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Urinary tract infections in menUrinary tract infections are most commonly seen in the bladder in men. The symptoms include: Pain or burning during urination The urge to urinate often Pain in the lower abdomen Urine that is cloudy or foul-smelling Fever with chills and vomiting If the infection has spread to the kidneys, there may be pain in the back in the region of the kidney along with high grade fever, nausea and vomiting. UTI occurs very commonly and is not a medical emergency, but it is advisable to see the doctor immediately to avoid further complications. Elderly people and people suffering from diabetes should report instantly as they are at a higher risk for complications. The main risk is of the infection spreading up and affecting the kidneys. This could result in severe damage to the kidney and in people already suffering from any kidney disease, it could mean even kidney failure. There is also a small chance of the bacteria entering the blood stream and reaching other organs. Risk Factors for developing UTI: Not drinking enough water Holding in urine for long Kidney stones Taking frequent baths These factors may increase your chances of developing UTI A urine test is the only way to diagnose UTI. It not only checks for bacteria in the urine but also for abnormal cells like pus cells and red blood cells. Dipsticks are accurate. Home test kits are also available but they do not boast of 100% accuracy. Stealth or Asymptomatic UTI is the same as UTI, except that the symptoms are not seen. The bacterial infection is revealed in a routine urine test. This is serious and since it affects elderly people and immune-compromised people, needs immediate treatment. UTI is treated symptomatically. Specific antibiotics are prescribed for killing the bacteria. Symptomatic treatment is offered for the fever and pain if present. Along with this you will be recommended to drink plenty of water and fluids and regularly empty your bladder. Men with diabetes need to take special care due to several reasons. Since their immune system is weak, they are prone to infection easily. The high amount of sugar in the blood and urine may encourage the bacteria to flourish. Also, the diabetic neuropathy affects the nerves of the bladder and there may be no proper signals for emptying the bladder fully. All these add up as potential risk factors for UTI. Urinary Tract Infections are easily preventable. Here's how: Drink Plenty of water Empty your bladder at regular intervals Take showers instead of baths Visit the toilet before and after sex Avoid strong smelling soaps and washes to wash the genitals Wash from front to back.
Mammary duct ectasiaSigns and Symptoms In most of the cases, female patients do not have any symptom. In few cases, women may present with nipple discharge, tenderness or inflammation of the surrounding region. In some cases, there may be a lump over the breast or the nipple may get inverted. Causes Exact cause of mammary duct ectasia is unknown. But few possible cause or risk factors have been proposed by the doctors : Increasing age - Probability of developing mammary duct ectasia increases with age. With ageing, the breast changes its nature. Glandular tissue is replaced by fatty tissue. This change may lead to duct ectasia. Smoking- Milk ducts are widened due to smoking. This increases risk of inflammation which may lead to duct Ectasia. Inverted nipple - Inverted nipple obstructs the milk duct. It may lead to inflammation followed by duct ectasia. Complications Complications of duct ectasia may be may be of varying severity. They are usually minor, but sometimes become serious. Localized discomfort- Discomfort occurs due to pain and swelling around the nipple. Nipple discharge - Ectasia is frequently associated with discharge of thick and sticky fluid from nipple. Infection- Bacterial infection may develop due to stagnation of fluid in the milk duct. If it is neglected, it may lead to localized collection of pus known as abscess. Abscess requires surgical treatment. Abscess is drained surgically. Diagnosis The doctor usually diagnoses duct ectasia by clinical examination. However, few investigations may be required. Mammography- X-ray of the breast tissue is known as mammography. It helps the doctor to evaluate the breast tissue. Ultrasound- Ultrasound enables the doctor to evaluate milk ducts beneath the nipple. Treatment Duct ectasia is usually relieved by treatment. Following are the treatment options : Medications: The doctor prescribes antibiotic therapy for 10 to 14 days. It may be accompanied by mild painkillers like ibuprofen, etc. for initial few days till the remission of the disease sets in. Most of the cases are usually relieved by medications. Surgery: If duct ectasia is not controlled with medications then the doctor chooses to remove the duct ectasia surgically. Surgery is required very rarely.  Self care measures Following self-care measures often provides relief to the patients. These remedies can be adopted at home. The patient may wear a breast pad or support bra. The patient may apply warm compression to the affected region. The patient must stop smoking. The patient may be advised to sleep on the opposite side of the affected breast. Female patients should be educated regarding mammary duct ectasia so that they can detect possible symptoms of duct ectasia themselves. This will help to prevent possible complications of mammary duct ectasia and early diagnosis will provide early cure.
A correctable disfigurement of face: Cleft lip and palateThe Times of India reports that "With an incidence of 7 per 1000 children, cleft lip and palate deformity is one of the most common deformities among Indian children." The number of infants born every year with cleft lip and cleft palate in India is 28,600. This means 78 affected infants are born every day or 3 infants with clefts are born every hour. Cleft lip and palate develop early in pregnancy where lack of adequate amounts of tissues lead to two parts of the face failing to join adequately at the middle. A cleft lip or hare lip (as it is commonly called) refers to separation of the two sides of the upper lip. There appears a narrow opening or gap over the skin of the upper lip. This separation may sometimes extend beyond the base of the nose and may involve the upper gum and/or the bones of the upper jaw. A cleft palate refers to the gap between the two edges of the roof of the mouth, causing it to remain open at birth. The bony front portion of the roof of the mouth or the hard palate may be involved alone, or along with the soft palate or the soft back portion of the roof of the mouth. Since lip and the palate develop separately, it is possible to have a cleft lip without a cleft palate or vice versa. Causes of developing cleft lip and cleft palate: The exact cause of cleft lip and palate is unknown. Some research, however, suggests that these clefts are caused by a combination of genetic and environmental factors. The risk of such clefts thus can be reduced by adopting a healthy lifestyle during pregnancy. This includes avoidance of smoking, alcohol and having a healthy diet to avoid excessive weight gain during pregnancy. Cleft lip and palate can occur alone with no other problems or defects. This is called non-syndromic clefts. They may also occur as part of other birth defects and then may be called part of a syndrome. Cleft lip and palate may occur on one side (unilateral) or may occur on both sides (bilateral). Unilateral cleft lip and palate is more common than bilateral cleft lip and palate. Left-sided cleft lip and palate is twice as common as right-sided cleft lip and palate. The reason for this is unclear. A cleft lip or combined cleft lip and palate are seen more commonly in male babies. Cleft palate alone is more common in female babies. The face of the baby usually develops around 5th and 9th weeks of pregnancy thus this defect may arise early in pregnancy. Treatment of cleft lip and palate: Cleft lip and palate is usually corrected using cosmetic or plastic surgery. Results are usually very good. After treatment, most children have a normal appearance. To prevent and correct associated speech problems and dental problems, treatment is also sought from speech and language therapists, as well as dental surgeons (orthodontic specialists). Excellent results may be seen if the specialists work in tandem.
Your bundle of joy comes with bundles of fascinating facts Blue-eyed wonder: Most babies are born blue-eyed. The melanin pigment that decides the color of the eyes is not developed at the time of birth. So the babies are born with blue/light eyes irrespective of the genetic makeup. By the time the baby is 6-7 months old, the pigments start developing and the baby's eye colour changes as per the genetic makeup of the parents. Marked for life: One in every three infant is born with a birthmark! No tears: That is true! New born babies do not shed any tears. The lacrimal duct and the tear glands are well developed but they produce just enough tears for lubrication. Actual tears start appearing after one month of age. Crawling wonders: New research has found that babies can crawl almost as soon as they are born. When left to themselves, they are quite capable of using their limbs and find their way to food i.e. the mother's breast.And we thought that they are tiny helpless creatures! Temperature sensitivity: Babies are much more sensitive to temperature changes and body heat.Though the baby can't throw off the clothes to cool down, it is smart enough to do other things. When the baby is cold, it will move around more and if it is too hot it may just lie still as if sunbathing. Touch therapy: Touch is the most highly developed sensation in babies, even in premature ones. The touch sensation develops from head to toe with the mouth being the most sensitive. No wonder they tend to put everything in their mouths. Short-sighted: Babies are short sighted at birth. Their vision is set to a limit of 8-to-12 inches. They can see people and objects clearly only if they are within this range. Brain size: The brain grows at such a rate in newborns that by the end of the first year,the brain is double the birth size and half its final size! Palmar Grasp: New born babies have a strong grip, as strong as a monkey's. The grip is so strong that if you dangle them on one hand, they can support their own weight. This probably originated from the primitive survival instinct. This strong grasp reduces after a couple of months. Taste buds: Babies have more than 10,000 taste buds situated all over the tongue and even at the roof and sides. As they grow, these extra taste buds disappear.
What is megalomania?Bertrand Russell's quote on megalomania perfectly describes the condition:"The megalomaniac differs from the narcissist by the fact that he wishes to be powerful rather than charming, and seeks to be feared rather than loved. To this type belong many lunatics and most of the great men of history." Megalomania is a delusional bipolar disorder. The sufferer believes he is an all-powerful person and that he is superior to all other people. Megalomania comes from the Greek words megalo which means large or great and mania which means madness. It is a psychopathological disorder that has delusional fantasies of power, exaggerated self esteem and a sense of omnipotence. The sufferer may believe he is God or some famous athlete. Although megalomania is a term used for power hungry people, it is clinically described under the mental disorder of narcissism. Narcissism is self-love. Though self-love is a healthy concept, narcissism is a pathological state where one loves oneself to the extent that he starts despising others. Megalomania is caused by certain phobias and mental conditions associated with emotions and personality. In everyday life, megalomania can be a person's mental way of reacting to frustration, abandonment or some serious loss. In the social world, the term megalomaniac is often synonymous with control freaks, power-drunk army generals, executives and politicians. The treatment of megalomania includes medications. The challenge here is that the person may not believe he has anything wrong with him. He, in fact, believes that he is so great that no harm can come to him, so talking him into getting himself treated is very difficult. Adolf Hitler, the German dictator, was a power-hungry control freak. He believed that he was the supreme commander and that his race was the only race suited to inhabit earth. All other races, especially Jews, were inferior and had to be wiped off the face of the earth. Adolf Hitler was megalomaniac.
Balancing marriage and work: The top 5 tricksFor women juggling between home and work is very difficult. Yet, the number of women choosing to go out and work, while managing their homes, has increased over the years. This is because a successful career helps a woman establish her identity in society, gain respect and do justice to her inherent qualities, passions and dreams. So, a successful working woman, is a happy woman and statistics show that such women also keep their kids and spouses happy. More stable marriages During the seventies, when women started entering the workforce in large numbers, there was an instant rise in the divorce rates. However, over the past decade, the divorce rates among working couples have actually declined. Today, men have extensively adjusted to the idea of having a working woman, as a partner. In many countries, men actually share the domestic chores and devote time to childcare, so that their women can successfully handle both, work and home. However, the main responsibility of the home and the kids is still primarily, in the hands of the women. Here are the six keys to manage your work and marriage successfully: Find the right job You can ease out the stress of managing the work and home front, if you make the right decisions. Studies indicate that couples having access to less demanding work, have better sex and better relationships and hence, are less likely to be stressed out. However, in case the working hours are long, the situation can become the opposite. Hence, it is important to find an exciting job, over which you can still have control, especially when you have small kids at home. Adjust the working hours Most women have to leave their careers halfway because their husbands work for long hours and there is no one available to care for the kids. If the wife too is good at work then, the couple should take up jobs that provide an opportunity for both of them to work, since doing this will keep both of them satisfied. There is a possibility that the husband, or the wife, may lose a bit on the income in this adjustment, but ultimately it increases the chances of having a happier marriage. The negative impact of leaving work If a career-oriented woman leaves her job due to family demands, it can shake the very base of the marriage, while also leaving her, depressed. Also taking a break, means you have to catch up very fast when you want to restart your career, which in reality, is quite difficult. In these situations, there is also a huge wage gap, between what you used to get before your break, and what you are getting after, that can lead to depression. Working moms help fortify the relationships between kids and their fathers When the father spends time babysitting the children, a closer bond develops between the kids and the father, which is usually not possible in families where the dad goes to work, full time. Studies show that children raised with equal devotion from both father and mother, have higher goals and aspirations and are even more empathetic. Feel less guilty A working woman usually feels guilty because she cannot spend as much time with her children, compared to the dedicated housewives. However, if the husband shares the duties related to bringing up the children both parents can be happy while playing their parts well for their kids. A woman with a successful career is positive and confident about everything she does, which ultimately makes her family happier.
Arthritis friendly workoutsRheumatoid arthritis is more common in women over 60, and is the inflammatory type of arthritis where the synovial fluid functioning is disrupted. The synovial fluid maintains the health of joints, bones, and cartilages. Osteoarthritis is the most commonly occurring type in both men and women, and in this type there is gradual wearing away of the bone cartilages, which, in turn, causes stiffness, and pain in the muscles, joints and tendons. There is a classic catch 22 situation in arthritic patients and that is they avoid exercise or are advised extreme caution while exercising. The pain and soreness which comes from exercising can be extremely discouraging, so some shun exercise altogether. Now, the lack of exercise is going to precipitate the condition further, and could even increase the soreness, and lead to deformity. This is what challenges most arthritic patients. Should someone with arthritis be allowed to exercise? And if yes, then what type of exercise will prove to be most beneficial? Main question is: Are there any arthritis friendly workouts? Doctors now recommend that exercising could actually work wonders for arthritis patients. The right method and type of exercise can help ease the inflammation and soreness of the joints, and build overall health, strength and flexibility of the bones, and joints as well. What would be a good exercise routine? The arthritis foundation recommends routines which exercise the flexibility of the joints, and build muscle mass, for better shock absorption, coupled with physical endurance should be specially designed for arthritics. Regular walking: Walking is a great exercise for arthritics. Walking at a steady pace for about 30 minutes, thrice a week, can help keep the limbs active, and could reduce the swelling at the knees, and hip joints. Warm up is absolutely essential in any work out, and here it is of paramount importance that you go through a warm up routine before you begin your walk. Simple leg raises, hand to toe stretches, and light back bends can be done to warm up the muscles and joints for your walking activity. That will also reduce the possibilities of strain or sprains of the ankles along the way. Choose your exercise route to ensure that you don't walk up a gradient, and put unnecessary pressure on your knees and ligaments. Aquatic Exercises: Exercising in water is perhaps the best possible alternative, as water is absolutely low impact. This is great for arthritic patients to reap the benefits of a swimming pool workout. The easiest for chronic arthritis patients would be to simply walk, or wade in water for about 20-30 minutes. This can help greatly with building strength, and endurance in the extremities. For enhancing co-ordination you can even try walking backwards in water, or simply float and relax the body. Avoid water which is too cold, as that might adversely affect your condition. Stretching and Yoga: All easy stretches for the limbs and joints will be helpful to facilitate ease in movements, and dealing with joint pain. Standing leg raises, shoulder raises, wrist rolls are exercises which can be done quite easily, and can help keep the body supple. Though yoga also enhances flexibility, it goes way beyond just that, and actually aims at harmonizing the life force in the internal and external organs as well. No matter what type of exercise suits you, always remember: Proper warm up exercises are a must for the arthritic patient, as that can help reduce, and eliminate the possibility of injuries while working out. Do not force your body into an exercise regimen, if you are experiencing pain. It is quite ok to take a day off if the joints are sore. Get into an exercise routine slowly as your body might take a little longer to recover from it. Always seek the advice of an expert or a doctor before making any alterations to your regimen.
5 tips to reduce your salt intakeSalt is an inevitable part of our food, but added salt has harmful effects on the body. The list of benefits in reducing sodium/salt intake in our diet runs long, ranging from lower blood pressure, in turn leading to reduced risks of heart disease, obesity, and diseases of the kidney. The daily sodium intake of an individual should not exceed 1500-2300 mg per day (a table spoon of salt approximately), and this needs to be maintained in the salt added to our food, including the processed food and drinks we buy. Sodium, an indispensable component of our diet, is consumed in excess by most of us. Follow the tips, as mentioned below, to curb your daily salt intake. Avoid added salt. Do not add salt to already cooked food while eating. Keep a diary and make a list of foods with salt in them that you eat daily. Do not forget to add pickles, spices, papads, salted biscuits, and salted nuts. All of these are highly loaded with salt. Next time you go shopping read the labels. Choose low-salt options-sauces, crackers, khakhra, instead of papad. Make an attempt to eat less canned and processed foods. Choose fresh fruits and vegetables over processed food. Eat less bread. Each bread slice has about 250 mg of sodium. Do not mistake bread to be healthy. Next time, keep this in mind when you go out to eat pizza. Pizza base is like bread. While cooking food, make it a point to add salt only towards the end in the recipe. This way you will need to add lesser salt. Sodium content of some foods Bread (one slice) - 250mg Cheese pizza: 450 - 1200mg Tomato soup: 350 - 1000mg Potato chips: 100 - 150mg
Advantage of the average - Automated continuous blood pressure monitoring technologyAlthough mercury sphygmomanometers (though a deadline is set for them to be phased out due to environmental concerns) are still considered the gold standards, the Aneroid and Digital counterparts represent the future of blood pressure monitoring. The need of long-term blood pressure monitoring arises with disorders and health conditions that demand more attention from the medical teams. Experts say that the fluctuations in BP in conditions like cardiovascular diseases, pregnancy, etc., if tracked at regular intervals, can reduce 22% of risks due to delay and no treatment. This necessity pushed the invention of invasive arterial blood pressure to be used during surgical procedures and further a continuous noninvasive arterial pressure measurement (CNAP) system. There have been multiple researches to overcome some of the roadblocks in measuring the arterial blood pressure in the noninvasive and external approach. Among these developments, the need for measurement of mean blood pressure was felt and the 24-hour BP variation in the patient was taken into account. The 24-hour model eliminates the errors in readings taken during clinic visits due to factors such as fluctuations as a result of white coat fear or after-effects of some stress or exertion. Trendsetting New-age Technology : In 2004, the medical world received the BpTRU non-invasive automatic blood pressure monitoring device. BpTRU devices proved to be a superior and more precise alternative when compared to other manual BP assessment techniques and even other 24-hour ABPM alternatives. The automated oscillometric devices precision and accuracy of assessed BP and heart rate is earmarked with a unique automatic technique - the device records 6 consecutive BP readings of the patient, discards the earliest, and the rest of the five values are put to average function and instantly the resultant mean BP reading flashes on the screen. Compatible with guidelines of American National Standard/Association for the Advancement of Medical Instrumentation (ANSI/AAMI EC13:2002) this is a time-saving, portable, and user-friendly device. A compact and automatic wrist cuff BP monitor, the smart blood pressure monitor that can be synchronized with with Apple’s iOS devices and a Bluetooth connectable and Android compatible blood pressure monitor marks the revolution of CNAP in modern times.
Bile block - Understanding gallbladder problemsRavi was a young intern working the night shifts in a government hospital when he was asked to examine a patient who had just been brought in. The patient was a 45-year-old, a fat man, who was complaining of pain in the right side of the abdomen along with nausea and vomiting. On inquiry it was revealed that he had eaten a very heavy fat-laden dinner. Remembering what his surgery professor had taught him about cholelithiaisis, Ravi immediately guessed what the diagnosis could be. He, however, sent the patient for a blood test and an abdominal scan. The reports confirmed Ravi’s suspicions- cholelithiasis, gallstones. The gallbladder is a tiny pear shaped organ that lies just below the liver. It is responsible for storing the bile that is produced by the liver for digesting food. It ensures the smooth outflow of the bile from the bile ducts. When the bile components aggregate in the gallbladder, they build up to form gallstones, similar to kidney stones. The gallstones are usually small enough to pass on to the intestines and be eliminated without causing too much trouble. At times, these stones may be big enough to block the outflow of the bile and give rise to a variety of symptoms depending on the size of the stone and severity of the block. The symptoms include -  Intermittent colic. A bloated sensation with constant nausea. Inability to tolerate fats. Vomiting.  Fever with chills if the stone becomes infected. Gall stones though found in both sexes, is more common in females. The risk factors for developing gallstones include - Diabetes. Organ transplant. Diseases like hemolytic anemia, sickle cell anemia. Liver cirrhosis. Failure of the gallbladder to empty properly, e.g., during pregnancy. Rapid weight and nutrition loss due to any reason. Gallstones are confirmed by a blood test to check the liver function and by an abdominal scan. Medications to dissolve the stones, and surgery in case of large stones that do not dissolve with medications, are the treatment options.
Know your safe period for low-risk sexNot every act of sexual intercourse will result in pregnancy. There are days when your chances of conception are very high and days when the chances are almost nil. Know these days to help you enjoy a rocking sex life! The menstrual cycle starts from the day the bleeding starts and ends about 28 days after that, on an average ovulation occurs around 14th day of the menstrual cycle. The 14th day is the ideal day theoretically. Since every woman's menstrual cycle differs, the day of the ovulation also differs. Hence doctors calculate the fertile period as the 12th day to the 18th day of the menstrual cycle. This is the period when the chances of ovulating and hence getting pregnant are very high. The 1st to the 7th day and the 19th day to the start of the next cycle are the days when the ovulation chances are very less. This means if you make love during these days, there are very less chances of getting pregnant. This is the case with women who have regular period cycles. In case the cycles are irregular, then you would need to do a bit of math for calculating the safe period. For example, if your shortest cycle is of 26 days and the longest cycle has been of 31 days, then- 26-18= 8 and 31-10=21 The 8th day to the 21st day are the fertile days; 1st day to the 7th day and then the 21st day until the day the next cycle starts are the days that are safe to enjoy sex without fear of getting pregnant. Opting to have sex during the 'safe period' isn't fool-proof though. A lot of women have irregular cycles and the cycle length can vary from women to women. That's why the so-called 'safe period' is, in truth, not that safe! And it's better to use condoms or other contraceptive methods like the oral pill to prevent unwanted pregnancies.
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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