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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.
Weight gain and prostate cancerOne of the hormone therapies involves increasing the production of LH-RH. Luteinizing Hormone-Releasing Hormone (LH-RH) is a hormone which is produced by your body. This lessens the production of testosterone. The drug given induces the generation of this hormone. One of the side effects of this therapy is weight gain. Along with this, breast pain, hot flashes, nausea, and growth of male breast tissue might occur. Apart from hormone therapy side effects, the presence of fatigue can also stop a patient from regularly exercising, thus, resulting in gaining weight. However, it is important that this weight gain is averted as the chance of cancer returning is a possibility. You can keep your weight in check by following these tips: Ask your doctor if your hormone therapy can lead to weight gain. If you receive an affirmative answer, then ask for a diet chart to be followed. You can also keep a food and activity journal to get an idea of how your body is reacting to the treatment. Inculcate physical activity in your schedule. This will not only help to reduce fatigue, but also keep at bay the chances of becoming constipated or feeling nauseous. Medical studies have shown that cancer patients must have at least 2-1/2 hours of moderate physical exercise per week. Have about 2.5 cups of fruits and vegetables every day. Also, shift to whole grain food items. You should also consume at least a cup of legumes, for example, beans, to keep up your protein levels. It is best to opt for lean protein snacks like yogurt and chicken. You must stay adequately hydrated during your treatment. Drink about 10 to 12 glasses of water everyday. Do not consume excessive amount of sweetened beverages like coffee and cola. Have a small portion of nut and nut seeds. If you feel distressed due to the therapy, go for a massage. These have been proved to reduce anxiety and stress caused during the treatment of cancer. Most importantly, keep up with your appointments with the doctor and convey the bodily changes that you may notice. Have an optimistic outlook towards the treatment and do not repress any emotional disturbance. Weight gain in men who had been previously healthy often leads to depression regarding weight issues. Being proactive and focusing on keeping your weight under check is the key here. You could also approach a psychologist if you have been feeling low. The LH-RH therapy is also known as Androgen Deprivation Therapy (ADT). This therapy leads to a weight gain of around 9 pounds within a year of starting treatment. You can make sure that your weight is controlled by altering your lifestyle and getting adequate physical exercise everyday.
Pamper the newborn without forgetting yourselfIf you are a new mom, chances are you are busy 24/7. The baby's complete dependence on you helps you bond with him/her and makes you aware of the responsibility that is now on you. But, your own health is an equally important responsibility. So, you need to give yourself permission to take care, or even pamper yourself from time to time. Here are simple ways for you to look out for yourself. Eat your favorite breakfast: As your day starts, you need fuel to keep your energy levels high. So, grab your hands on healthy and tasty breakfast options like whole grain cereal, skim milk and sliced strawberries or a banana. The combination of lean protein, whole-grain foods, and nutrient-rich fruit allows the brain to form more feel-good chemicals. Don't let stress come near you: We know that a lot of changes in your life have transpired, due to the entry of a baby in your world. The difficulty to cope with the changes may cause stress and depression. Try to avoid stress by asking for your husband's and relatives' support. Take a walk with your baby: Walking with your baby in nearby parks will give you fresh air and it is an excellent form of exercise. Don't be sleep deprived: Having a baby doesn't mean that you have to always sacrifice your sleep. Never miss an opportunity to sleep or take rest. This will keep your energy levels high for the day. Sleep when your baby sleeps. Delegate baby care: Parenting is not your sole responsibility. Ask your husband to lend a hand in taking care of the baby for some time. Not just the husband, if you live in a joint family, you can ask other relatives for help as well. Don't be a multi-tasking person: We know a woman has so many roles to play. But, it doesn't always have to be that way. Being a new mom, you must focus on one activity at a time. You can prioritize your tasks, if you have a lot of things to do. Exercise regularly: Add exercise to your daily routine. Choose the exercise which you love and enjoy, like walking, cycling, yoga, swimming or aerobic dance. Consult a doctor before starting any exercise program.    
Making babies, the best way!Some couples get pregnant easily. But many couples have to wait months before the baby is conceived. There are several factors that affect conception right from fertility to the position during intercourse. Some believe that positions have nothing to do with conceiving a child. This is not true. Some positions are ideal to help the sperm meet the ovum. Let's see what some of these positions are. Missionary position:The best position for getting pregnant fast is the missionary position.Here the man is lying on top of the woman allowing for the deepest possible penetration, making it possible for the sperm to get deposited closest to the cervix. It is also the most common and comfortable position preferred by couples. Raise your hips high: Your hips have a lot to do in helping you get pregnant. Raise your hips high during sex by placing a pillow below you. This helps to expose the female cervix to as much semen as the male can release. Doggy position: Considered to be the most erotic and pleasurable position,this rear-entry position where the man enters the woman from behind is also recommended for increasing the chances of getting pregnant. In this position too, the sperm is deposited closest to the cervix, thereby increasing the chances of conception. Side-by-side: You can also try having intercourse while lying side by side. This position, likewise, causes the most exposure of the cervix to the male sperm. While these positions certainly improve your chances of getting pregnant, there is no guarantee that you will conceive. The most important thing is to enjoy this special time and have fun with your partner. So keep enjoying and keep trying!
LBW - Babies that don't throw too much weight around!You'll hear this term if your baby weighs less than 2.5 kg (5.5 lb) when born. About six in 100 babies who are born in the UK have a low birth weight. There are a number of reasons for LBW in babies, with premature birth topping the list as far as reasons go. Babies born prematurely could have extremely low birth weight as compared to babies that are born between the natural term of pregnancy, i.e., between 36-40 weeks. So what are the other reasons behind LBW babies? Descent is an important factor that could also determine birth weight. A survey conducted in the UK showed that children born to people from the Indian sub-continent (Indian, Pakistani, or Bangladeshi) or African parents are more likely to be born with LBW as compared to babies born of white Caucasians. In case of twins or triplets, there are chances that one or all offspring might have LBW due to lack of space in the womb. The mother's health would largely determine the healthy weight of the child as well. Emotional problems faced by the mother during pregnancy could have a link with LBW. Same goes for addictions like smoking, alcohol abuse, designer drugs, and at times, health conditions like high blood pressure which cuts off healthy blood supply to the fetus. Even damage to the placenta can cause LBW, as the fetus does not receive vital nutrients, blood, and oxygen which can cause stunted growth or low weight at birth. Any congenital or hereditary conditions can also affect the baby's weight. There is much uncertainty with regard to the future of a baby with low birth weight. There have been instances where LBW babies have developed conditions like obesity, diabetes, or heart disease in later years. It is a common fear that LBW babies develop behavioral or emotional problems in schooling years and they are likely to have low intelligence. Of course, there isn't any concrete evidence. The pivotal factors here would be to find the cause for LBW and what trimester of pregnancy was it detected. Providing a stable family environment and taking special care of a LBW baby can also go a long way in keeping it healthy in subsequent years. Not to forget that the parents' size and genetic predisposition would have a lot to do with the baby's health and even weight. If the parents are small in size or underweight, then the chances are that the baby will be born small or with LBW. Breastfeeding the baby is the best strategy that a mother can adopt to ensure that the baby grows up well. While growing up, the parents will have to ensure that the baby receives a balanced nutritious diet to ensure healthy weight.
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  
Balancing marriage and work: The top 5 tricksFor women juggling between home and work is very difficult. Yet, the number of women choosing to go out and work, while managing their homes, has increased over the years. This is because a successful career helps a woman establish her identity in society, gain respect and do justice to her inherent qualities, passions and dreams. So, a successful working woman, is a happy woman and statistics show that such women also keep their kids and spouses happy. More stable marriages During the seventies, when women started entering the workforce in large numbers, there was an instant rise in the divorce rates. However, over the past decade, the divorce rates among working couples have actually declined. Today, men have extensively adjusted to the idea of having a working woman, as a partner. In many countries, men actually share the domestic chores and devote time to childcare, so that their women can successfully handle both, work and home. However, the main responsibility of the home and the kids is still primarily, in the hands of the women. Here are the six keys to manage your work and marriage successfully: Find the right job You can ease out the stress of managing the work and home front, if you make the right decisions. Studies indicate that couples having access to less demanding work, have better sex and better relationships and hence, are less likely to be stressed out. However, in case the working hours are long, the situation can become the opposite. Hence, it is important to find an exciting job, over which you can still have control, especially when you have small kids at home. Adjust the working hours Most women have to leave their careers halfway because their husbands work for long hours and there is no one available to care for the kids. If the wife too is good at work then, the couple should take up jobs that provide an opportunity for both of them to work, since doing this will keep both of them satisfied. There is a possibility that the husband, or the wife, may lose a bit on the income in this adjustment, but ultimately it increases the chances of having a happier marriage. The negative impact of leaving work If a career-oriented woman leaves her job due to family demands, it can shake the very base of the marriage, while also leaving her, depressed. Also taking a break, means you have to catch up very fast when you want to restart your career, which in reality, is quite difficult. In these situations, there is also a huge wage gap, between what you used to get before your break, and what you are getting after, that can lead to depression. Working moms help fortify the relationships between kids and their fathers When the father spends time babysitting the children, a closer bond develops between the kids and the father, which is usually not possible in families where the dad goes to work, full time. Studies show that children raised with equal devotion from both father and mother, have higher goals and aspirations and are even more empathetic. Feel less guilty A working woman usually feels guilty because she cannot spend as much time with her children, compared to the dedicated housewives. However, if the husband shares the duties related to bringing up the children both parents can be happy while playing their parts well for their kids. A woman with a successful career is positive and confident about everything she does, which ultimately makes her family happier.
5 Muscle building smoothiesProtein is highly important for muscle building as it repairs the muscles and help in their rapid recovery after a workout. That is why most of the trainers recommend taking protein smoothies after workouts. Generally, banana and peanut butter alternatively, are used to add the protein content to the smoothies. Apart from these, Chocolate is a hot favourite as well. But if these do get boring, here are some smoothie ideas, only for you. Hot Cocoa (bed-time and post workout) Ingredients: 1-cup milk (fat-free), 1 scoop whey protein chocolate, 1 packet Swiss Miss Diet hot Cocoa and ½-cup cottage cheese (low fat). Recipe Heat the milk and just when it gets to the boiling point, blend it in the blender with the protein, cottage cheese and cocoa until smooth. Ensure that the mixture has mixed well. This protein smoothie can be taken just before bedtime as well, because the cottage cheese contains slow digesting proteins that are great for overnight muscle repairing. Each glass of the Hot Cocoa smoothie contains: Calories-275 Protein-44 gms Carbs-20 gms Fat-1 gm Fiber-0gm Root Beer Float (post-workout) Ingredients: 1 scoop vanilla flavored whey protein, ½ cup vanilla yoghurt (fat free(, 1 scoop vanilla casein protein and 1 ½ cup root beer Recipe In a bowl mix all the protein powders into the yogurt slowly and stir well to avoid clumps. Now, pour the root beer in a large beer glass and add this mixture of yoghurt carefully, without stirring. Since the root beer starts carbonation process, the shake becomes quite frothy without having to use a blender for mixing. Each large glass of the Root Beer Float smoothie contains: Calories-443 Protein-48gms Carbs-61 gms Fat-1 gm Fiber-1 gm Post workout or pre-workout smoothies provide the necessary protein to the body that contributes in rapid muscle recovery and growth. Peach Cobbler (pre-workout) Ingredients: 1-cup water, ½ can of sliced peaches with juice, 1 scoop vanilla whey and 1 packet Quakers Instant Oatmeal (lower sugar maple and brown sugar) Recipe Mix all the ingredients in a blender and serve. Use an immersion blender for this one, to get a finely mixed smoothie. Each glass of the Peach Cobbler smoothie contains: Calories-305 Protein-24 gms Carbs-49 gms Fat- 2 gms Fiber-3 gms Orange Creamsicle (pre-workout) Ingredients: 1-cup orange juice, ½ cup fat-free yoghurt (vanilla flavor) and 1 scoop vanilla whey protein Recipe Mix all the ingredients in the blender and enjoy your smoothie. Ensure that you use real orange juice and not the flavored orange drinks for this one to get the desired result. One glass of the Orange Creamsicle smoothie contains: Calories-280 Protein-27gms Carbs-43 gms Fat-1 gm Fiber-2 gms Chocolate Almond Brownie (pre workout or early morning) Ingredients: 1 cup milk (fat-free), ¼ cup almonds (chopped), ½ Clif brownie bar (chocolate flavor-chopped finely) and 1 scoop of chocolate flavored whey protein Recipe Mix the milk and the flavored protein in the blender and serve with almonds and Clif bar topping. Use a spoon as you will be eating as well as drinking the shake, because the almonds and the bar chips can settle to the bottom. One glass of this Chocolate Almond Brownie smoothie contains: Calories -457 Protein-39 gms Carbs-41 gms Fat-17 gms Fiber-8 gms
Benefits of meditation: How daily meditation helps you lead a wholesome life Sharper memory: One of the most important cognitive capacities we use daily is our memory. With higher amount of stress on your brain and body due to demands at workplace and home, there is high probability of negative effect on your memory. This can be countered by mindfulness meditation where the focus of attention is a particular physical sensation. This lets you quiet your mind and learn to be attentive solely to the matter at hand, thus allowing your brain to be able to remember more sharply and quickly. Dealing with stress: Stress is the buzzword for anyone who is leading their life in busy cities. Starting from the hurried walk into the office to the pressure of meeting deadlines and reaching home exhausted only to find oneself engrossed in another set of tedious jobs is the condition of daily life for most people. Meditation will allow you to cope with stress in a stronger way by bringing the energies of your body under your control, thus giving you the power to channelize them effectively. Giving up painkillers: Recent medical studies, especially ones conducted in Montreal in 2010, showed how the practice of Zen meditation structures the brain in such a manner that its capacity to sense and deal with pain increases. Primarily practiced by Buddhist monks, Zen is the form of meditation where you focus on your breathing and posture while watching and letting your mind gradually turn quiet. In this way, you can put those pain killers away and increase your innate capacity to deal with pain. Happiness quotient: Prefrontal cortex is the part of brain concerned with positive emotions and feelings. Those who meditate have been seen to have greater activity in this area. Major journals and research institutions focusing on depression and role of meditation in reducing it have found that meditation helps the person to feel in control of their life by subtly changing the working of their brains and thus, resulting in greater capacity to cope with depression and negative feelings. Good for your heart: Two kinds of meditation which are greatly beneficial for smooth working of your heart are Zen and Transcendental meditation. Transcendental meditation, taking after its name, helps you to transcend your worries through attention on chanting. It has been found that meditating daily helps to reduce the chances of stroke and heart attacks by over 40%.
Stay healthy, keep flu at bayKeep the influenza virus away from you by following these simple routines : Wash your hands!Hands are a germ factory. Innumerable things are touched by us through the course of a day and that lends the germs a perfect breeding ground. Hence, it becomes imperative that we clean our hands thoroughly, especially before eating. Always keep a sanitizer handy in case you don have access to water and soap. Even while you wash your hands with soap and water, do not rush with the process. Wash thoroughly at least for 20 seconds. Clean the surfaces!Computer keyboards, tables, pens and pencils, shared stationary are all great places to find the flu virus. Regularly clean these surfaces with an alcohol-based disinfectant that will kill these germs. Exercise!Nothing can be as good as regular physical exercise for maintaining good health. Regular exercising boosts the immunity. This makes you fall ill less often. It also gives you greater resistance against viruses so you will not be affected by them no matter how strong the exposure. Top up on vitamin C!Vitamin C is known to boost your immunity levels. It also increases the resistance against viruses. Eat a lot of citrus fruits like oranges and tomatoes. Amla, that is a rich source of vitamin C, can also be consumed in the form of juice or eaten raw! Chicken soup for the ill-soul!Chicken soup is known to be the most effective against the flu virus. So if you feel you are coming down with a flu fever, rush to the kitchen and fix up some nourishing chicken soup for yourself. Nothing works as effectively as this does. Try poking yourself!The ancient Chinese system of medicine, acupuncture, has been known to treat everything from headaches to nausea to arthritis. Acupuncture experts may prick at particular pressure points with hair like needles to keep flu at bay and to reduce the severity if already infected. Though there is no significant scientific evidence against it, there is absolutely no harm in trying it, if you can tolerate the pain from the needles!. OTC drugs!Over-the-counter medications are available in plenty for flu symptoms. The achy feeling all over the body, the sore throat, and the muscle pain are the worst symptoms of flu. Doctors suggest that you do not over-medicate yourself. Instead of going for multi-drug combinations, doctors advise you go for generic medicines like acetaminophen for fever and a cough suppressant. Garlic pods!These smelly things can be of great use when it comes to prevent a lot of diseases, the flu included. Studies show that people who ate two or three pods of garlic daily had better resistance against the flu virus and fell ill less often. Proactive Probiotics!The strength of your immune system lies in your gut, called gut-associated lymphoid tissue or GALT. Almost 80% of the immunity comes from your gut. To keep the gut healthy, eat a lot of probiotic, pro-GALT foods like yoghurt. Sleep well!Sleep is the most essential component of staying healthy. A well-relaxed body is fitter and stronger and will have better immunity against diseases! Prevention is always the better form of cure. Stay protected and stay healthy.
Psychological impotenceSex is not just physical but just as equally mentally involved. Mental stimulation and response are responsible for arousal and overall enjoyment; and therefore any sort of psychological disturbance or mental issues like stress, tension, or anxiety can lead to psychological impotence. Stress or exhaustion are most possible explanations for psychological impotence. Depression and post-traumatic stress disorder also may result in impotence. A mental trauma of sexual or physical abuse, guilt due to sexual relationship, problems amongst partners contribute too. Confusion over one's sexual identity is also a major cause for impotence. Impotence results from underlying physical disorders, especially if the people choose to stay unaware of it. Absence of knowledge of this disorder leads to anxiety and stress building up over a period of time.  So when determining factors rule out physical causes first and then go for identifying mental causes. Psychological impotence can be sometimes situational or only with a particular partner and the treatment approach differs with the cause. Counseling works wonders in the case of psychological impotence. For example, depression or anxiety may require treatment to improve condition. Post-traumatic stress disorder or abuse needs therapy on coping skills. Sometimes simply explaining underlying cause of physical condition resulting in impotence and comfort and reassurance are sufficient. So don't hold back, share to get your mojo back!!
The link between oral sex and cancerSymptoms of oral cancer: The common symptoms of oral cancer include: Red and white spots on the tongue or the lining of the mouth, inflammation of the mouth which continues well over two weeks, mouth ulcers which take over three weeks to heal, discomfort and pain during swallowing food, and lastly, sensation that something is stuck in the throat. HPV types and their nature: There are over 100 different types of HPV. Out of these, 15 have been found to cause cancer. These 15 types of HPV are called high-risk HPV. The HPV types which are found in the mouth are sexually communicable and the primary means for its transference is considered to be oral sex. It could also be carried through anal and vaginal sex, causing laryngeal cancer, anal cancer, cervical cancer, tonsil cancer, vulval and vaginal cancer, and penile cancer. Some of the HPV types get passed through skin contact. These cause warts, especially in the genital region. These types of HPV which cause the warts are less likely to escalate and cause cancer. Though there is no determinate answer as to how common the HPV mouth infection is. Advanced studies during the 21st century have put forward the role of HPV16 in new types of cancer. This was done using DNA testing. Through a medical study, it was found that the most vulnerable groups are: People in the age group of 30 to 34 and 60 to 64 years old. People who have had over 20 sexual partners in their lifetime, around 20% suffer from HPV oral infection HPV leads to cancer?: HPV does not directly cause cancer. It stimulates modifications in the cells which it has infected, like those in the mouth or cervix and due to the modifications the cell becomes cancerous. In only 10% of the cases where the patient suffers from HPV infection does cancer develop. The infection generally treats itself and is removed naturally within 2 years by the body. The chances of progression of the HPV infection into cancer is increased by smoking and drinking. Smoking injures the immune surveillance cells. Due to this injury, they are not able to fight the virus and the virus continues to persist over 2 years, leading to cancer. Vaccinations: In the United Kingdom, girls (aged 12 and 13 years old) are vaccinated against HPV. This vaccination protects the women against cervical, vulval, and vaginal cancers. Men and boys also take vaccinations against HPV, though it is not pursued as strongly as in the case of women. This leaves men who have sex with other men at a greater risk of getting oral and anal cancer. Even though the link between oral sex and cancer is not completely proven, what we do know is that oral sex causes many other infections like gonorrhea, herpes, syphilis, and chlamydia. Did you know that a very low percentage of people (only 10%) who are infected with HPV virus develop cancer? In 90% of the cases, the infection is naturally cleared by the body within two years. The natural process is, however, obstructed in those who smoke and drink.    
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