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Male infertility : An overview of the causesWhy men shy away from infertility tests? However, it is ideal for both the man and woman of a relationship to get infertility tests done. This would not only avoid unnecessary tests and expenditure later and could also result in prompt medical treatment of the problem. Following an appointment with a urologist/andrologist, the patient is instructed to provide a semen sample for analysis of the quantity and quality of the sperms in the semen. An additional semen test might be recommended for confirmation of the initial results. The semen analysis is an effective method of knowing what is going wrong in the reproductive system : No-sperm count (azoospermia) - Absence of production of sperms or the non-appearance of sperms in the semen. Sperm Morphology Issues - Issues related to the structure and form of the sperm. Low-Semen Production (oligospermia) - Production of low amount of sperms. Sperm Motility Problems - Abnormal movement of sperms resulting in incapacity to fertilize egg. Did you know that use of laptops placed on your thighs can result in increase of scrotal temperature? This could lead to abnormality with sperm production. Thus, using laptops is best when they are located on table or desks, away from constant contact with your genital region. There could also be a primary medical condition, the symptom of which could be manifested reproductively. The physician will suggest blood and urine tests, among others, for the same. There can be 10 major causes of male infertility : Semen : Semen refers to the ejaculated fluid containing sperms during sexual intercourse. There could be low or no count of sperm. It is also possible that the mobility of sperm is restricted. Sterilization : The cutting and sealing off the vas deferens (the tubes which carry the sperms from testicles to the semen) ensuring that your semen does not contain sperms is known as vasectomy. Though this process can be reversed, they are mostly not fruitful. Lack of sperms : Even though the testicles are producing quality sperms, it is possible that they do not reach the semen. The lack of sperms in the semen is medically known as obstructive azoospermia. Such a condition could be caused due to the blocking in one of the constitutive tubes of the reproductive system. This could be further resulting from an infection or a previous surgery. Ejaculation issues : Some men might find it challenging to ejaculate normally due to retrograde (ejaculation of semen into bladder) or premature (ejaculation in very short period of sexual activity) ejaculation. Medicine and drugs : Certain medications have been found to catalyze the onset of infertility. These include sulfasalazine, chemotherapy, anabolic steroids, and herbal remedies (for instance, the consumption of root derivates of Tripterygium wilfordii). The quality of semen can also be negatively affected by illegal drugs like cocaine and marijuana. Testicles : The function of production and storage of the semen lies with the testicles. In case of injury to them, the quality of the semen could be negatively affected. Causes of injury to testicles include a congenital defect, testicular infection, physical trauma, testicular surgery or cancer and undescended testicles (case where one or both of the testicles do not descend into the scrotum). Hypogonadism : This refers to the presence of a very low level of testosterone (male sexual hormone) which plays a major role in production of sperms. This could be due to tumors, Klinefelter's syndrome, or consumption of illegal drugs. Sexually transmitted diseases (STDs) : A series of sexually transmitted illnesses can result in male infertility, for example, chlamydia. Alcohol and weight : Consumption of over 3 to 4 units of alcohol per day can result in infertility in men. Both men and women are affected adversely due to obesity. Occupational factors and stress : Contact with certain types of pesticides, solvents, and metals can result in deterioration of sperm quality. Stress has also been associated with the loss of sexual drive resulting in lesser instances of sexual intercourse. Moreover, in case of severe stress, sperm production can be unfavorably affected.
Breast lumps- myths busted!The rise in the occurrence of breast cancer in women, since past decade or so, has made women, especially in the urban areas, very cautious about lumps in their breasts. Whenever there is a small lump in the breast, the first thought that comes to mind, is may be this is cancerous. However, instead of taxing your brain with worries, it is better to take action and consult your caregiver. Here are some of the myths that are regularly associated with breast lumps and the real facts related to the same. Myth: If there is a breast lump, it must be cancerous Statistics reveal that out of 10 cases of breast lumps in women, only 2 are cancerous. More often, these lumps are due to fibroadenoma or cysts. In many women, lumps are formed during the menstrual cycle and they go away after it ends. It is not simply possible to tell exactly what kind of lump it is, just by feeling through hands. However, it is important to detect the composition of the lump and to do so at the initial stages, so that if it is detected cancerous, early diagnosis and treatment can save your life. Myth: If your mammogram is normal, you are safe and the lumps are not cancerous This is not particularly true. To detect the presence of cancerous cells, you need to get more tests done; an ultrasound, an MRI and also a follow up mammogram, to get a second view of the lump. Doctors also suggest a biopsy to be 100 percent sure of the diagnosis. If the lumps persist but there is no detection, your doctor may ask you to keep doing the tests at frequent intervals, to assess the development. Myth: Malignant breast lumps do not cause any pain Although breast cancer patients do not suffer from much pain, this does not mean that if you do not have pain, the lump is non-cancerous. There are different types of breast cancers; and in some types such as the inflammatory breast cancer, the patient can suffer from warmth, tenderness, redness and swelling, followed by pain in the lumps. Myth: If you get a lump while breastfeeding, it is not cancerous It is true that breastfeeding reduces the chances of development of cancerous cells. But there is still a possibility and hence you should not ignore the formation of lumps. It is advisable to immediately get an ultrasound to confirm the condition of the lump. Myth: Lump in young women cannot be cancerous Women can develop breast cancer at any age. Hence, if you have a breast lump at a young age, or even if your teenage daughter has developed a suspicious lump in her breast, you should always get it checked, at the earliest. Most often, cancer develops in the breast when women are past their menopause period. But this, in no way means, that they cannot get it at younger age. Myth: Only a larger lump can be cancerous, not a smaller one Lumps in the breasts can be of all sizes; and the size, does not determine the presence of cancerous cells. According to breast-imaging specialist at New York's Manhattan Diagnostic Radiology, Melissa Scheer MD, you must immediately see a doctor, whenever you feel the presence of even a tiny lump, because, a small lump too may turn out to be aggressively cancerous. Most often, the lump in the breast is non-cancerous; however, it is advisable to consult your caregiver immediately, once you discover the lump for the first time.
Even women can kick up a storm - Martial arts and the modern womanMartial arts! Yup you have seen enough of Bruce Lee, Jackie Chan and Jet-Li films on the telly to know there is a lot of hard work involved. All that glass breaking, torso-twisting, nun chucks, whirling to kicking ten opponents at once. Is that all for real? Can a dainty woman go about hurling armed robbers off their shoulders? Or does that happen only in Kung Fu films with real weird names like 'Shaolin Temple Monks down ....' or something equally corny. That apart! Won't you need to learn a bit of Chinese or Japanese to even imitate those shrieks that women in those films emit? Worse still! Imagine they will need sub-titles to even know that you mean business! Jokes apart and no offense to the masters of Muay Thai, Akido and Tae Kwon Do! Martial arts is way beyond just fighting and is in fact a great way of disciplining the body, mind and soul. As a woman too martial arts can have a tremendous impact on your self confidence and awareness about dynamics of the mind. True what they show in martial arts film is all about smashing bones and tables but martial arts goes way beyond that. Through different movements, kicks and punches and holds one may learn to overpower an opponent using his own weight, but martial arts is ALL ABOUT CONQUERING THE SELF AND DESTROYING THE ENEMY WITHIN! So if you are intent on learning martial arts be ready for some action-packed exercise routines that Promote flexibility Increase strength, stamina and endurance Help you gain better control over yourself Help you deal with any problem that life may throw your way Help you be competitive and assertive There are different types of martial arts which have evolved over several centuries. The main forms are Kung-Fu, Karate, Akaido, Judo, Tae Kwon Do, Kalayraipatu amongst others. There is also centuries of philosophies behind the exercises recommended by these disciplines. Some martial arts concentrate only on unarmed combat while there are others which blend both armed combat with weapons like swords, sticks and nun chucks. Martial arts can indeed go a long way today in equipping women with the art of warfare so that they can defend themselves against any assailant armed or unarmed. It will go a long way in shaping societies and culture if the womenfolk are empowered both physically and mentally too. These days it is not uncommon to see martial arts blended with aerobics dance steps. It may not exactly be pure martial arts but that too isn't a bad idea at all. It will only go a long way in developing interest in these ancient art forms and help in their promotion. Just as much as any martial arts movie can. Or maybe even more!
Tips and tricks to deal with my toddler's tantrumsWhen your child is having a tantrum, it may usually be for something that it wants and cannot have. Throwing a tantrum is a child's way of getting what it wants. Conversely, giving in to the child's demands may be the easy way out for the parents too. But always remember that giving in is not right. The child may get habituated to this and it may prove quite a nuisance to you too. Learn to say no, gently but firmly. Giving an acceptable reason for your 'no' and also an option at the same time works wonders. All said and done, children are not that easy to handle. If your child doesn't fall in line and is adamant, let it pass the phase. Screaming out the rage, throwing away things may help the child. When the anger subsides, looking at the destruction and the obvious uselessness of it may help the child realize his efforts were futile. But be careful that the child doesn't get physically hurt in this process. For some kids, a gentle hug helps soothe the anger pent up. Tantrums in public places can be extremely embarrassing. In such situations, do not argue or scold your child or order him to hush up. It will only end up making the child more adamant. Wait till the storm subsides. Take him out to a quieter place and talk gently but firmly. One thing to remember here is to never let the child know of your embarrassment and concern that you are in a public place. Children are very smart and may end up using this to work things in their favour. It is not easy being a toddler and it is definitely not easy being a toddler's parent either. By the time your toddler is old enough to go school he will have overcome this stage.  
Anxious about anxiety?Anxiety disorder is a term that almost everyone has heard and experienced in some form or the other. It is a generic term used to describe different forms of a mental disorder wherein those afflicted show typical characteristics of great apprehension, fear and trepidation. The symptoms, of course, vary depending on the severity of the affliction. So you can have 'anxious moments' when you narrowly escape an accident while driving - that's temporary and natural, while some others might have chronic anxiety which might need medical aid. Types of anxiety disorders Generalized anxiety disorder: There is no specific reason for the symptoms of anxiety i.e. restlessness, apprehension, worry, and panic. Thus the term general anxiety disorder (GAD) is any irrational worry which is disproportionate to the source of anxiety. GAD is a state of perpetual irrational and persistent fear which absorbs a person's time or can disrupt his normal functioning. The symptoms of GAD are light headedness, sweating, difficulty breathing, nausea, and numbness. Phobias: Phobias are an irrational morbid fear for certain things or objects. The list of phobias is exhausting as it is anything that a human being is capable of being afraid of. Thus you have arachnophobia which is the fear of spiders, homophobia, which is the fear of homosexual people orxenophobia,the fear of foreigners. Phobias can completely paralyze and terrorize a person and is a form of anxiety disorder. Obsessive compulsive disorder: This is the classic loop where a person is afraid of certain situations arising constantly and thus takes precautionary measures to ensure that it won't. Only thing is that this turns in to a compulsive ritual which can throw her in a loop. Thus a person can be said to have OCD if she persistently checks to see if the gas valve is off as she has a fear that she will set fire to her home. It is a particularly distressful anxiety disorder. Post-traumatic stress disorder: This is anxiety arising out of a traumatic incident which the person undergoes. It could be a horrific accident or an extremely brutal incident which the person has witnessed. The trauma is revisited again and again in the mind and manifests as anxiety. This disorder is based on real events that the person has experienced or undergone and can take a long time to heal. Panic disorder: This is characterized by panic attacks or episodes where great terror or discomfort is experienced. It is a very unsettling experience as the patient feels he is about to go unhinged or something dangerous or embarrassing is going to happen to him. Thus the sensation or feelings of panic build up and reach a crescendo resulting in a panic attack. Sometimes in a panic attack, the patient's reality and perceptions are distorted and blurred and can thus put him in danger. According to the National Institute of Mental Health there could be a number of reasons for anxiety disorders. They vary from early childhood environment to lifestyle causes, heredity and even environment.    
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.
Arthritis friendly workoutsRheumatoid arthritis is more common in women over 60, and is the inflammatory type of arthritis where the synovial fluid functioning is disrupted. The synovial fluid maintains the health of joints, bones, and cartilages. Osteoarthritis is the most commonly occurring type in both men and women, and in this type there is gradual wearing away of the bone cartilages, which, in turn, causes stiffness, and pain in the muscles, joints and tendons. There is a classic catch 22 situation in arthritic patients and that is they avoid exercise or are advised extreme caution while exercising. The pain and soreness which comes from exercising can be extremely discouraging, so some shun exercise altogether. Now, the lack of exercise is going to precipitate the condition further, and could even increase the soreness, and lead to deformity. This is what challenges most arthritic patients. Should someone with arthritis be allowed to exercise? And if yes, then what type of exercise will prove to be most beneficial? Main question is: Are there any arthritis friendly workouts? Doctors now recommend that exercising could actually work wonders for arthritis patients. The right method and type of exercise can help ease the inflammation and soreness of the joints, and build overall health, strength and flexibility of the bones, and joints as well. What would be a good exercise routine? The arthritis foundation recommends routines which exercise the flexibility of the joints, and build muscle mass, for better shock absorption, coupled with physical endurance should be specially designed for arthritics. Regular walking: Walking is a great exercise for arthritics. Walking at a steady pace for about 30 minutes, thrice a week, can help keep the limbs active, and could reduce the swelling at the knees, and hip joints. Warm up is absolutely essential in any work out, and here it is of paramount importance that you go through a warm up routine before you begin your walk. Simple leg raises, hand to toe stretches, and light back bends can be done to warm up the muscles and joints for your walking activity. That will also reduce the possibilities of strain or sprains of the ankles along the way. Choose your exercise route to ensure that you don't walk up a gradient, and put unnecessary pressure on your knees and ligaments. Aquatic Exercises: Exercising in water is perhaps the best possible alternative, as water is absolutely low impact. This is great for arthritic patients to reap the benefits of a swimming pool workout. The easiest for chronic arthritis patients would be to simply walk, or wade in water for about 20-30 minutes. This can help greatly with building strength, and endurance in the extremities. For enhancing co-ordination you can even try walking backwards in water, or simply float and relax the body. Avoid water which is too cold, as that might adversely affect your condition. Stretching and Yoga: All easy stretches for the limbs and joints will be helpful to facilitate ease in movements, and dealing with joint pain. Standing leg raises, shoulder raises, wrist rolls are exercises which can be done quite easily, and can help keep the body supple. Though yoga also enhances flexibility, it goes way beyond just that, and actually aims at harmonizing the life force in the internal and external organs as well. No matter what type of exercise suits you, always remember: Proper warm up exercises are a must for the arthritic patient, as that can help reduce, and eliminate the possibility of injuries while working out. Do not force your body into an exercise regimen, if you are experiencing pain. It is quite ok to take a day off if the joints are sore. Get into an exercise routine slowly as your body might take a little longer to recover from it. Always seek the advice of an expert or a doctor before making any alterations to your regimen.
10 bedtime beauty essentials! Here are the beauty essentials you need to take into consideration, before you hit the bed: Baby-soft soles :Before you sleep, apply Vaseline on the sole of your feet. This will adequately moisturize your soles and you can wake up to the great opportunity of wearing those heels you have been dying to try out! Healing the puffy eyes : If you are worried about waking up with puffy and tired eyes (even after 6 to 8 hours of sleep), then put on a little eye cream. You can also keep an extra pillow and make sure you sleep on your back. This will allow the fluids around your eyes to drain easily and reduce the puffiness. Trying out wavy hairstyle : Bedtime is the best time to work on your hairstyle. Before you sleep, shower and fashion your hair into the style you want. Apply a styling cream on your hair gradually, after having air-dried it. Now, decide if you would like to put them up in buns or braids. Stylize them into the pattern and wake up to wavy hair! Let your skin breathe : Those who are suffering from dry skin can apply moisturizer. A humidifier is also a great accessory for help in these cases. You can switch on the humidifier before you go to sleep. This will help your skin to retain its moisture through appropriate hydration. Keep aging at bay :Did you know that sleeping on cotton pillowcases can increase the chances of creases and wrinkles on your skin? Prevent wrinkles by using silk or satin bed clothing. This will also reduce hair breaking. Wake up, miss white smiles: If you want to take off the yellows from your teeth, then brush some baking soda and let them stay for about 8 minutes. Afterwards, thoroughly rinse your mouth. Do not perform this beauty tip more than once a week, it will negatively affect the structure of your enamel. Work on your complexion :During the day, sunlight might disable some face creams from working effectively on your complexion. Make the most use of night and apply a face cream containing retinal and vitamin C. Lengthen your lashes : Eye lashes depth and grace to your eyes. You might feel that working on your lashes will require way too much effort. But, much to your surprise, everything your lashes need is contained in a natural ingredient - castor oil. Consisting of Omega-3 fatty acids, which are highly hydrating, they will avoid your lashes from breaking and also strengthen them. Apply castor oil on your lashes before you sleep and watch them grow thick and healthy within a few weeks! Taking care of your hair : Skim leave-in conditioner through your hair in the evening and let them stay on till the morning. This will let them become soft and shiny. You can also use coconut oil as an alternate conditioner. Readying your nails for polish : Depending on the skin type, the nails of certain people become dry. If you are one of them, it would be best to apply a cuticle cream or oil on them before you sleep to wake up to polish-ready nails.
Bile block - Understanding gallbladder problemsRavi was a young intern working the night shifts in a government hospital when he was asked to examine a patient who had just been brought in. The patient was a 45-year-old, a fat man, who was complaining of pain in the right side of the abdomen along with nausea and vomiting. On inquiry it was revealed that he had eaten a very heavy fat-laden dinner. Remembering what his surgery professor had taught him about cholelithiaisis, Ravi immediately guessed what the diagnosis could be. He, however, sent the patient for a blood test and an abdominal scan. The reports confirmed Ravi’s suspicions- cholelithiasis, gallstones. The gallbladder is a tiny pear shaped organ that lies just below the liver. It is responsible for storing the bile that is produced by the liver for digesting food. It ensures the smooth outflow of the bile from the bile ducts. When the bile components aggregate in the gallbladder, they build up to form gallstones, similar to kidney stones. The gallstones are usually small enough to pass on to the intestines and be eliminated without causing too much trouble. At times, these stones may be big enough to block the outflow of the bile and give rise to a variety of symptoms depending on the size of the stone and severity of the block. The symptoms include -  Intermittent colic. A bloated sensation with constant nausea. Inability to tolerate fats. Vomiting.  Fever with chills if the stone becomes infected. Gall stones though found in both sexes, is more common in females. The risk factors for developing gallstones include - Diabetes. Organ transplant. Diseases like hemolytic anemia, sickle cell anemia. Liver cirrhosis. Failure of the gallbladder to empty properly, e.g., during pregnancy. Rapid weight and nutrition loss due to any reason. Gallstones are confirmed by a blood test to check the liver function and by an abdominal scan. Medications to dissolve the stones, and surgery in case of large stones that do not dissolve with medications, are the treatment options.
Aids defining cancersIn fact the presence of such aids defining cancers is an indication of advanced AIDS having developed in these patients. However, the reasons for these cancers are unclear. It is possible that since people with AIDS have low immunity, they become more susceptible to these cancers. The double attack of these already complex diseases complicates treatment plans too. Thus, it needs care under experienced doctors who specialize in these diseases. The cancers that define AIDS are: Kaposi's Sarcoma:This is a type of skin cancer. It was usually found usually in people who have received organ transplants. Nowadays it is also most prevalent in homosexual men with HIV/AIDS and is also called epidemic Kaposi's Sarcoma.  It causes lesions to show up in multiple points in the body such as skin, lymph nodes, liver, lungs, spleen and digestive tract. Non-Hodgkin Lymphoma:This is the second most commonly associated cancer with HIV/AIDS. The various sub types of NHL are primary central nervous system lymphoma and primary effusion lymphoma. Approximately 4-10% people with HIV/AIDS develop NHL. Other kinds of cancers are anal cancer, liver cancer, mouth cancer, Hodgkin's lymphoma, testicular cancer, melanoma, throat cancer, colorectal cancer and multiple skin cancers.  Treating Cancer in HIV people: Till anti-HIV medication were not discovered the future for infected people was bleak. They were already sick and their bodies weak even before their cancer treatment were started. Presently the cancer treatment is mixed with anti-HIV drugs. However, depending upon the extent of cancer and the need of AIDS care, variations are made between chemotherapy and other HIV related drugs needed. Treating Kaposi's Sarcoma: Often anti-HIV drugs are enough to treat this cancer. The lesions, which are viral, shrink, as the immune system gets better. Sometimes chemotherapy and radiation may also be needed if the lesions are internal. Treating Non-Hodgkin Lymphoma: AIDS related NHL is fast growing and needs intense chemotherapy treatment. Introduction of highly active anti-retroviral therapy and use of drugs that help the infected body make new blood cells has relieved a major concern for HIV patients where previously due to their low blood cell count, chemotherapy could not be administered to them. But with these advances, acutely monitored chemotherapy treatments can be administered now. Treating Cervical Cancer: In case of women who have a good immune system and invasive cervical cancer can still be treated similarly as non-HIV women. They can even do well in surgeries and other conventional treatments. Discovering Cancer Early: Screening helps discover presence of cancer when no symptoms are evident. However AIDS defining cancers cannot be detected through screening. Thus, close monitoring, regular checkups and a keen lookout for symptoms of these cancers can help discover the ailment if present. Pap tests help discover cervical cancer in women. However, in case of HIV women, these should be undertaken more often. Even as often as 2 tests a year, 6 months apart in the first year of HIV detection. If the tests are clear, they should get Pap tests done regularly once a year henceforth. For other AIDS related cancers, the screening tests are still being devised. Lowering Cancer Risk: HIV ruins the body's immune system making it susceptible to a variety of diseases. Good health practices are a must for those detected with HIV in order to ward off cancer. They should surely not smoke or consume alcohol. Injection drugs and unsafe sexual practices also pose increased threat of cancer. Maintaining balanced diets, physical activity and proper body weight are extremely important and helpful too.
Importance of sex educationOur society is beset with a lot of myths about Human Sexuality and hence the family relationships are affected adversely. A man is considered (mistakenly) as a man only when he performs effectively in bed. In other words a man hangs his self-esteem on his male organ. Hence whenever there is a problem in performing sex, he becomes frustrated and depressed. In order to cover up his inadequacy he may blame his wife for his problems. This attitude will adversely affect the martial relationship, leading to unhappiness in nonsexual aspects of marriage. He may become violent when the wife retaliates. Marital break down, even if not ending in legal separation will be a very messy affair. Sexual behavior is determined by information or knowledge one has on hand and the parameters of comfort zone. Unfortunately we are dealing with a behavior that is besmirched with myths and misconceptions, and a breeding ground for stigmas and taboos, which leads to unhealthy sex life. These barriers have to be broken; otherwise healthy sexual and family life cannot be achieved. It is guesstimated that one in every three couples have some sexual problem or other and they do not know how and where to seek help. The media gives them anonymity and guides them in proper direction. The three main enemies of sexual satisfaction are guilt, anxiety and fear. All these stem from ignorance. Due to the stigmatization sex education is not available. Hence the streets have become not only the libraries for knowledge on sex but also the laboratories. When one of the dimensions (recreation) becomes problematic it impacts the health of the other two dimensions (procreation and relation). Magazine columns endeavor to dispel sexual ignorance and empower people with scientific knowledge. The aim is twofold: First, to inform in simple language, the scientific aspects of sexual problems and clarify myths surrounding sexuality; Second, to help people become comfortable with their own sexual life and elaborate on various treatment options available. People will thus be empowered to take responsibility for their own health and happiness. Have an open mind. All dimensions of human life are important. To consider one as unimportant and attach a stigma will hamper the development of the full potential of an individual. Understanding sexuality will enrich our lives and relationships.
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