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Caught in the snore snare....A real nightmare!Snoring is caused due to obstructed air movement during breathing while sleeping. It may suggest an underlying medical problem like obstructive sleep apnea. Studies have also revealed a correlation between snoring and risk of heart attack. There are different reasons for snoring and to find out the exact reason and the right solution is important. Snoring affects the quality of sleep can cause irritability and fatigue. Snoring causes poor quality of sleep, irritability, lack of concentration the day after the deed. Snoring is a tad like fingerprints , no two sets are the same and so it is with snoring, There are different rhythms or snoring patterns and even the reasons for snoring vary. Snoring or that irritating sound which people make through their mouths and nose while asleep happens because of narrow airways failure of air to pass through the respiratory system easily. The air vibrates against the obstruction in airway causing the sound of snoring. The air is unable to escape normally through the airways and hence it causes that grating sound with each inhale and exhale. Yes that sound which makes you wish you could smother the fella with a pillow. We say fella because men are more prone to it than women. Snoring can happen due to various reasons: Habits: Those who smoke and drink regularly are likely to have a more relaxed set of jaw muscles causing them to snore readily and loudly. Weight: People with excess weight and poor muscle tone are likely to snore more. Age: The wide open mouthed gape kind of snoring usually happens in old people as the breathing muscles lose their tone somewhat. Posture: General posture and sleep posture in particular can affect snoring patterns. Especially, sleeping with the back flat against the bed constricts free exhalation. How to put a clamp on your snoring? If you have a snoring problem evaluate how serious it is and then take the necessary elimination strategies. Understand that your snoring can cause sleepless nights to your partners, family or whoever is within ear shot so instead of going in for fancy anti-snore devices which don't do a thing to help If this is a recent habit then consult your doctor and have him re-evaluate any medications that might be responsible. Try and establish a regular sleep time and ensure that you follow it to the T. Exercise to lose weight as losing flab around the throat can lead to better sleep. Ask a partner to awaken you if you snore too loudly as regular jabs in the gut can help train the mind to behave. Blow your nose out before bed time as clear air passages is what you need. Any nasal constriction or chest congestion is really what gets you started. Sleeping on your side is a better option than sleeping on your back. Before hitting the sack try and hum a few bars of the blues as singing can help tone the vocal cords and they are less likely to go into vibrate mode. According to help-guide.org there is a rather quaint method to cure snoring and that is to play on a certain musical instrument called the 'Didgeridoo' which is supposed to strengthen the soft palate and throat muscles. If you have no Australian connections then don't despair as rolling your tongue out from all sides before sleep can work just as effectively.
Make no bones about this - Men have osteoporosis tooOsteoporosis is a condition in which the bones of the body lose their strength gradually and become thin and brittle. This is most commonly seen in women who have attained menopause. The reason being the decrease in the hormonal levels, particularly estrogen. Studies reveal that 20% of sufferers are men. Falling levels of testosterone are one of the causes for men developing brittle bones. Men's bodies convert some amount of testosterone into estrogen, which is very essential in maintaining the bone mass. Genetic deficiency of the enzyme that helps the conversion of testosterone to estrogen also is a major factor for men developing osteoporosis. Calcium and vitamin D play an important role in developing the bone mass and in helping the bone grow. Exercising helps too. When you exercise, the muscle gets pulled and the bone responds by growing. Too much of indoors and sedentary work may make men get the less of all three and it eventually leads to weak bones and osteoporosis. Studies reveal that 20% of sufferers of osteoporosis are men. Certain medications like anti-seizure drugs, drugs for prostate cancer and steroids have side-effects that make it impossible for the body to use vitamin D. Using them for a long time reduces the bone mass density and leaves the bones brittle making them easily prone to fractures. Smoking is a vice that has to be quit for more reasons than one. An analysis of several major studies on the effects of smoking shows that smokers have a 55% higher risk of hip fractures and low bone mineral density than non-smokers. Nicotine has also shown to have a direct effect on bone cells. A long list of medical conditions like diabetes, rheumatoid arthritis, and digestive and blood disorders can take a toll on your bones. Long term medications for the same also have side-effects on the bones. How to prevent osteoporosis? Exercise- As young boys, men have usually been exposed to a lot of bone building exercises through sports. This helps in building up on the bone strength and comes in handy in the later years. A brisk walk for 30 minutes 5 times a week and moderate impact exercises help in maintain the bone mass and reduce the thinning of bones. Calcium intake- The daily calcium needs for men is the same as women. Hence, the dietary recommendations remain the same too. 1,000 mg of calcium a day from ages 19 to 50 and 1200 mg of calcium a day if you're over 50.Along with this, make sure you get the required dose of vitamin D too, so that the calcium you eat is absorbed properly. The standard recommended dietary allowance is 400 IU. Some doctors advise to increase the intake to 800 IU. Regular medical checkups will help you to know beforehand about the risk factors and the necessary precautions you will need to take.Osteoporosis in men is as much a reality as in women. However, there are ways to avoid it too. Awareness about the condition and about the ways to prevent it can help keep osteoporosis at bay. Bone mass matters. It could mean the difference between a hip fracture later in life - or keeping an active, high-energy lifestyle.
Hairy tale: Hirsutism in womenThe condition is called Hirsutism where women grow coarse hair just like males on the face, chest or elsewhere. The primary cause for Hirsutism is hormonal imbalances by the over stimulation or excess production of male hormones (present in minute quantities in females too). The thickness of hair that grows largely depends on our genes and at times Hirsutism in women may be just a hereditary trait rather than an imbalance. Self care and medication can take of it in such a case. Idiopathic Hirsutism is a type of this condition where there is no possible cause for the male type hair growth. These women have regular menstrual cycles and no Androgen excesses, yet they have Hisrutism. Hirsutism with excessive bodily and facial hair, usually in a male pattern, in women may be present in normal adults as an expression of an ethnic characteristic or may develop in children or adults as the result of androgen excess due to tumors, or of non-androgenetic or other drugs. Hirsutism can make its appearance at menopause or soon after as there are a lot of hormonal changes that occur in the female body, and in certain cases women grow hair even on the lip, nipples, abdomen and upper shoulders. And just as men go bald there can also be a receding hairline and baldness in women accompanied by a deepening of the voice and enlargement of the clitoris. If the hair growth occurs at puberty then a doctor's evaluation is most essential as it could be more than just Hirsutism.
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.
Bonding with the babyIt is an immense pleasure to hold a baby in your arms, isn't it? The bonding between amotherand her baby starts within the womb itself. When the baby is born, a few parents bond with the baby within minutes. But for others this may take some time. If the baby is taking time to respond to your affections, don't worry, here are some tips to help you with the bonding. Babies respond to the mother by making sounds, grasping, smiling, or crying. Touching, holding, kissing, cuddling, talking and singing help build a bond with your child. Infants prefer a human face to any other stimuli. So face your child as much as possible. The attention span of a new born baby is quite short. Hang a colorful object on top of the pram, cradle,or cot. Your baby already likes toys of different shapes. Various reflexes develop by the fourth week after birth. These include sucking, grasping, searching for the nipple and blinking. Baby may gaze at you some time. Respond by nodding, smiling, and talking to the baby. Babies are sensitive to their surroundings. They respond to music or the phone ringing by staring at it quietly. They observe toys keenly, spot colours and become happy at times. These are heart warming moments for the parents. Father's care usually builds a protective and secured feeling in a child which he carries for life and prevents building of any unreal fears in him in later life. So dads should care for and make their babies feel secure. You love to touch your bundle of joy, right? Babies love, enjoy, and need it as well. Skin-to-skin touch helps growth and development of the child. Mom's touch soothes the baby when he is irritated. Start reading to your child. It is never too early. It helps the development of reading skills and language. Babies enjoy pictures in the book. Even if baby can't understand words, they love to hear the parents' voices. During the first few months, they understand little of it, but they are thrilled by listening to you. Have a short reading session with your child daily.Dads can try this trick to make the baby sleep. Carry her around while patting her very gently on back.
Lost in wonderland? - Absentmindedness!The Daily Telegraph reports that on an average every adult in UK forgets three things per day. Forgetfulness is a human tendency. If this absentmindedness or forgetfulness is limited to forgetting three to five things per day, then it can be left unattended. However, if you or a near one is facing a lot of trouble in your daily life due to this habit or problem, you should immediately have a consultation with your doctor. Mystery behind Absentmindedness According to Maria Jonsdottir, an investigating neuropsychologist from Iceland, absentmindedness is the mental lapses that usually happen in connection with the actions that are routine or well-rehearsed. You can perform these actions without any need to be careful. This includes regular actions such as squeezing out toothpaste or moisturizer from the tube. These action slips are very common and if you observe carefully, you do forget some such regular things every day unknowingly. Psychologists believe that an individual makes such mental lapses around 30 times in every week. On an average, the nervous system of a human brain runs quite efficiently. However, sometimes temporary fault may develop that may make you use incorrect word or slip to your native tongue while conversing. This does not mean however, that something is wrong with your brain. When the team of Jonsdottir surveyed around 200 people, they found out that on an average the slips are 6.4 per week although the number also greatly depends upon the gender, intelligence level, and age. One startling fact that was discovered is that most of the events of forgetfulness occurred before 8 p.m. that means people tend to forget more during the daytime than in the evening. Apart from a momentary lapse in the functioning of brain efficiency, other reasons that can lead to increase in the incidents of forgetfulness are high stress levels, mobile phones, e-mails, and busy lifestyles. Today, people are pressed for time and they have more work at hand than time and that has increased the occurrence of forgetfulness. Types of Absentmindedness A team of neuropsychologists has divided these mental lapses into five categories. The most common are the storage failures in which people cannot recall what they had planned for a particular occasion or they can recall the action, but cannot remember for whom it was meant. Another category is test failures in which people come back home to check whether they have turned the light off and find out that they have already done so. Discrimination failure is another category of absentmindedness wherein you for a moment fail to identify the difference between your things and others'. During the study, a male participant accepted that he picked up the jacket of his female partner thinking it to be his own. Sometimes you put books in the dustbin and the trash on the shelf and laugh at your behavior a moment later when you find out what you have done. This is discrimination failure. Another mix-up includes program assembly failure wherein you put salt in the tea instead of sugar or you just do not keep the right things at the right place. The fifth one is the sub-routine failure wherein you go to the market to buy tea and instead come back home with coffee. The research proves one thing that if you are absentminded, it does not mean that you have a bad memory or can suffer from dementia as is widely publicized in the media. It is perfectly all right to forget or being an absentminded person. Sometimes the incidences of absentmindedness can increase due to fatigue. A good sleep and rest can fix the problem easily.
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?
Aerobics: dancing your way to healthAerobic exercise is any comprehensive activity that makes you breathe hard while exercising your large muscle groups at a standard, even pace. The body uses stored carbohydrates and fats for energy. What is aerobics? Aerobic literally means having or providing oxygen or an activity that takes place only in the presence of oxygen. What is aerobic exercise? Aerobic exercise is any comprehensive activity that makes you breathe hard while exercising your large muscle groups at a standard, even pace. The body burns stored carbohydrates and fats for energy. Thus aerobic exercises help the body to utilize oxygen efficiently with increase in respiration and heart rate. What are the best ways to do aerobic exercises? There are number of ways by which you can exercise aerobically. Some easy and best ways are: walking, running, biking, using stationary bike, using stair stepper, elliptical machines or rowing machines, or joining an aerobic exercise class Benefits of aerobic exercises Fat reduction: Aerobics burns calories and body fats directly while using oxygen to produce energy. So this is the healthiest way to get rid of extra fat.  Strong heart: Aerobic exercises not only use your larger muscle groups like hamstrings, but also strengthen the heart muscles. This improves heart function resulting in improvement of blood and oxygen supply to all body parts, which provides healthy nourishment to body cell and removes toxins. Improves breathing: Exercises improve your lung capacity and function,which improves oxygenation, or competence of respiratory system to deliver oxygen to all body parts. It also improves overall health of the respiratory system. Cholesterol control: LDL cholesterol is bad cholesterol mostly responsible for clogging of arteries and HDL is good cholesterol. Aerobic exercises invariable increase the amount of HDL and lower LDL cholesterol thus preventing fat deposition and plaque formation and maintaining optimal blood supply to heart. Other benefits: Aerobics is the best exercise when it comes to prevention of various diseases like hypertension, diabetes, stroke and arthritis and osteoporosis. It helps to keep mood elevated and cures depression and boosts immunity. Make sure to incorporate some form of aerobic exercise in your daily routine.  
Top 10 tips for weight maintenanceTIP 1: Stay Calm and PlanDon't worry about your weight excessively. This will only result in stress which can be counter-productive to your pursuit. Remember that you have reached the goal you had to and you are strong enough to sustain it. Take one day at a time. Do not think about how you are going to keep it forever. Just focus on the next day. TIP 2: Health JournalKeep a journal where you note down your eating and exercising patterns. Write down what you eat, plan your meals, drink adequate water, and form an exercise regime. Did you know that you can include an activity within your life as a habit by performing it for 21 days? Do these things not because you have to but because they are good for your health. Slowly, they will become a part of who you are. TIP 3: Being Healthy Is A Lifetime DealOne of the greatest mistakes that people do is to think that once they have lost weight, they can return to their early eating habits. Remember that your health is with you for life. Shift your perspective from 'I have to become thin' to 'I have to be healthy.' Once you do this, you will find it easier to stay healthy for the well-being of your body. TIP 4: Be RealisticWhen you are planning your lifestyle, don't take up unrealistic goals. This is one of the reasons why weight-trainers say that the best way to reduce and sustain right weight is to make it 'your life.' Eat right, sleep well, and drink lots of water. These three, if done properly, can help you to have the right body weight. If you have any rules like 'don't eat cake or pastries ever,' 'quit drinking,' then rethink about them. Are you going to be able to never eat sweets? The primary goal is to make a balance, choose the middle path. TIP 5: Get An Idea Of Your Weight-PatternMany people stop weighing their body once they have reached the ideal weight. They think that the scales are only for the fat ones. A person with such a perspective is only looking for slim bodies and not healthy ones. Remember that your weight is not a judgment of your appearance, but a barometer of your health. So do not stop doing the weekly weight checks. Keep a report of your weight every week and check out the causes for any abnormal changes. TIP 6: Accept Your Limitations And Learn From ThemEveryone has their ups and downs. Don't get discouraged and be angry at yourself if you binged on a donut on a cloudy day. Everyone makes mistakes. It is not the end of your weight maintenance. It is simply a blip. Learn from it. Know what the causes are for it and work on making sure you react to the cause differently next time. TIP 7: Thirst And HungerYour body could confuse your thirst for hunger. So, if you are feeling hungry really soon after your previous meal, then start by drinking a glass of water and check if you feel better. If you do not, then it is time for a light healthy snack. TIP 8: Inspire YourselfWeight maintenance is primarily a psychological task. Till the time you were reaching the ideal weight, you learn everything you had to about being healthy. Now, you have to make sure you don't let obstructions stop you from sustaining this healthy lifestyle. So, join other people who are only in the process of maintaining their weight. Become part of the running blub or catch up with a health conscious friend regularly. TIP 9: Mind Over MatterBalance your eating patterns. If you think that you will be going out for lunch, then have a healthy breakfast and cut down on the dinner. You might be craving for a dessert, so you can have salad for the main course and treat your sweet tooth. Talk to yourself about what you are going to eat. Ask yourself if you really want to eat it because you are hungry or are there any other reasons for it. How would you feel about it after you are done eating? TIP 10: Celebrate Your AchievementsLastly, be proud of your weight maintenance program. Celebrate the fact that you worked hard towards making sure you have a healthy body and invite people who were part of your pursuit. Embrace your body and toast to the next year of a healthy lifestyle.
7 Pains you should not ignoreWhen the body cries out in pain, most of the times, you know what is bringing that pain, and you do what will help relieve the pain. For example, a serious workout may cause sore aching muscles, for which you will rest a day or two, or take a painkiller. What does one do to know why a body part is paining? One needs to sit up and take notice! The pain could be anything, from a heart attack, to an aneurysm, and could cost you your life! Pain in the head: Headaches are the most frequent pains that we suffer from. Headache could be due to a migraine, due to staying too long in the sun, due to a cold, or simply due to working too long without a break. However, in case you have a headache, and are not able to pinpoint to an obvious cause, rush to the emergency room. Headaches with no apparent cause may be due to a brain hemorrhage, a tumor in the brain, or an aneurysm in the brain arteries! Get yourself checked as soon as possible, if you keep getting headaches for no apparent reason. Pain in the jaw: This could be due to a caries ridden tooth. But most often it is due to an impending heart attack. The classical left sided chest pain radiating to the left little finger is not always seen in all cases of heart attacks. Pains to the jaw and the back are reported very frequently. Often, people tend to take the pain in the jaw lightly, and brush it off to a tooth problem. This may be potentially life threatening, as you never know the severity of the attack! Tingling, numbness and burning of the feet: Diabetes mellitus is a silent killer. Peripheral neuropathy is often the first complication of diabetes. Tingling numbness, and burning in the feet may be attributed to wearing tight shoes and to keeping your feet suffocated in socks all day long. Dipping your feet in a tub of cold water will give you a good night's sleep. But do not let it go at that. Get your blood sugar levels checked before it is too late! Pain in the calves: Do you get nightly pain in your calves that get better with putting your feet up? This is due to long standing hours at workplace, you may say. True, it is due to that. But, it is not something to be left unattended. Calf pains are due to deep vein thrombosis that occurs when the stagnated blood in the veins starts to form clots. The danger here is that the clot could break off and travel to your lungs causing pulmonary thromboembolism that is fatal! Take a break regularly and put up your feet frequently. Let the blood flow and not stagnate! Pain in the back: Most commonly, back pain is caused due to arthritis, and improper sitting postures. But if you suffer from high blood pressure, and are an alcoholic and smoker too, do not take your back pain lightly. It could be due to a heart attack or an aortic dissection! Pain in the abdomen: You may attribute this pain to gases, over eating or indigestion. While these may be occasional causes, persistent pains need to be checked. It could be anything from a gall stone, to gastric ulcers, to a swollen liver, or maybe even pancreatic cancer! Vague, medically inexplicable pains: When you have a recurrent headache or a stomach ache or a backache and you come out with a 'perfectly healthy' report after visiting all the specialists, it is perhaps time to seek the help of a psychiatrist or a counsellor. Your pains could actually be a symptom of depression. Psychosomatic pains are on the rise. The stresses we face in our lives everyday get pushed to our subconscious, and eventually are pushed up bodily in the form of unexplained aches and pains!
What Is slowing down your sex driveBeing sleep deprived can lower the levels of sex hormones in your body. Are you feeling dull lately and wondering what happened to your sex drive? May be, the stressors in your life are also creeping on to your bed. Find out some of causes that could be the reason behind this. Lack of sleep: Hectic work and busy life takes a toll on everybody. The first hit is your sleep - the hours go down, the quality reduces and the effects are insufficient. Sleeping six hours or less can push down the levels of testosterone in the body. Testosterone is the hormone that influences sex drive for both men and women. Though it is primarily a male hormone, it is also present in small quantities in all women and drives their sexual desires. Emotional problems: Stress, tensions, depressions, irritability, anger are negative emotions that lower the sex drive. Try not to bring the work pressures home. Marital problems or relationship issues may be hampering your bond with the spouse. Weight gain: Being overweight makes you lazy, tires you easy and decreases your self-confidence, especially in bed. When someone is not comfortable with his/her body image, it affects their sex drive. The pill: If the wife is on the contraceptive pills. The period of ovulation is the time in a menstrual cycle when there is a surge of testosterone in a woman's body. During this period, she experiences a strong sexual desire. The pills regulate the hormonal activity and reduce the sex drive to some extent. Alcohol: If you are feeling a little tipsy, be prepared to pass out and fall in deep sleep as you hit the bed. No scope for sex drive here. In the long run, increased consumption of alcohol can affect erections and make you generally dull. Diabetes Mellitus: Uncontrolled high blood sugar levels lead to impotence in men and dryness of the vagina in women. It also increases the risk for urinary infections. This results in lowered sex drive. Medicines: Some medicines like the anti-allergic ones and the antidepressants reduce the sex drive. Don't let complications of life affect the intimacy in your relationship.
Female circumcision - Health EffectsThe procedure is carried out by either snipping off a piece of the clitoris or removal of all external genitalia for non-medical reasons. The procedure is carried out outside hospitals and the environment may not be effectively clean and could lead to infection. The painful procedure causes a lot of fear and distress. Some countries have begun to use healthcare personnel to cut the genitals, which reduces pain, bleeding and infection but it does not mean that it is acceptable by the United Nations. Even though the United Nation has termed female circumcision as a violation of human rights, there are millions of girls suffer because it is a requirement for girls so that they remain pure. It is supposed to lower female libido so that they do not indulge in any kind of sexual activity before marriage. Immediate complicationsGirls are likely to suffer severe pain besides the fear that accompanies such a procedure. It can cause them more pain when they try to urinate. If there is severe bleeding, it can lead to haemorrhage. The tissues that form the genitals are severely damaged and healing may not take place immediately and sores can form leading to more pain. Girls can retain urine for fear of the pain. There is always a chance of contracting tetanus or other bacterial infections like sepsis which lead to formation of pus. Besides cutting, procedures can include pricking, piercing, incising, scraping, and cauterizing the genital area. Long term health problemsBesides the immediate problems, female circumcision can lead to long term effects including infertility. The girls can be subjected to urinary tract infections and bladder infections that can recur again and again. Sometimes cysts may also form. There are chances that there could be increased risk of problems during childbirth which could in extreme cases result in the death of the newborn baby. According to UN estimates more than 125 million girls and women are living with female circumcision. Women may be subjected to continuous surgeries especially in those cases where the vagina has been stitched to make it narrow as part of the circumcision process. Once the girls are married, the vagina is unstitched to have sexual intercourse. During childbirth, the vagina may need to be cut again to deliver the child and then stitched up again. This is a continuous problem and women should be spared from this pain and trauma.
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