothies provide the necessary protein to the body that contributes in rapid muscle recovery and growth. Peach Cobbler (pre-workout) Ingredients: 1-cup water, ½ can of sliced peaches with juice, 1 scoop vanilla whey and 1 packet Quakers Instant Oatmeal (lower sugar maple and brown sugar) Recipe Mix all the ingredients in a blender and serve. Use an immersion blender for this one, to get a finely mixed smoothie. Each glass of the Peach Cobbler smoothie contains: Calories-305 Protein-24 gms Carbs-49 gms Fat- 2 gms Fiber-3 gms Orange Creamsicle (pre-workout) Ingredients: 1-cup orange juice, ½ cup fat-free yoghurt (vanilla flavor) and 1 scoop vanilla whey protein Recipe Mix all the ingredients in the blender and enjoy your smoothie. Ensure that you use real orange juice and not the flavored orange drinks for this one to get the desired result. One glass of the Orange Creamsicle smoothie contains: Calories-280 Protein-27gms Carbs-43 gms Fat-1 gm Fiber-2 gms Chocolate Almond Brownie (pre workout or early morning) Ingredients: 1 cup milk (fat-free), ¼ cup almonds (chopped), ½ Clif brownie bar (chocolate flavor-chopped finely) and 1 scoop of chocolate flavored whey protein Recipe Mix the milk and the flavored protein in the blender and serve with almonds and Clif bar topping. Use a spoon as you will be eating as well as drinking the shake, because the almonds and the bar chips can settle to the bottom. One glass of this Chocolate Almond Brownie smoothie contains: Calories -457 Protein-39 gms Carbs-41 gms Fat-17 gms Fiber-8 gms
All you need to know about angioplasty!Why would you need coronary angioplasty? The walls of the arteries are being constantly lined with a fatty material called plaque. This plaque increases in certain conditions like atherosclerosis. When the build-up is too high, the artery gets blocked and the subsequent tissue receives very less or no blood, causing it to die. The plaque at times may be dissolved by medicines but if it is too big, medicines prove ineffective. This is manifested outwardly as a heart attack. This is the time when the doctor would recommend the coronary angioplasty as a treatment for you. How is it done? A thin catheter with a deflated tiny balloon at one end is inserted into the affected artery. Once the exact location of plaque build-up is reached, the balloon is inflated causing the plaque to get pushed against the artery wall and creating free space for the blood to flow. A small mesh called a stent may be placed to hold the artery in place. Some stents are coated with medicines that prevent the scar tissue formation following the angioplasty procedure. The procedure may be done as an emergency or it may be planned. If it is a planned procedure: You will have to get hospitalized and stop eating or drinking 6 to 8 hrs before the procedure. Once the procedure is done, the doctor would prefer you staying in the hospital overnight to watch for any adverse events that may happen. What happens after the surgery? The surgery lasts for 1 to 2 hours and you would be allowed to go home the next day. You will be advised not to undergo vigorous and strenuous exercises and to rest adequately. Most people are fit to return to work a week after the surgery.
Are long hours of work bad for your sex life?As researchers in 'Occupational Health' indicate that working more than 8 hours a day could seriously shorten your life span by inviting all sorts of ailments like heart disease, sleep deprivation, chronic fatigue syndrome among others, it could very well mean sounding the death knell on your love life! So how does work affect play? The stress that goes with long work hours could certainly lower sex drive leading to feelings of frustration and inadequacy amongst partners. 'Erectile dysfunction' and lack of sexual desire are now on the increase amongst men with high pressure jobs and fancy designations. This in turn adds more strain on the relationship as partners naturally feel spurned due to the general lack of intimacy and sex. There is also the added danger of extra marital affairs as hours away from home can increase the chances of one night stands or casual sex thereby increasing the risk of STDs and sexual guilt which can only spell doom on the home front. So if you are a busy person this is what you can do to keep your bed from crumbling: Take a break now and again from work to call your spouse or partner. This can indicate that though you are busy he/she is foremost on your mind. Do not sacrifice your weekly offs as this is the time that your body, mind and spirit need all the healing that they could possibly get at the hands of your mate. Try and involve your mate as much as possible on what is happening at the work place. This way your contribution at your work place can be appreciated and can lessen the grouse, somewhat, like you are never available and similar other complaints. Preferably keep time for making love. These moments of intimacy are really what makes life worth living and should be given as much prominence as your promotions and annual appraisal. Do not miss out on your meals and exercise routine that ensure that despite hectic work pressures, you can still summon up enough energy to make love. Try a relationship counsellor to help you fine tune your work schedule to your home life.  
The earlier yearsSexual concerns experienced during the drastic body changes and feelings of adolescence are often carried into adulthood. Sexual desires are powerful and frequently go beyond the earlier popular forms of sexual expression - kissing, hugging and petting without being aware of the consequences. Anxiety the commonest case of erectile dysfunction is compounded by the present life style - get-togethers, parties, with alcohol and drugs, visits to sex workers or massage parlours which offer other sexual services leading to unplanned, unprotected sex. Consequently seen are unwanted pregnancy, abortions, drug addiction, sexually transmitted diseases, anxiety and depression leading sometimes to suicide. Males seem to have more concerns then females. A common concern is nocturnal emission (night fall, Swapana Dosh) of semen and length of penis. Nocturnal emission of spermatic fluid is falsely believed to weaken a person. Really all that's happening is that excess of sperms is being thrown out to make place for the new ones. The length of the penis troubles many. Young people fall prey to advertisements that claim to lengthen it. The fact of the matter is that a penis an erection of 2.5 wide (10cms) is enough for a sexual intercourse for a person who knows the art to satisfy a partner. Ignorance about masturbation is widely prevalent among males of all ages leading to guilt, anxiety, depression and at times to suicide. Older men erroneously think their cause of erectile dysfunction or premature ejaculation is masturbation. Masturbation is a highly pleasurable act in males. It does not harm the body or exhaust the sperms. In fact it is a safe way to satisfy. Females also masturbate but the percentage to men is much less. They also seem more comfortable with the activity. Masturbation has gone through years of superstition fear of ill effects, considered as a unhealthy practice and considered sin by some religions. Fifty or more years ago doctors and activities thought it caused harm to the body. It is said that corn flakes, the popular breakfast cereal was specifically formulated by Mr. Keleog to help a person not to masturbate. Today thinking has changed. It is now thought that it is an activity that does not cause any harm to the body. It does not finish all the vital sperms over the years so that it will not hinder having children in future. Its wide misuse is common. Persons use it indiscriminatingly when they cannot sleep, when they are tense for e.g. before an examination, some do it more than four to six times a day, which only indicates their immaturity. When done to satisfy a natural sexual urge it is a healthy activity. It keeps the person safe from infection and is said to teach the person skill for sexual intercourse. Technology has helped in many ways but sometimes it creates problems. A person hooked on to porno sites to arouse his desire is found to cause a loss of self confidence conflict with the partner sexual intimacy and intercourse. Before marriage or a partnership both male and female have concerns. Females if they have a previous partner but are getting married to another worry about the husband finding out of their loss of virginity, others worry about the size of their breasts, excessive hair on body or excessive fear of pain at intercourse. Men worry about whether their penis is long enough whether their long standing masturbation will hinder intercourse or prevent them of being a father. The absent hymen a false notion for virginity can be congenitally absent, split by exercise like swimming, cycling etc. or most commonly by masturbation. The hymen therefore is no proof of virginity. Learning to do with what they have making full use of their points and feeling comfortable and proud of their bodies help a lot to overcome the concern. Adopting a safe sex policy is best achieved by masturbation; avoiding sex with an unknown person and multiple partners; during intercourse with sex workers not using condoms every time and being careful of oral sex. Satisfying each other by caressing, hugging, kissing etc. with clothes on is safe; without clothes extra vaginal sex by mutual masturbation is safe with a trusted partner and finally not so safe is vaginal intercourse unless done with a condom correctly worn.
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