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Too much of these can be detrimental to healthModeration is the mantra for everything in life. There are a lot of things in our daily life that we do. Excess of these can be detrimental for your health. Let's see how: Television, Laptop, Mobile: That screen is torture for your eyes. Looking at the TV/ laptop/ mobile screen for too long can cause dryness of the eyes. It also makes the mind dull and inactive. Even though you have not done anything much, you feel tired. It is also unhealthy for your social and personal life. Gadgets are meant to add convenience to your life, and not alienate you from real people. These also lead to sedentary lifestyle which further triggers obesity, hypertension, diabetes and other chronic ailments. Travelling: Many of us travel for work, for education. Frequent meetings are a part of work life. Some like to holiday a lot. But too much traveling upsets routine for the body. It changes schedules too often, adds new stressors to an ordinary day. Food options also get limited and sleeping patterns are influenced. If your job demands excessive travel, make sure you consciously put an effort to choose a healthy lifestyle when away from home. Worrying: Worry is unavoidable. Think of a day you did not worry about anything, isn't it difficult? Normal stress is a part of life, but if you are worrying too much, you are weakening your immune system in more ways than one. It makes you weak, susceptible to infections, prone to lifestyle diseases, and also affects your social life and relationships. Vitamin supplements: Supplements are not your daily diet. Have them in moderation and with due consultation from a doctor. Some vitamins get stored in the body when taken in excess quantities. This can result in condition called as hypervitaminosis and various health problems. Exercise: Body is not a mechanical machine that can keep functioning at the click of a switch. Even a machine needs oiling and repairs. If you love to exercise, that's great. But don't do it all day. Too much physical exercise is strain on the body. It can lead to muscle exhaustion, weakness, breakdown and may even damage the kidneys. Sleeping: Sleeping is the rest the body needs but too much of rest means rusting. Oversleeping makes you dull and may even trigger your migraines. It annoys the body clock and may create metabolic disturbances Social Networking: This is not good for your mental health. Those two hundred friends who like and comment are not your world; the one whom you call when you want to cry is your friend. Posting images and sharing updates on social media is fine, but it is more important to talk to those who live with you, who are physically around. Many peer pressures and image issues also arise from excessive social networking and people may tend to live in a 'make believe' world.
Pregnancy myths bustedChances of getting pregnant each month gets increased by 50% in the women of the age of early 20's: This not right, for a women to get pregnant is not easy. When a woman is below 25 the chances of hitting baby bingo are only 20 to 25 %, while the women above 35 years of age the chances are 15%.   The baby's gender could be understood by the shape and size of the belly. It is believed that woman carrying a girl has high belly: False again. The shape of belly depends on original shape of the abdomen, amount and the distribution of the fat, strength of the abdominal muscles, the number of babies conceived and the position of the baby... but in no way possible can the shape or size of a belly give away the sex of the baby inside.   The best fertility lubricant to be used for conceiving is saliva: This is totally wrong, actually saliva is the sperm killer, most of the lubricants and massage oil are also not good for fertility, so it is better to go without using any lubricant.   Sperm production is impaired by laptops: This is true. Heat is not good for male fertility when laptops are used on laps they may generate heat and affect the fertility. So it is good to use the laptops as desktops.   The conceiving period of most of the couples is 3 months: This is not right, most of the couples take about 6 - 12 months of active efforts to conceive if they are not having any fertility problems.   There are more chances of conceiving, if you do more sex on the fertile days: This is true, the man having normal sperm count to have sex during her partners fertile days is good for conception. Having everyday sex was suggested in earlier days but anything which is done in excess is always more.   The egg can be fertilized within two days after it is released: This not true, an egg has the shelf life of only 12 to 24 hour, and the sperm have to meet with egg within that time, though it has the shelf life of 3 days or more.   Position during conception matters: This is not true, the sperms which are healthy are good swimmers, they can make you pregnant in any condition.   Eating oysters is good for getting pregnant: This is true, oysters are the good source of zinc, which is the most fertile mineral, it is also a good booster for libido, it can be used by both sexes.   Having cough medicine is good for getting pregnant: This is true, cough expectorants loosens up the cervical mucus as it does with the mucus in the chest, and the looser cervical mucus gives the sperm an easier and faster way to get pregnant. But some cough medicines contains an antihistamine that dries up all the mucus, which makes for a difficult swim for the sperms.   The sex of the baby is known by the glow on the face of the mother: This is not true, as the morning sickness of the mother is stopped, she starts eating well, the blood circulation also improves and in general the mother feels good, which gives the glow on the face. There is no relation between the glow on face and delivery of a baby.   The baby having lots of hair causes heartburn to their mother: Completely false, heartburn is the common complaint of the mother during pregnancy, this is due to reflux in oesophagus, in this the food particles come up through the food pipe and due to its acidic nature it causes heart burn. There is no relation between baby having lots of hair and heartburn.   The food intake of the pregnant woman should be doubled, for baby and the mother: This is not true, the pregnant woman, should take a balanced nutritious diets containing ample of proteins, vitamins, and minerals, small meals should eaten for every two hours rather than eating only 3 times the bulky meals.   Labor can be induced having sex during pregnancy: Not true, if the woman is physically fit during pregnancy can have sex as advised by the doctor only the position during sex should be taken care of, it should not cause discomfort to the woman.   Regular breastfeeding is a barrier for getting pregnant: Again a myth, the women can get pregnant even in the lactational ammenorrhea before the first menstrual cycle. You should always use contraception to avoid pregnancy.   Using computer during pregnancy can harm baby: This is not true, there may be backache if you continuously work for a long time on computer, but there is no direct effect of computer on the baby.   Source: What to Expect Before You're Expecting
Honeymoon cystitisHoneymoon cystitis is a term for urinary tract infections that occur commonly during early marriage. Sexual intercourse is the primary reason for developing this infection. The infection occurs when the E. coli bacteria that are normally present in the bowel are introduced into the urethra. This may happen through sexual intercourse, inserting unclean fingers or objects into the vagina. Women who wash their private parts from the back to front also have an increased chance of developing infection. Symptoms of honeymoon cystitis may include a burning or painful sensation during urination, the urge to urinate frequently, cloudy urine, blood-tinged urine, and/or pain above the pubic bone. Any of these is enough o play a spoilsport and dampen your honeymoon mood! Symptoms of honeymoon cystitis generally emerge within a day or two after bacteria are introduced into the urethra. A physician can confirm the diagnosis of infection through a simple urine test. The treatment usually involves antibiotics and pain-killers. What care should you take to avoid honeymoon cystitis from recurring? Use water based lubricant during sexual intercourse Urinate before and immediately after intercourse to flush out the bacteria from the urethra. Drink plenty of water to keep the urine normal Avoid coffee, tea and aerated drinks See a gynaecologist or a urologist if the problem recurs.  Urinary tract infections are extremely common in women and are the leading cause for visits to the doctor.
Cranky kids in a diner? dealing with them made a bit easy!This has happened to many a parent. They make a reservation at a fine dining restaurant, perhaps with friends and relatives. But their kid screams, and cries,disturbing the entire restaurant, and spoiling the general mood. For this reason, many parents avoid going out altogether, especially to fancy places. But there are ways in which you can handle the toddler when you are at a restaurant. We will show you how. Carry toys Restaurant may be boring at times for toddlers. That's why they turn peevish and may start playing with forks, spoons or knife. So carry some toys, crayons, notebooks, or even a story book, which will keep them busy and you can have a good time. Order something yummy and healthy for the kid A hungry kid is an angry kid. So, order something which is your kid's favorite and also healthy at the same time. Or you can carry something along with you like fruits breads, cherries or other nutritious treats. Keep responding to what kid says The best way to keep childrenwell behavedis to talk to them and respond whenever the child speaks. Don't avoid them or get too engrossed with other people. They get cranky when they don't get a response from you. Take a round with your kid When the kid becomes difficult to handle, just pick him in your arms and take a mini tour of the restaurant or walk outside. This will distract him and relieve his boredom. Don't tolerate any bad behavior If the bad behavior of the kids is intolerable, then firmly tell them that they need to adopt good manners if they want to visit restaurants again. Disturbing other diners is not acceptable. But it doesn't mean that you punish them.You just have to remove them to a place where they don't bother anyone. Make your outing relaxed and enjoyable Above all, don't forget to have fun and make it an enjoyable evening. Don't get too carried away disciplining the kid. You can afford to be a bit silly and enjoy the time with your child.
Accepting your flawsThere are basically two kinds of 'flaws,' one that is physical and the other that is in your personality. A physical 'flaw' like being too short, fat, or darkis never a person's fault. Thus accepting what you are can only boost your self-esteem and confidence. Despite these 'shortcomings,' it is your character and your achievements that stand out in the long run and not the way you look. The first step in creating a better life is accepting if you are wrong! Personality traits and habits are mostly visible to others but not to you. These are those faults that can cause bitterness in relationships or cause problems at work or in our social interactions. Some people lose their temper easily, some are lazy, and some are rude, while some are either introverts or extroverts. If you have flaws that can cause problems for others then the best thing you can do is to change those negative traits in yourself. Character flaws might be natural, but they can affect others negatively. The first thing in making improvements is to analyze yourself. What are you so angry about ? Is it really some other person's fault or that you have had a bad day at the office? Give it a thought and once you find the answers, you will feel relieved. Accept your physical flaws and love yourself for what you are, as this is the key to lasting happiness. Major flaws like alcoholism, splurging money, borrowing money, or addictions are what one should be willing to overcome. If you accept you have any of these major flaws and need help to overcome them, then you need to seek help. There are professionals who can help out, provided you are a willing party to the process. Improvement will come only if you are willing to change. Remember that flaws are easy to acknowledge and to change;the only thing required is the desire within you to do so.
Not very chummy! Menophobia - The fear of periodsMenstruation or periods begin as female reaches puberty. This is the time when there are hormonal changes which occur in the body as nature takes the girl and makes her ready for womanhood. The onset of periods can be distressful with lots of mood swings accompanied by abdominal cramps, bloated feet as the menstrual blood flows. This is also a time when the girl needs to be comforted and educated the most, as it can be truly a terrifying experience. Normally mothers or elder women in the family ensure that they take complete care of the girl in this transition phase. For some women, their initial experience with periods may not have been particularly pleasant, causing them to actually dread those 4 days and this fear can then take the shape of a full blown phobia -Menophobia! The reason could vary. For some the pain factor could be the reason for menophobia, while for others, it could be the memory of embarrassing red stains on the clothes which could set it off. In menophobia, just before the onset of the periods, the person starts getting anticipatory anxiety and the pain which could be normal period pain, is then imagined to be ten times worse. This brings on panic attacks and feeling of utter dread which while is entirely psychological can be utterly distressful and downright crippling. Counseling can help greatly along with pain medication to manage the pain and the fear of this natural phenomenon called periods. In therapy, this is what is iterated. That menstruation is a completely natural process and if there is a fear of menstrual blood then gradually, the woman is encouraged to accept it as a natural body function which plays a major part of her being a woman.
Sleep tight at every good night!A good night's sleep! Oh, what would some of us give for that luxury! Sure, you can blame it on the fast paced world and the things you have to do to keep the competition off your turf, and millions of other reasons to be sleep deprived. Yes, sleeping soundly and regularly is well within our control. Maybe it has eluded you so far and you are caught in a vicious circle of staring at the ceiling for hours on end; so read on to see what simple things you can do to gently drift off in to the arms of nature's greatest restorative- beauty sleep. Do's and don'ts for beauty sleep Fix a regular bed time, so that your brain will adjust to this by sending sleep signals to the body. If your bedtime is completely at the mercy of your activities then even as fatigue sets in the body will refuse to obey. So, even as your body is screaming for rest, the mind does otherwise. This is where good old discipline comes in to play. Take in to consideration the activities which are absolutely necessary to do and note the frequency with which they are likely to interfere with your bedtime before setting a realistic bed time. Initially the mind will refuse to obey, and you are most likely to get up, after tossing and turning in bed, to switch on the computer or whatever it is that you do when you cheat your bedtime. Rest assured, in a couple of days the brain will get used to this sleep routine and prepare you for shut down. Sleeping well also largely depends on how stress free you are. If the mind is in a state of constant excitement or anxiety, sleep will elude you. So when you lie down to sleep you need to fade out and blank everything out- joy and sorrow; expectations and ambitions, all of these out for later access! Tell yourself that tomorrow is another day and what you need today, is a state of neutrality! That's what most Indian philosophers would want you to do anyway. A good eight hours of sleep may depend largely on our minds but external factors can matter too. Sleep comes easily when your mattress is comfortable and not too soft or too hard. Use a pillow that won't give you neck pain, as any discomfort in the neck is likely to throw sleep off gear. Wearing clean night clothes can give you better quality of sleep. That goes for the bed spread as well.  Try this for yourself. Tight and uncomfortable night clothing is not recommended as this will only make you wriggle about for comfort. A cozy blanket and some clean nightclothes make great bedtime mates. Some people have a nightcap to help them sleep better while others still, drink themselves to sleep. Alcohol in large doses can only numb but does not help you sleep and you will only find yourself waking up frequently. Sleeping pills can be habit forming and might have serious side effects in the long run. So try simple remedies like a glass of warm milk or hot chocolate before bedtime to help you sleep better. Avoid stimulants like coffee, tea or nicotine before bedtime as that can keep your nerves all hyper thus making sleep quite difficult to come by. Computers and television are also largely responsible for us staying up late and disrupting our sleep patterns. We often find ourselves mechanically flipping channels or browsing without any real need for it. Try and go offline before bedtime, especially if you want to be able to schedule your sleep time. Television or movies can excite the brain and then you will find it difficult to fall asleep. So about an hour before bedtime switch off the telly or computer and just sit quietly and do some deep breathing exercises. Just sit cross legged for about ten minutes and relax your body. You are now ready for a deep slumber.
Good and bad calories-How do they affect weight loss?Not all calories are bad calories. Surprisingly very few people are aware that good calories are quintessential for burning fat and can rather help you in losing weight. So, it's very important to know how to differentiate between good calories and the bad ones. What is a Calorie? In scientific terms, one calorie equals to one unit of energy. When the term calorie is being used in relation to nutrition, it means consumption of energy through what you drink and eat and use of energy for carrying physical activity. Many people think that in nutritional terminology, calories are only associated with drink and food; but the truth of the matter is that everything has energy is calories. For example, since coal provides you energy it contains calories. 7,004,684,512 calories are equal to energy produced by 1-ton of coal. Coming back to weight loss, 100 calories of fiber and protein is not similar to 100 calories of a cake. This is because there are good and bad calories and much like us humans all calories are not equal. Calories are the measuring units of energy that are produced by the food once it reaches your body. This energy works on the law of physics and hence less energy intake leads to weight loss and vice versa. Varying types of Calories Different types of food provide varying calories or energy amount to the body. The analysis of a tightly scrutinized weight loss experiment has revealed that when people of two different groups were fed the same measure of calories albeit from varying food sources, the weight loss was almost similar. However, the effects of weight loss were variable; like uncontrolled emotions, cravings, hunger and more. This happened for the same reason that some calories are good and some calories are bad. Good and bad calories Sugar is a powerhouse of energy. But if you keep on eating only sugar all day long it will be suicidal. This is because; the calories present in the sugar are devoid of any nutrients and your body cannot function without the right balance of different minerals, nutrients and vitamins. Most food not only carry calories but they also constitute a complex mixture of additives, fiber and nutrients. These mixtures of varying components directly affect the leptin hormone that controls the hunger trigger in your body. These hormones tell the body to either burn the fat or store it. The process of weight loss is made complicated by the fact that biologically our body is programmed to protect the fat stores so that they can be utilized during starvation. So, the question remain, which calories should you eat to lose weight but still keep on getting the required amount of energy? Eating lean protein, healthy fats and unrefined and unprocessed carbohydrates such as fruits, beans and vegetables are the best for losing weight. Calories with more nutrients are the best The foods that do not store fat and make us eat again and again, are the ones you should eat as good calorie food. Choosing them is simple. These are the same food that humans used to eat before processed food was invented. For example; avoid using the processed whole grains and switch over to brown rice instead of the polished white rice. Also, stone-ground whole wheat, oats or quinoa bread is much better than the white bread. Replace the processed carbohydrates from your platter with whole grains and vegetables to lose weight, control hypertension and blood sugar. Use fats derived from plant sources such as olive oil or nut oil. Eat lean protein more such as chicken and fish.
Dos and don s during heat crampsHeat cramps can affect people who exercise or work in the heat. It could be due to dehydration, so if you are going to be active in the heat then you need to drink a lot of water even if you are not thirsty. Before going out, find out what the temperature is and do not exercise outdoors in the heat. Heat cramps may not be as serious as heat exhaustion or heat stroke, but the condition needs to be treated with the same urgency. People who are on low-sodium diets may be affected more than others. Heat cramps may seem mild, but they can be the first sign of heat exhaustion, so pay attention and stop all activity, and rest. Here is what you can do and what you should avoid if you suffer from heat cramps: Dos : If you have muscle spasms and the muscles are unable to function properly, then immediately stop all activity. Get inside a room or go into the shade and take some rest. Raise the feet to 12 inches above the body. Gently massage and stretch the muscles. Wet a paper towel or handkerchief and drape it around your face, at the back of your neck and underarms. Drink a clear natural juice or a sports drink to get the electrolyte balance back. Do not go out in the sun again even if the spasms have subsided. If the cramps last more than an hour then go to a doctor. If you are on a low-sodium diet then tell the doctor about it. Don s : Don take any painkillers or fever tablets as they could cause harm. Avoid caffeine, alcohol, and sugary soda drinks. Don rub alcohol on the muscles. Don drink ice cold drinks as they can cause stomach cramping. Don take salt tablets unless the doctor has prescribed them. Don do your full quota of exercises if the heat is getting on to you. Don stop drinking water even if you do not feel thirsty. Don resume any strenuous activity for several hours after a heat cramp. Prevention:Prevention is always better, so it’s a good idea to reduce exercise in the summer, especially when it is extremely hot. If people are working outside, like construction workers, then they must take more breaks, keep their heads covered and sip on water after every 10 minutes to prevent heat cramps. Always plan ahead and get acclimatized if you know you have to do a physical activity in the heat that could cause sweating. If you are an athlete, then do take a mix of sports drink, water, and juices to maintain the electrolyte balance. Always carry water with you if you are playing any sport in the heat. All events must be planned at a time when the heat is bearable and not when it is too hot. Keep a close watch on the person if there are signs of vomiting and nausea along with flushed skin. Rush them to the hospital.
Thyroid may make your heart flutter!Thyroid is a small gland situated in the area of neck. In Greek, thyroid means the shape of a shield. Yes, thyroid gland is vital to a variety of important body functions and does act as a shield. But what happens when the shield is disturbed and goes weak? Thyroid dysfunction is recorded in approximately one to four people out of hundred Thyroid link to heart A research study was conducted in 2009 by Weill Cornell Medical College researchers. It was done to investigate and analyze the genetic link behind rhythm control of heartbeat. They found that the genes that are responsible for synchrony and rhythm in the functioning of heart are also closely connected to the thyroid hormone synthesis and could cause dysfunction of the thyroid. Thyroid activity directly influences the metabolism, blood flow and electrical activity of the heart. When there isn't enough thyroid hormone (low levels), the patients complain of low energy levels, fatigue and reduced heart rate. On the other hand, with increased thyroid hormone levels in the blood, patients report symptoms of hyperactivity of systems. There is diarrhea, palpitations, increased heartbeats and advanced cases show arrhythmias of heart, where normal beating rhythm of heart is disturbed and becomes irregular. Thyroid hyperactivity can be appropriately controlled with regular medication. Understanding arrhythmias When the rhythm of the heart is disturbed, it becomes irregular - this is called cardiac arrhythmia. There are various types of loss of rhythm - heartbeat is too slow (that is, the cycles are taking too long to complete), too fast (the cycles are repeating too quickly), too early (that is, before a cycle is even completed, another starts), too irregular (this is called fibrillation, where no specific pattern may emerge). The patients who have arrhythmia will often come with complaints of dizziness, shortness of breath, suddenly feeling weak or lightheaded, fainting and feeling of a flutter in chest (flutter can be understood as light but quick flapping of wings by a bird). Arrhythmias are usually harmless and most people would continue to live a healthy life for years with arrhythmias. But that does not mean it can be ignored. There is a battery of tests available to diagnose and indicate the seriousness of arrhythmias and let your doctor take a call on the line of treatment. If you have a thyroid dysfunction, get your heart checked immediately. And if you have faced arrhythmias, get your thyroid checked immediately. Both the conditions are controllable and treatable; there is no cause to worry over what could go wrong. Just be vigilant and informed.
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
The link between oral sex and cancerSymptoms of oral cancer: The common symptoms of oral cancer include: Red and white spots on the tongue or the lining of the mouth, inflammation of the mouth which continues well over two weeks, mouth ulcers which take over three weeks to heal, discomfort and pain during swallowing food, and lastly, sensation that something is stuck in the throat. HPV types and their nature: There are over 100 different types of HPV. Out of these, 15 have been found to cause cancer. These 15 types of HPV are called high-risk HPV. The HPV types which are found in the mouth are sexually communicable and the primary means for its transference is considered to be oral sex. It could also be carried through anal and vaginal sex, causing laryngeal cancer, anal cancer, cervical cancer, tonsil cancer, vulval and vaginal cancer, and penile cancer. Some of the HPV types get passed through skin contact. These cause warts, especially in the genital region. These types of HPV which cause the warts are less likely to escalate and cause cancer. Though there is no determinate answer as to how common the HPV mouth infection is. Advanced studies during the 21st century have put forward the role of HPV16 in new types of cancer. This was done using DNA testing. Through a medical study, it was found that the most vulnerable groups are: People in the age group of 30 to 34 and 60 to 64 years old. People who have had over 20 sexual partners in their lifetime, around 20% suffer from HPV oral infection HPV leads to cancer?: HPV does not directly cause cancer. It stimulates modifications in the cells which it has infected, like those in the mouth or cervix and due to the modifications the cell becomes cancerous. In only 10% of the cases where the patient suffers from HPV infection does cancer develop. The infection generally treats itself and is removed naturally within 2 years by the body. The chances of progression of the HPV infection into cancer is increased by smoking and drinking. Smoking injures the immune surveillance cells. Due to this injury, they are not able to fight the virus and the virus continues to persist over 2 years, leading to cancer. Vaccinations: In the United Kingdom, girls (aged 12 and 13 years old) are vaccinated against HPV. This vaccination protects the women against cervical, vulval, and vaginal cancers. Men and boys also take vaccinations against HPV, though it is not pursued as strongly as in the case of women. This leaves men who have sex with other men at a greater risk of getting oral and anal cancer. Even though the link between oral sex and cancer is not completely proven, what we do know is that oral sex causes many other infections like gonorrhea, herpes, syphilis, and chlamydia. Did you know that a very low percentage of people (only 10%) who are infected with HPV virus develop cancer? In 90% of the cases, the infection is naturally cleared by the body within two years. The natural process is, however, obstructed in those who smoke and drink.    
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