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Broad chest, weak lungs - Are men more prone to respiratory diseases?The long-standing, chronic afflictionof the respiratory disease is called as COPD, i.e., Chronic Obstructive Pulmonary Disease. COPD is the obstruction within the lung tissue, causing improper circulation and entrapment of air. This limits the space for air to move in and out, directly affecting the quality of inhalation. A small reminder here may be necessary - breathing is synonymous with life, why? Because that's how we get oxygen, which is vital for the functioning of each and every cell within the body. With COPD, the ability to take in oxygen gets compromised increasingly. Continued cough, sputum, and shortness of breath are the main symptoms. COPD is more common in men. Does it have to do anything with being a male? Not necessarily. No specific link has been established to say that COPD risk is higher for you solely because you are a man. Then, what could it be? A study conducted in 2011 in USA showed that the number of men who smoke is 5% more than the women who do. To understand the reason behind this, let us see the primary causes of this disease. Air pollution, some genetic predispositions, frequent acute infections, exposure to harmful chemicals for a long time (usually occupational) - are some of the main causes, and the number one cause is smoking, owing to almost 80-90% of the cases. Park this thought. Next piece of information is simply revisiting some facts you may already know: #The gender classification ofsmokers - Men are known to smoke more than women all over the world, not only in numbers, but also in quantity. Whether it is a developing country or a developed one, 2011 studies say there are more male smokers everywhere than female smokers. Not only there are more men who smoke, they smoke for longer periods and more number of cigarettes than female smokers. This may vary from country to country, like India has much less women smokers than USA does, but the difference between the two genders holds true everywhere, only the ratios differ. #Occupational exposure to harmful chemicals and gases - These are industries of mining, textile, chemical engineering, welding, etc. The number of men working in such industries is way higher than women. #Air pollution - Men are more exposed to air pollution since they are outdoors more than women. This may not apply to all countries and societies, but is generally true. Now, we can put the pieces together and understand why COPD is more common in men? Yes, they are at a higher risk because of higher exposure to smoking, pollutants and irritants. Cigarette smoking is the leading cause of lung diseases and male smokers outnumber women across the world. You can figure out the math here!
The moody man - Mood swings in menMen, such jokes on a woman's monthly mood swings are passe. Recent research proves that men are equally prone to have mood swings. Have you experienced a myriad of emotions? Angry, irritated, feeling helpless, self-pity, an irrational urge to throw things and cry and be depressed all at the same time? These are signs of mood swings. And the point of interest here is that you don't have to be a woman to experience mood swings. Men face their share of mood swings too! Men undergo hormonal influence too. And like women this causes them too to be irritable and cranky. The difference here is that the hormonal fluctuations are not as severe in men as in women. So the mood change lasts for a lesser time compared to a woman. Men's moods are also affected by psychological and physiological stressors. So a man who has to work against time to meet a deadline will be very irritable. A man who is deprived of sleep will end up snapping at you for no apparent reason. The myth that men don't cry, is something that men take to heart. Men are emotional beings and it is okay to show some of the emotions. The male stereotypical image is such that if a man is expressive of his emotional side, he isn't considered macho enough. Hence men tend to internalize their emotions and feelings. Often this leads to chronic depression. Taming the mood swings. Any form of physical exercise helps keep the mood in balance. This helps in keeping the aggressiveness under check. Sex is also a great way to release the stress and feel better, rather than snapping and using profanities. Another helpful way is to ask yourself 'why'. Whenever you feel that you are doing something irrational or out of character, ask yourself why. The answer you get from yourself will help clear the situation and you will end up handling it in a mature fashion. The irritable male syndrome. This is the male equivalent of the female menopause - The Andropause. It covers the symptoms seen in middle-aged men that occur due to the drop in testosterone levels. Like women, men show mood changes, bouts of irritability, grumpiness, hypersensitivity, anxiety and frustration. The recent research on men having mood swings and the society's acceptance of these findings is very encouraging. It helps stress in the fact that men are emotional too. There is nothing anti-macho about a man crying his heart out at times. It only shows he is human, after all.
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.
Smell like roses, without the thornsYou bathe regularly and use the best possible deodorants, underarm anti-perspirants, panty perfume but the bad odour just doesn't go away. Pat yourself dry Very often you have a leisurely bath with scented bubbles and what not but when it comes to drying your body thoroughly, well you just pat yourself quickly, for you are in a hurry. The moisture on your body then attracts bacteria with fungi and they cause that embarrassing mouldy kind of stench on your body. So make sure you dab yourself thoroughly dry all over your body. Especially in places like the lower back where it is difficult to reach without some really flexible shoulder joints. Use the archer's swipe (The towel extended between the right hand over the head with  the left hand extended back to form the bottom grip, which looks like an archer reaching for a bow from the quiver). In case you are endowed with love handles and folds of fat then be generous with the patting, as those are the parts most susceptible to host bacteria. Change clothes often If you wear the same set of clothes and lingerie then you are surely going to have an odour which is lingering. So for those ladies who occasionly wear the same set of clothes without washing, the sweat is going to accumulate in there and raise a stink. Remember the Celine Dion song? It's a new day, a new start! Menstruation + Stress = Bad smell There is nothing that you can really do about your periods. Instead, try and be a little more extra careful during those 4 days. You can have an extra jab at the deo bottle or perfume lotion. However stress, nervousness and fear also leave chemical traces which come out along with the sweat. This adds to the bad odour. Humble pie for dessert? What you eat also affects the way you smell. Go easy on the garlic, onion rings and fish for they can make you smell slightly worse than an open sewer. Always rinse your mouth after eating and use a good minty mouthwash if at all you choose to pepper your meal with onion and garlic to ward offthe evil eye. You can add conditions like diabetes to cause a fruity kind of odour. Well in that case make sure you exercise regularly so that the skin sweats out the toxins. In case you are the extra-sweaty types then use medicated soaps or ensure you use steam baths regularly to keep your skin pores open.
Avoiding nappy rash - A few words of adviceNappy rash is a skin condition that takes its name from the nappy in which a baby is wrapped. It is a reddish rash, or tender skin around the buttocks and inner thighs of babies, which occurs due to prolonged wetness from either urine, or stools, or both. Nappy rash may be in the form of an unusually tender bottom on a child, or an inflammation around the genitals, and inner thighs, or folds of the skin. It generally occurs in really small babies, less than a year old. Most times, nappy rash is not a very serious condition, provided care is taken. No matter what type of nappy you use, whether promising complete dryness, or absorbent nappies, your baby is likely to develop 'nappy rash' at least once. The rash can make the baby feel uncomfortable, and cranky as a result. Steps to avoid nappy rash: Always ensure that your baby's bottom remains dry by changing nappies at regular intervals. Use a mild medicated baby soap which will help in keeping the skin around the inner thighs and buttocks soft. Give your baby some nappy free hours. You will be the best judge to know when she is likely to have comparatively dry spells, which can allow the skin and parts below the waist some breathing space. Regular bathing should take care of most rash related problems. Use an emollient, or medicated soap for bathing. Sometimes, nappy rash is a result of a thrush or yeast infection. The baby's resistance at these times is low so that it allows the yeast to thrive in the form of ugly red patches. Always show a medic to rule out the possibility of bacterial infections. Anti-fungal creams should also take care of normal nappy rashes.    
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.
Boost your mood after a long day at workUp before the sun rise, rush to get ready, say hurried goodbyes to the family and crawl like a tortoise through traffic to get to work. Go through a long day of meetings, calls, deadlines, reviews, and then crawl back again through traffic at a snail's pace. Does this sound like a day out of your life? Then surely, weekends go by faster for you than you can say lickety-split, leaving with no time for yourself, your family or your hobbies. Social life is definitely a far cry from possible. This rigorous schedule eventually catches up with the mind and body and lethargy sets in, discouraging any sort of activity that breaks the monotony of day-to-day life. Is there no escape from this? Yes, there is. At the end of the day, when your mind is tired, you do not feel like taking anything more than you already have on your plate. Only the warmth of your bed allures you. However, if you were feeling fresh and enthusiastic, surely, you'd be ready to do a lot more - move mountains or at least drive to meet friends, anyway. An energetic life full of happy times with families without the constant desire of solitude after a long day's work is what you seek, then try these mood boosters to uplift your mood and get your feet tapping right away! The Aroma of Good Mood:Scents play a great role in the way we feel. They have the power to turn the mood around completely. Light a few scented candles or set up an oil diffuse of your favorite oil and you will feel lighter and De-stressed soon enough. You can also mix a few drops of rosemary and bergamot to create an energizing and refreshing infusion. Walk it Off:Most of us work in functional buildings in temperature-controlled environments. The lack of windows makes natural light and ventilation scarce and aids the buildup of gloom and tiredness. A good way to turn the mood around is to walk it off. A short walk around the block or in the building compound can bring you back in touch with nature. If you are lucky to be living in a green community, you have the added benefit of watching the trees and bird life in them. The exercise also helps release hormones in the body that uplift your mood immediately. A Good Deed Begets Good Mood:Giving is the greatest joy! So perform a good deed - if you see someone who needs help on the way back from work, stop for a few moments and help them. Or simply help your spouse, children, parents or neighbor out. And voila! You will find yourself feeling a lot better than how you did when you entered the house. Clear the Clutter:Organizing things and creating neat, clean spaces is a great mood booster. As you clean the clutter, you will find the clutter of thoughts in your head also clearing. Neat, well-kept spaces invite good vibes and energies, which again makes you feel better in turn. Petting a Furry Friend:Petting a dog for even 15 minutes releases the feel good, happy hormones. It does wonders for the stress level too. So the next time your furry friend comes rushing to the door, to welcome you back home, take time to give it some love. The Human Touch:We spend 10-12 hours a day away from our family and familiar touch. The human touch releases uplifting hormones such as serotonin and reduces heart rate and blood pressure making you relaxed. So when you get home, remember; a nice warm hug to your spouse or children will make you both feel better.Remember you work to live and not the other way. So when you get home from a long, tiring day, just boost your mood so you can thoroughly enjoy life with your family!
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?
Exercise, a healthy way to deal with hypertensionYou have not exercised for a long time. You took it easy when it came to physical activity. Now that you are diagnosed with high blood pressure, you will do anything to control it. Even exercise! Exercise, weight management, and a healthy diet are important ways to help prevent high blood pressure and lower the blood pressure that is already high. Benefits of exercise for people with hypertension include: Improve blood and oxygen circulation in the body Promotes sound sleep Improves stamina and endurance Keeps heart healthy Reduces stress and promotes mental health Exercise enhances the effectiveness of medication So how much should one exercise? An exercise session of atleast 30 minutes per day is important. Get started Start slowly and increase gradually. Start with 10 to 15 minutes of exercise and increase it, as youget comfortable. Choose exercises you enjoy and will do consistently. Avoid sudden vigorous activities; they can cause injuries and hamper the routine. Warm up Warming up helps the body adjust slowly from rest to exercise. A warm-up will reduce stress on the body muscles, increase heart rate and respiratory rate, and body temperature slowly. It will also decrease soreness of muscles. Best exercises for lowering blood pressure Stretching: It is the best. It relaxes and helps prepare the body and muscles for activity and prevents injury and muscle strain. Stretching regularly will make you flexible and improve motility. Aerobic exercise: This helps to improve circulation to the entire body. It improves heart function. It gives maximum benefits to the heart. They also help to reduce heart rate and blood pressure by improving breathing pattern thus lowering blood pressure. Walking, swimming, jogging, and skipping are all aerobic activities. Do aerobics for at least 30 minutes three times a week. Strengthening exercises: These include exercises that have repeated muscle contractions till the muscles are tired. These include side balance crunch, climbing a rope, and push-ups. Join a gym. Here are some  exercise guidelines for a better exercising routine in the gym:  Schedule a fixed time for exercise. Find a buddy to exercise with you. Select an exercise that you like. Make variations to avoid getting bored. Boredom can make you stop exercising. Start slowly and increase gradually, especially if you do not exercise regularly. You should wait for an hour after eating before you exercise. Ten minutes of warm up and ten minutes of cool down sessions are must Keep a record of daily exercise.
Diet to help manage stressYou cannot avoid stress, as it has now become an integral part of modern lifestyle. Children are worried about their exams and performances in the cultural events, teenagers are stressed out about their looks and body shape, adults take stress owing to competition at work, and so on. One thing is sure that you cannot stay away from stress. So, how can you avoid the side effects caused due to stress? You can include certain foods in your diet that help manage your level of stress. Researchers are already on to it, studying the effects of various foods on the stress levels. It is always better to choose from the organically harvested nuts, veggies, fruits, and fish for better health benefits. Nori Sushi nori is a type of seaweed that is rich in magnesium that contains anxiety-fighting properties. Magnesium is also known for stress reducing abilities. Apart from this, it also carries other essential health nutrients that are necessary for the overall development of health. Vitamin C Foods Cantaloupe is composed of vitamin C that is a renowned stress buster. Another great stress busting food is orange. When you are under stress, adrenal glands in your body start producing cortisol that lowers your immune system's capacity. This leads to breaking down of muscle tissue. Vitamin C in oranges have the ability to return the high blood pressure to normal level. Moreover, when you are stressed there are chances of this vitamin getting used up and hence the need to increase your intake of vitamin C rich foods. Another popular vitamin C enriched food is blueberries that are also packed with lots of antioxidants which relieve stress. Almonds Almond is a treasure trove of essential nutrients such as vitamin E, B2, zinc, and magnesium. Although they are high in fat, they provide your body with all these essential nutrients. You can easily have a handful of almonds every day and still feel less guilty about.  Apart from the fat, energy, and the essential nutrients, almonds give the brain and its memory a shot in the arm. Broccoli Broccoli is rich in vitamin B and folic acid, both proven stress busters that helps in giving you relief from panic, anxiety, stress, and depression. Bananas Bananas contain one of the most important amino acids - tryptophan that gets transformed into serotonin which is a stress-busting hormone that is known to induce a feeling of well being. This makes you happier and gives you relief from stress. Banana is also rich in potassium. Potassium regulates the heart due to which the blood pressure can be kept under control. That is why many health experts recommend inclusion of a potassium-rich diet, as it normalizes your heart rate and help you calm down in stressful situations. This makes banana an essential food addition to your diet. Chocolate The dark chocolates are bitter and give you a feeling of satiation despite the little amount you devour. Due to this feeling, you eat less, but you still enjoy the flavor of the chocolate, much more than the milk chocolate varieties. When you are under stress, most of your body organs are vulnerable to damage. The antioxidants polyphenols that are present in the dark chocolate slow down the damage and also contribute in its repair. Studies have also revealed that 40 grams of dark chocolate per day helps reduce stress-causing hormones such as catecholamine and cortisol. Increasing the intake of stress busting foods in your daily diet can help control diabetes and hypertension.
Thyroid may make your heart flutter!Thyroid is a small gland situated in the area of neck. In Greek, thyroid means the shape of a shield. Yes, thyroid gland is vital to a variety of important body functions and does act as a shield. But what happens when the shield is disturbed and goes weak? Thyroid dysfunction is recorded in approximately one to four people out of hundred Thyroid link to heart A research study was conducted in 2009 by Weill Cornell Medical College researchers. It was done to investigate and analyze the genetic link behind rhythm control of heartbeat. They found that the genes that are responsible for synchrony and rhythm in the functioning of heart are also closely connected to the thyroid hormone synthesis and could cause dysfunction of the thyroid. Thyroid activity directly influences the metabolism, blood flow and electrical activity of the heart. When there isn't enough thyroid hormone (low levels), the patients complain of low energy levels, fatigue and reduced heart rate. On the other hand, with increased thyroid hormone levels in the blood, patients report symptoms of hyperactivity of systems. There is diarrhea, palpitations, increased heartbeats and advanced cases show arrhythmias of heart, where normal beating rhythm of heart is disturbed and becomes irregular. Thyroid hyperactivity can be appropriately controlled with regular medication. Understanding arrhythmias When the rhythm of the heart is disturbed, it becomes irregular - this is called cardiac arrhythmia. There are various types of loss of rhythm - heartbeat is too slow (that is, the cycles are taking too long to complete), too fast (the cycles are repeating too quickly), too early (that is, before a cycle is even completed, another starts), too irregular (this is called fibrillation, where no specific pattern may emerge). The patients who have arrhythmia will often come with complaints of dizziness, shortness of breath, suddenly feeling weak or lightheaded, fainting and feeling of a flutter in chest (flutter can be understood as light but quick flapping of wings by a bird). Arrhythmias are usually harmless and most people would continue to live a healthy life for years with arrhythmias. But that does not mean it can be ignored. There is a battery of tests available to diagnose and indicate the seriousness of arrhythmias and let your doctor take a call on the line of treatment. If you have a thyroid dysfunction, get your heart checked immediately. And if you have faced arrhythmias, get your thyroid checked immediately. Both the conditions are controllable and treatable; there is no cause to worry over what could go wrong. Just be vigilant and informed.
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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