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Health check up checklist for men Prostate Cancer - Prostate cancer is the lesser known killer in men. It is a slow growing cancer, but at times, its symptoms can be aggressive as well. Detecting prostate cancer at its onset can help in treating it effectively. Tests include a digital rectal exam and a blood test for Prostate Specific Antigens (PSA). Testicular Cancer - This uncommon cancer can affect any male between the ages 21 to 55. A physical exam during yearly medical checkups is recommended for all men. Men having a higher risk, with family history, should speak to their doctors regarding additional tests for screening. Self-examination through regular gentle palpation of the testicles to notice any change in shape or size, presence of lumps is also suggested by doctors. Colorectal Cancer - This is the second most common cancer in men. Men over 50 and younger, if they have a familial risk, are suggested to get a screening colonoscopy done to detect this cancer. It usually starts as a polyp that grows and invades the nearby areas to develop into a full-blown cancer. The polyps, if detected early, can be removed and cancer prevented. A CT scan or a double barium enema can also help in detecting polyps. High Blood Pressure - With the kind of lifestyle men lead today, almost every other man is bound to have BP issues. Regularly checking the BP is essential as it helps detect high BP which may lead to a variety of other problems including stroke and heart attacks. The sooner the detection, the sooner the measures for control. Cholesterol Levels - Bad eating habits, sedentary lifestyle, and mental stress can all lead to lots of cholesterol roaming around in your arteries. This will eventually clog the arteries and cause diseases like high blood pressure and atherosclerosis which can be life-threatening. Get your total cholesterol, LDL, VLDL, HDL, and triglyceride levels checked regularly and initiate timely interventions to bring them under control. HIV - This is the most commonly spreading STD among men. Due to its chronic nature, HIV is often detected accidentally when it may be too late. Regular tests for HIV detection are essential if one is physically active with multiple partners. Be safe though and use a condom. Glaucoma - It is extremely common and is one of the leading causes of blindness. Glaucoma has no cure, but it can be controlled well with timely detection. Screening tests should be undertaken by men under 40 years at an interval of 2 to 3 years after 35. A yearly test is recommended for older men.
Infertility at workplaceSince infertility among the younger age is increasing, it is important that a couple decides an early suitable date to attempt conception. Time and again it has been found that infrequency of intercourse is the cause of delayed pregnancy. It is advisable that the woman has a thorough examination by the gynecologists to identify the ovulation dates and for the man to have a thorough spermatic fluid check.  If both are normal then they could wait for a suitable date later. Should there be a problem the quicker it is attended to better. Also, early in the marriage they should start a fund which could be utilized for matters related to conception. For the male, the main treatment covers his personal sex life and a detailed examination of his spermatic fluid. It is the female who has to undergo many detailed tests and possibly surgeries which are expensive. It is often seen that not only the procedures for both take a toll on their personal and intimate relationship but also severely affect their finances which may come to a point that it does not allow them to complete the treatment as for e.g. the woman undergoing IVF may costs several lakhs of rupees. The treatment of infertility has improved greatly, but interferes severely with the work schedule. Working couples particularly women may have a hard time keeping to their schedules. Depending on their infertility diagnosis, many workplace challenges exist including the need to take time off to undergo tests and other appointments. It is difficult to balance the medical and surgical procedures with daily life and work. This is a difficult issue for many people as they fear their employer may discriminate against them for taking time off from work. Sadly in India there are very few employers who include medical benefits and cost of treatment for infertility. Suggestions have been given on stress dealing with infertility treatment and work. Here are few pitfalls to avoid: Do Your Homework: Review your organization's HR policies so you understand the amount of leave you have and other policies that pertain to your situation. You may be able to arrange for flex time or work from home on the days of your appointments, so that you do not actually miss any work. Be Honest:  Go to supervisor and let her or him know that you will be using your leave time and will give as much notice as possible. Honesty is the best policy. Remember people are inherently curious about the disease of infertility. If you feel the questions are invasive and make you feel uncomfortable, remember you do not have to answer the questions. You can respond nicely and let them know that you appreciate their concern but you are not ready to answer any questions. Your co-workers are asking question because it is human nature to be curious. In conclusion, not everyone needs to know what is happening with your reproductive health. At work place should medical help be available do take advantage of it.  This treatment has nothing to do with your performance at work. Go to work feeling confident that you will be able to perform your job and handle your workload during this time.
Bow legsCauses: Physiological - As mentioned before, bow legs are normal below 18 months of age. Thereafter as the child continues to grow the bowing begins to improve slowly. By the age of 3 to 4 the deformity usually gets corrected. Blount’s disease - This disease results in bowing of legs due to abnormality of the growth plate of the upper part of shinbone known as tibia. Growth plates are the growing end of the bones. It is diagnosed after the child is 3 to 4 years old. Rickets - Rickets is a group of diseases that occurs due to deficiency of vitamin D. Rickets is characterized by bow legs and other bony deformities. Most commonly rickets occurs in children due to deficient intake of vitamin D. Signs and symptoms: The bony deformity becomes visible when the affected child walks or stands. The uncommon walking pattern of the child is the commonest symptom. Bow legs usually do not cause any pain. However, persistent and severe bow legs cause discomfort to other bony structures like spine and hip. Test and diagnosis: The doctor at first asks questions to the parents regarding the development of the child. This is followed by physical examination of the child. Physical examination often suggests bow legs. If the doctor suspects an underlying disease, necessary laboratory tests are done. The doctor always asks for an x-ray of the affected legs to evaluate the severity and extent of bowing. Treatment: If the bow legs persist after 3 to 4 years or an underlying disease is detected, treatment is undertaken. Medical and non-surgical treatment- In cases of physiological bow legs, no treatment is required. The parents are reassured by the doctor and spontaneous resolution takes place by the age of 2 years. Continuous followup is advised for borderline cases. Children with Blount’s disease need treatment with a brace. Children with rickets need medical management by a specialist doctor. Additionally, they need advice and regular followup by an Orthopedic surgeon. Surgical treatment  - If the bony defects persist in children with bow legs even after medical and nonsurgical treatment, surgery is required to correct the bowing. Two types of surgery is advocated to correct bony deformity of the legs. Guided growth:  Growth of the healthy part of the growth plate is stopped and that of the abnormal part is promoted. This allows straightening of the legs. Tibial osteotomy: The shinbone (tibia) is cut and reshaped to correct the deformity. Then bone is fixed with screws and plate. In both surgeries a cast is applied to promote healing of the bone. Crutches may be required for a few weeks to prevent weight bearing on the limb. Later, physical therapies are advised for complete recovery of range of movements and regular activities. Prevention The parents need to be vigilant about appearance of any bony deformity in legs of their child. The child must be given adequate amount of vitamin D in diet or vitamin D supplementation to prevent development of rickets.
Stress - Even kids cannot escape!Often when we feel overwhelmed with stress, we go back in the past and reflect. We miss our golden days of childhood.We think of those days with fondness, miss the free and carefree times. We feel like becoming kids again. But the truth is that at no age are we free of stress and worries. It is just that with time, we move on to newer situations and every new stressor seems worse than the previous one. Children stress out too, some more than the others. Stressors Simple things like a test in school, a Physical Training class or poem recital could mean a lot of stress for the little ones. The desire to meet the expectations of parents or teachers also creates tremendous pressure on the children. They are eager to do well at all the times and the smallest failures can upset these kids immensely. Peer groups are difficult to manage. In childhood, the social maturity is not sufficiently developed to handle day-to-day conflicts. Trivial fights or comments from classmates and friends can lead to a long-lasting impact on the vulnerable minds. They get easily influenced by their friends. Elder siblings also play a major role. Some act as mentors, some as bullies. Some cause damage unknowingly, some are plain indifferent. Life is full of new things and childhood is a fast-track learning lesson. Every other day, there is something new a child has to do. Meet a new kid, learn a new subject, try to dodge a ball differently or ride a bicycle without side wheels; there is too much to learn. These cause anxiety and may make the child nervous. Performance pressures, technology, precocity, media influences, etc. are some of the other factors that add to the stress in childhood. Signs Watch out for subtle changes in moods and behaviour. With adults, it is easier to identify the stress and hence rectify it. But with children, it is quite a challenge. Most of the children are themselves unaware of the stress they are facing, they don't understand why they are feeling sad or angry or fearful. They are just not at ease. Inordinate crying or screaming is a common sign. Being withdrawn, aloof and quiet is another way by which kids express their tensions. Physical signs can be seen in basic physiological changes - in sleep patterns (oversleeping or inability to sleep), eating habits (not eating or eating too much), frequent aches and pains, especially digestion disturbances and headaches, etc. Managing childhood stress Pay attention to your child. Listen to what he/she is saying, but also try to listen to what he/she is not saying in words, although only in action. Help the kids open up to you, spend quality time with them and talk to them about everything under the sun. Be well connected with their school teachers and parents of their closest friends. If the need be, please don't hesitate to reach out and seek professional help from psychologists and child counsellors. "One of the luckiest things that can happen to you in life is, I think, to have a happy childhood." - Agatha Christie  
Afraid of the dark? understand your fear and cure it!Scotophobia, more commonly known as Nycotophobia, is a psychological illness, where the patient is afraid of the dark. Children are more prone to this fear, though it does affect quite a few adults as well. The dark often represents insecurity and uncertainty to children, and it symbolizes their entrance into an unknown territory. If the children are alone during their first few encounters with darkness, the absence of parents (who exemplify safety), tends to amplify this crippling fear. While most of us do actually possess this fear in relatively small amounts, as we grow up the fear diminishes. However, there are those of us who might carry this fear of the dark into their adulthood and in such cases, the fear is usually accompanied by quite a few intricate issues. People often tend to externalize a set of conflicting feelings about a certain situation, towards something else. For instance, you might be worried about your children; but your mind may externalize this fear, via your inefficiency at work. This process is called externalization. So, when it comes to the root of your fear of darkness, it is possible that at some point in your past, you experienced something untoward, which through externalization, inculcated this fear of darkness, deep into your psyche. Evolutionary Ties to Darkness: Many scientists have pointed out that this phobia might be linked to the process of evolution. Since predators hunt for their prey at night, we might have inherited this fear of darkness from our ancestors, who believed that darkness was a space where they could be attacked by wild animals. However, recent studies have shown that  Scotophobia begins at approximately the age of two in children, and thus, it cannot be said to be innate to us. In a study done by Ryerson University involving over 90 students, it was found that people who are afraid of the dark, are more likely to be poor sleepers, than those who are not afraid of it. More interestingly, it was discovered that any kind of noise made while the people with this phobia were asleep, frightened them the most.. Symptoms of Scotophobia: The first symptoms of this fear are the resistance to visit dark places and the yearning for company when such situations arise. However, many a times adults who are suffering from this fear, do not reveal it due to the added fear of embarrassment and this, sometimes, results in outbursts of rage when they are forced to go out for an event at night, or to confront the dark under any such circumstances. A person battling this fear may experience panic attacks, sweating and trembling prior to, or while staying in the dark. The blood pressure also rises, accompanied by chest pain and lastly, a difficulty in breathing. Diagnosis of Scotophobia: In children, this fear can be easily verified by their behaviour. However, adults might require further assistance, due to their natural resistance to openly admit to such a fear. Scotophobia can be diagnosed through a comprehensive psychiatric evaluation. Following this, your psychologist would be able to give you an idea of the source of your fear as well. Pursue a course of treatment immediately after the discovery of the phobia, which will ensure a faster and more effective recovery. Treatment of Scotophobia: The process of 'desensitization' is most commonly used to help with such a phobia. In this form of treatment, the patient is slowly exposed to the object of fear, in a situation where she/he will not feel vulnerable. This is done by asking the patient to confront the dark along with another individual who symbolizes safety for him/her. This could be a parent or a friend. Night lights can also be installed to gradually reduce the fear. You may try certain breathing exercises, which will reduce the panic attacks that accompany this fear. Hypnosis has also been said to be very effective in dealing with this phobia. If your psychologist sees fit, you might be also prescribed some medicines; antidepressants are given in some cases. Joining a self-help group is also a good option, in addition to your psychological treatment.  
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?
10 best and worst appetizersWhen you are munching on appetizers before your meal, the idea is to eat something that can trigger off the production of your digestive juices in the intestine, so that what you eat next, the food is easily digested. However sometimes, the appetizers are much more complex and heavier on your tummy and can actually reduce the metabolic activity and imbalance the digestion process. Here are some of the best and worst appetizers that are commonly served: Best Appetizers Vegetable Kababs: These highly nutritious and low calorie appetizers are a good alternative to fried items. Grilled vegetables or kababs are prepared by skewering red and green bell peppers, onions, tomatoes, mushrooms and zucchinis. To add to the taste, you may brush over some low-fat herbs and even garlic marinade. Two delicious vegetable kababs, will get you only 75 calories. Crab Cakes: Seafood offers you high nutrition and the best way to include the properties of seafood in your diet, is by choosing crab cakes as appetizers since these offer only 20gms of fat and 300 calories, while providing you with a high level of sodium (960mg). Spinach Salad: The best thing about good appetizers is that they are low calorie foods and provide great flavor and satisfaction while eating. One such fulfilling appetizer, is spinach salad. You can also use other green leafy vegetables to add more nutrition to the recipe. If you eat this appetizer before your meal, chances are, you will eat 10 to 15 percent less of the main course, which is certainly a great way to cut down on the calories. A cupful of fresh salad gives you only 80 calories. Beef Skewers: If you are in the mood to pamper your taste buds, but still want to stick to eating healthy, then beef skewers is the right option for you, in the appetizers section. These are usually served with peanut sauce in restaurants. You can opt for lean beef along with soy, garlic, hoisin, onions and barbeque sauce to make this dish yourself. Quarter to the pound is the recommended serving, which consists of 5 gms of fat, 130 calories and a high sodium content of 803 mg. Stuffed Mushrooms: Potato skins are a common appetizer people go in for, but these add more calories. Instead, you should opt for stuffed mushrooms that are way more delicious. The caps of mushrooms are stuffed with breadcrumbs and the cheese of your choice; and they provide only 50 calories per cup. This means that even if you eat six stuffed mushrooms, you are still within the limit of 300 calories. The worst appetizers are deceptive yet tempting in their looks and taste. But you should always keep a check on the ingredients before gorging on them, for your own benefit. Worst Appetizers Onion Blossom: Fried onions are certainly bad for your waistline. It is always better to eat a starter stuffed with more vegetables, instead of fried things. A restaurant preparation of onion blossom consists of 161 gms of fat, 1,049 calories and around 4100 mg sodium, which is more than double the limit required by an adult, making this appetizer a completely unhealthy choice. Cheese Fries: Cheese fries are one of the worst appetizers; these can be even more overwhelming than your meal itself, which is why health experts advise not to include this appetizer in any type of menu. Sometimes cheese fries actually come with more melted cheese on top, which is obviously worse. Spinach Artichoke Dip: Although this starter starts with the word 'Spinach', it is in no way a healthy appetizer. One dip of spinach contains loads of calories-1600, fat-100 g and 2500 mg sodium. It is certainly not the spinach but the cream base that is rich in saturated fat. Potato Skins: Potato skins have all the high calorie foods such as meats, sour cream and cheese. When you take one pop of these, you will be adding 150 calories, which is quite a big number. Moreover, these appetizers are not filling. A plateful of potato skins adds 1,340 calories, 1,850 mg sodium and 94 gm fat and yet leaves you hungy. Cheeseburger Skins: Although these appetizers look small, there are loads of calories packed in them. One order of Cheeseburger skins can total up to 1270 calories, with an added 2310 mg sodium and 82 gm of fat.
Sunburn: Overview and treatmentSunburns could also be accompanied by allergic responses to medicines, exposure to sun and sunscreen products, sight-related issues like reduced or complete loss of vision, as well as heatstroke. Over a long period of time, frequent cases of sunburn can result in cold sores, cataracts, skin cancer, and lupus.  The factors which will decide the vulnerability to sunburns are: Type of skin - The type of skin determines the vulnerability and intensity of the sunburn. The most vulnerable groups are those with freckled and fair skin as well with blonde or red hair. Regardless of the color of the skin, all skin types are vulnerable to skin cancer and proper sun protection must be used during times of sun exposure. Season - Summer days carry with them a higher probability of burning the skin. UV Index - This refers to the forecast of the strength of UV light on a particular day. This will let you know the cautionary measures you need to take in order to avoid skin damage. This is put forward on a scale of 0 to 11+ with 0 being the lowest exposure. Latitude - As you move to locations closer to the equator, the sunlight directly passes through the atmosphere to a greater extent. Age - Those who are younger than 6 years of age and those over 60 years are at a greater risk of getting sunburns. Altitude - As you climb higher and higher, the chances of sunburn are also greater since the amount of Earth's atmosphere to keep away the sunlight reduces. Every elevation of approximately 1000 feet, the UV exposure is amplified by about 4%. Location - If you are close to reflective surfaces like snow, water, ice, concrete and white sand, rays of the sun which get reflected off these might harm you. Time of the day - The rays of the sun are strongest between 10 in the morning and 4 in the evening. Though, the probability of getting sunburn are lower on cloudy days, it is possible for the UV rays of the sun to pass through the clouds and negatively affect your skin health. Here are the precautionary steps you can take to avoid getting sunburn: Avoid staying in the sun for a long period of time. Make use of sunscreen and choose clothing which cover your skin. In case you are suffering from sunburn, here are ways to treat it: An over-the-counter pain reliever: In order to lower the inflammation and relieve pain, use ibuprofen or aspirin. Anti-inflammatory condiment: Cortisone cream and aloe vera are two primary ways of reducing the inflammation. Cool bath: Take bath for about 10-20 minutes in water of cool temperature (make sure the water is not too cold). This will cut back the pain and irritation in affected area.  Do not use any bath oil, soap or detergent as this might increase the chances of allergic reactions and irritation to the injury. When drying yourself after the bath, do not rub with towel. Cold compressions: Try application of cold and wet compressions on the concerned region for about 20-30 minutes. Adequate hydration: Make sure you drink at least 8-12 glasses of water to help your skin to recover from the sun damage. Moisturizer: Once your skin begins to heal, use a gentle moisturizer without any scent. Blister treatment: In case you have blisters, do not try to pop them. This will lead to infection and marks.However, if you have large blisters which require to be drained, then pop them using a sterilized needle. Follow this by cleaning the area dry with gauze. After applying ointment to the area (Aloe vera or antibiotic ones like bacitracin and polymyxin B), wrap the area loosely using a gauze bandage. Make sure you do not tie it tightly and change the gauze daily to avoid infection. Medical attention: In case you feel nauseous along with fever, rashes and chills, then make a visit to the doctor. The following symptoms also require you to seek medical attention immediately: Pain in eyes with sensitivity to light, dizziness, high thirst without proper urination, painful blisters, and pale/cool skin.
Winter - When your heart feels the cold too!As per a study in America, 193.6 people of every 10000 people die of a heart disease every year. 53% of the heart attacks occur in the winter months. Heart diseases have a seasonal trend as found by medical research recently. A team of medical researchers recently conducted a survey which saw 10,000 participants between the ages 35 to 80 from around seven European countries. The study was conducted to see if there is any seasonal variation in the presentation of heart diseases. The participants were measured on the parameters of blood pressure, waist circumference, body mass index, blood glucose levels and blood lipid levels. The parameters were later adjusted for sex, age and smoking. The results revealed that the incidence of heart disease shows an upward trend in the winter month [Jan to Feb] as compared to the summer months [June-Aug]. The researchers accept that there is no logical explanation to these findings. A plausible cause being the fact that the eating habits change in winter. One tends to eat more which in turn increases the cholesterol levels leading to heart diseases. Several other theories are being put forth. According to one, during the winter months the body undergoes hormonal imbalance. The day and night variation in the hormone levels, especially that of cortisol varies. This results in a lower threshold for heart attacks. Yet another theory says that the cold temperature tends to constrict the arteries narrowing the blood flow to the heart tissue and this result in a heart attack. On the basis of this study, scientists advise that more attention is to be paid to heart health during the winters.
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.
Smoking causes impotence!Men who smoke heavily are twice as likely to suffer from impotence or erectile dysfunction. The link between smoking and ED has been established beyond reasonable doubt. Smoking causes a hardening of the arteries or blood vessels. For a penis to grow erect or tumescent there has to be a healthy blood supply. Now imagine the cross-section of a smoker's penis where there are plenty of blockages and hardening of the blood vessels. Can the penis then grow erect with so many hindrances to the blood? There is also an acute loss of sensitivity to the penis which is a direct contribution of smoking! Previously, alcohol was a hot favorite of the medical lobby when it came to 'impotence.' Wish smokers could say the same thing about moderate smoking! Even moderate smoking can make an existing condition of impotence worse. One could make changes to one's lifestyle and diet and curb stress to treat ED (erectile dysfunction), but all these will come to naught unless one really resolves to give up smoking permanently. Just within a few hours of kicking the butt, the body starts to repair itself. Of course, it may take longer for the blood vessels to actually undo the blockages and have a free run for the penis, but it will certainly happen, slowly and surely. Smokers may have an underlying condition of anxiety, which is made worse by nicotine, which in turn causes performance anxiety, not greatly helped by blocked blood arteries. So smoking not just makes you physically impotent, but also mentally impotent too. It is a powerful narcotic which is hateful to the body and spiteful to its salubrity. Please enroll into a 'stop smoking now' campaign with the help of friends or family. Check for any 'nicotine anonymous' programs in your neighborhood or just do it all by yourself. Otherwise, the only thing hard about your penis will be hardened arteries and lots of hard luck!
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