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Fashion tips for tall menRead on for the few tips which shall help you strike that perfect look always! No more tears for the "trousers" Trousers for tall men that you get in the market are too ill-fitting. They end up making you look "Too big for your pants", or "Too thin for your pants". The easy solution would be to choose a brand for your trousers, after proper research, and stick to it. Your quick checkpoints in this case can be: Your large thigh areas always make you look humongous. Hence, try to get a good and appropriate fit for your thighs. A small amount of flare in your lower legs can give you a good look, but that should go well with the texture and look of the trouser. Last but not the least, avoid loose fitting, or baggy pants. They will just make you look too thin, and tall always. Scare away the " shirt" hassles Have you picked up a T-shirt which lets your waistline be visible, the moment you move your hand a bit? That's a usual problem every tall guy faces. Try a few of these solutions, and see the results: If you are a tall and bulky person, then pick up a long double XL T-shirt, fitting you well. If you are a thin and tall person, then pick up a T-shirt which is long enough for your height, and then get it tailored for the perfect fit. Polo neck T-shirts can make you look too skinny. Try to get a formal shirt which fits you well, and is long enough to be worn tucked in. For tall people, tucking in the shirt helps them flaunt their height pretty well. You can also try and get the formal shirt fitted by a tailor, if you find it too big for your size. Forget the "Jacket" jeopardy Jackets and waist coats are the biggest gifts for all the tall guys out there. But how, and what to wear is the major turning point here as well. Complete your formal look with a waist coat. This shall make you look well built, and compliment your height as well. Blazers can be an option, for both the formal and informal look. Pick up a blazer which fits your broad shoulders well. A jeans, a t-shirt, and a jacket can be a killer combination. Go for earthy colors, as they give you a more masculine look compared to other colors. Tipping the "Tie"& Bolting the "Belts" Try to match the right clothes with the right accessories. Let's start off with the tie. Now, for tall men, getting a tie will be a pain. Always try the tie you are buying, and see if it comes till your waistline. You should also try to pick up a bit broader ties, as they make your chest look broader. When it comes to belts, try to pick up the big, horizontal buckles. Choose simple, horizontal buckles for the formal wear. For the informal look, however, you can experiment with other big buckles available. Watches Tall men with long hands and fingers should try to wear a big dial watch. This gives your fingers and arms a bulky look. Choose colors like gray, and black most of the time, as it makes you look more masculine. So, a few simple steps can make you flaunt your height. As the saying goes: "Wear your style; do not search for it in the stores. Your attitude is what matters the most to complete your look."
Urinary tract infections in menUrinary tract infections are most commonly seen in the bladder in men. The symptoms include: Pain or burning during urination The urge to urinate often Pain in the lower abdomen Urine that is cloudy or foul-smelling Fever with chills and vomiting If the infection has spread to the kidneys, there may be pain in the back in the region of the kidney along with high grade fever, nausea and vomiting. UTI occurs very commonly and is not a medical emergency, but it is advisable to see the doctor immediately to avoid further complications. Elderly people and people suffering from diabetes should report instantly as they are at a higher risk for complications. The main risk is of the infection spreading up and affecting the kidneys. This could result in severe damage to the kidney and in people already suffering from any kidney disease, it could mean even kidney failure. There is also a small chance of the bacteria entering the blood stream and reaching other organs. Risk Factors for developing UTI: Not drinking enough water Holding in urine for long Kidney stones Taking frequent baths These factors may increase your chances of developing UTI A urine test is the only way to diagnose UTI. It not only checks for bacteria in the urine but also for abnormal cells like pus cells and red blood cells. Dipsticks are accurate. Home test kits are also available but they do not boast of 100% accuracy. Stealth or Asymptomatic UTI is the same as UTI, except that the symptoms are not seen. The bacterial infection is revealed in a routine urine test. This is serious and since it affects elderly people and immune-compromised people, needs immediate treatment. UTI is treated symptomatically. Specific antibiotics are prescribed for killing the bacteria. Symptomatic treatment is offered for the fever and pain if present. Along with this you will be recommended to drink plenty of water and fluids and regularly empty your bladder. Men with diabetes need to take special care due to several reasons. Since their immune system is weak, they are prone to infection easily. The high amount of sugar in the blood and urine may encourage the bacteria to flourish. Also, the diabetic neuropathy affects the nerves of the bladder and there may be no proper signals for emptying the bladder fully. All these add up as potential risk factors for UTI. Urinary Tract Infections are easily preventable. Here's how: Drink Plenty of water Empty your bladder at regular intervals Take showers instead of baths Visit the toilet before and after sex Avoid strong smelling soaps and washes to wash the genitals Wash from front to back.
Marrying late in lifeConventionally, the marriage age is determined according to the linear formula of happiness that we have constructed and believe to be true. The formula being: getting married by 24 --> having children by 27 --> working (optional) --> becoming a grandparent (that too, real soon!). However, time and again, men and women wandering in their 40s-50s have woken up from the deep disturbed slumber to realize that maybe- just maybe, they had walked into things too fast. They had been unable to know who they are and to become a self-conscious human being before being ready to fuse their lives with another. The prime point of being single and marrying later in life is not to go on some form of egoistic joy-trip but to be able to know oneself and become ready to be the right person for the other. By marrying late, you give yourself time to experience freely what you like and dislike. You get to explore the world at your own terms- travel whenever you want and involve yourself in festivals and activities that manifest who you are. Marrying early doesn't allow for time to explore one's being, as marriage generally immediately follows the time you finish your studies or begin working. One of the most important aspects of adulthood today is travelling. However, every individual has unique wants of travelling and being a single adult will allow you to experience the world fully. You will also get in touch with yourself, exploring how you would like to live. The decision will arise from a ground of experiences which would clearly tell you what repels and what appeals to you. Such experiences are rarely findable once you begin living with another, as you would have to schedule your days and basically, your routine around the other's life as well. Financially, you have reached a point where you know how to take care and manage finances, allowing you to plan your wedding pragmatically. Marrying at a later point in your life allows you to be clear about when you would like to be a parent. Your experiences also ready you to be a considerate and understanding parent who can guide a child. As you grow older, you tend to become more tolerant and the propensity towards differences turning into unnecessary fights is lowered. As our ways of looking at the world change, every person as an individual has the need to learn to see the world as a home. This feeling of being at home is created only through series of experiences one has to go through as a responsible adult. In the face of inexperience, two individuals coming together often find themselves incapable of being happy with one another. Marrying later allows you to have grown into a wiser person yourself before sharing your life with another.
Perfect partners in crime - Midlife crisis and dementiaThe responses we have to common stressful events in our daily lives have a lasting impact on our brain structure. The effects of a stressful event last a very long time, though apparently we seem to have recovered from it. Researchers say that the stress hormones keep circulating in our body long after the stress has passed. According to a recent Swedish research study, our response to common life events may trigger long-lasting physiological changes in the brain. These interestingly shocking findings come from the Prospective Population Study of Women in Gothenburg, a long term study on 800 women that lasted for almost forty years. The women who were a part of this study were all born before 1930, and underwent regular neuropsychiatric tests. The study started in 1968 assessed women for any baseline stressors like workplace problems, widowhood, alcoholism and illness in the family. Women who had serious issues at the start of the study had a 21% higher risk of developing Alzheimer's Disease and 15% higher risk of developing dementia later on in life. Interestingly, having to take care of a mentally ill family member like a sibling or mother, was found to be a major cause for development of dementia later on in life. The findings of this study show that accumulated stress from common life events has severe physiological and psychological consequences. These physiological consequences include adverse effects on the central nervous, cardiovascular and endocrine and immune systems. There have been several studies that state that the effects of stressful events like earthquakes, cyclones and floods can have a lasting impact on life and often shape the person's personality. What makes this study interesting is its finding that daily stressors accumulated over a period of time and often left unresolved, have a lasting impact that shows up in later stages of life!
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.
What is megalomania?Bertrand Russell's quote on megalomania perfectly describes the condition:"The megalomaniac differs from the narcissist by the fact that he wishes to be powerful rather than charming, and seeks to be feared rather than loved. To this type belong many lunatics and most of the great men of history." Megalomania is a delusional bipolar disorder. The sufferer believes he is an all-powerful person and that he is superior to all other people. Megalomania comes from the Greek words megalo which means large or great and mania which means madness. It is a psychopathological disorder that has delusional fantasies of power, exaggerated self esteem and a sense of omnipotence. The sufferer may believe he is God or some famous athlete. Although megalomania is a term used for power hungry people, it is clinically described under the mental disorder of narcissism. Narcissism is self-love. Though self-love is a healthy concept, narcissism is a pathological state where one loves oneself to the extent that he starts despising others. Megalomania is caused by certain phobias and mental conditions associated with emotions and personality. In everyday life, megalomania can be a person's mental way of reacting to frustration, abandonment or some serious loss. In the social world, the term megalomaniac is often synonymous with control freaks, power-drunk army generals, executives and politicians. The treatment of megalomania includes medications. The challenge here is that the person may not believe he has anything wrong with him. He, in fact, believes that he is so great that no harm can come to him, so talking him into getting himself treated is very difficult. Adolf Hitler, the German dictator, was a power-hungry control freak. He believed that he was the supreme commander and that his race was the only race suited to inhabit earth. All other races, especially Jews, were inferior and had to be wiped off the face of the earth. Adolf Hitler was megalomaniac.
Crossing the smoke screenWhy should someone quit smoking? Smoking is probably the worst sedentary lifestyle habit that we pick up. Quitting smoking changes everything right from the way you feel, taste and smell, your breath smells better and even your cough goes away. Quitting smoking cuts down the risk of cancer, stroke, neuropathy, heart disease and breathing disorders like bronchitis, pneumonia, and emphysema. Not just that, quitting saves money too... just one of the many financial rewards of quitting. Quit Smoking Tips Write down the reasons you want to quit for, and how it will benefit you: for e.g. live longer, feel better, family safety, save money, smell better, find a soul mate easily, etc. You know what's bad about smoking and you know what you'll get by quitting. Read the list daily. Ask for help from your family and friends. Help and support of family and friends without being judgmental helps a lot. You need their support when you become irritable and even irrational while you withdraw from your smoking habit. Set a Deadline. Set a quit date when you will extinguish forever. Prepare a plan. Talk with doctor and take his support and guidance. Exercise. Exercise helps relieve stress and recovers body from damage caused due to cigarettes. Start slow and increase up to 30 to 40 minutes. Begin to breathe. Daily deep breathing for 5-15 minutes will help cleanse the respiratory system and provide more oxygen repairing the damage caused to respiratory system and help cope with withdrawal symptoms. Do not quit abruptly. Cut down on cigarettes gradually. Plan everything about number of cigarettes you will smoke each day till the quit date, reduce the number each day. Buy single cigarette at a time. This helps a great deal to limit smoking. Change brands. This way you won't enjoy smoking as much. Undertake social commitment. Keep your packet of cigarettes with someone else, so that you have to ask for them each time you want to smoke. This way you'll feel guilty about asking and hence smoking; hence lowering the number of times you smoke. Find a mate who is trying to quit. This will boost the morale and keep up the positivity. Try finding a quitting chat room. Learn what triggers desire to smoke - like stress, the end of a meal, arrival at work, entering a bar, etc. Avoid these triggers or if that's impossible, plan alternative ways to deal with the triggers. Now, after you have read this, sit down and write your own list suitable to your personality and way of doing things and create your own plan for quitting.  
When the grey matters!Greying of hair happens to all of us at some point in life. Some may get it early and other fortunate ones may get it when they are 50. Premature greying and hair fall is a common problem faced by 70% of females in India these days. What are the causes of greying of hair and what can be done if your hair starts to go grey early? What are the probable causes of grey hair and hair fall? Deficiency of nutrients in diet. Excessive stress. Dandruff. Diseases like thyroid disorders, anemia, and vitiligo. Side effects of certain medication. Hair problems are seen more in women who smoke or drink. Childbirth and menopause are the periods of life when most of the women invariably have hair loss. Hereditary pattern of premature greying. Today's beauty procedures like coloring, bleaching, dyeing, perming, and straightening cause hair problems at a young age. Environmental pollution. Treatment and prevention Have a balanced diet. Ensure proper nutrients reach your body in every meal. If you are anemic, treat it with proper medication. This can be an underlying cause. Have a good sleep. Avoid tension and stress. Apply oil regularly and massage. Drink lots of water. Avoid exposure to chemicals. What can be done to hide the grey hair? Apply amla oil to your hair to make it healthy. Apply henna, lemon juice, fenugreek seeds paste, made in an iron container, on your hair to give them a color and reduce greying. Boil gooseberry pieces in coconut oil. When they turn black apply it on the hair. If you have 45-50% grey hair then you can use a permanent hair color.
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.
How to communicate with a patient who has a strokeThe first and the most important thing to communicate with the patient, is to give undivided attention. Give attention to his activities, gestures, his facial expressions through which he may try to communicate so his feelings could be understood. Eye contact is also important but the patient having stroke may look at you square in the eyes but he may not respond to your conversation. While communicating with the patient you should always stand in front and tune out all the other sights and sounds in the room. Maintain full silence around the patient in the room, turn down the volume of the television, radio and ask other people in the room to be silent. You may communicate with the patient by making contact by touching the hand, chin, cheek or areas which are not affected by stroke. As the side which is affected by stroke, does not have any sensations. You may communicate with the patient through his family member by telling the family member to communicate with patient by saying, "Look at my face"; through this we can gain the patient's concentration. You should always speak clearly with the patient in a normal soft volume. Express your ideas in simple terms, form simple sentences, do not use complex words. You may repeat the sentences or an important term again. For example to ask if the patient wants tea, repeat the word 'tea'. More complex thoughts can also be similarly conveyed and repeated. You may also use hand gestures with clarification like doing Hello by waving your hand or through your hand action, you may ask questions like, How are you? Are you ok? What do you want? Through this both caregiver and stroke patient can benefit. You may ask your patient to point out whatever he wants or if he needs anything. And gradually he will develop the habit of pointing the daily items like television, newspaper, remote, eyeglasses radio, drapes an uncomfortable foot, the patient can indicate any pain or headache. Through this communication we can make the patient learn, use mechanical lifts to get in and out of the bed, and with the help of the attendant by demonstrating the patient how to use it. Sometimes when the communication does not work, take a break, give it time and try again, do not get frustrated and reassure the patient that yes, he or she can do it. Good communication with the patient is very important as they cannot speak their basic wants and needs clearly. The patients suffered a stroke also have slurred speech. There is a deviation of the angle of mouth. They are mostly bed ridden and could not carry out the routine activities.
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.
Stress-free sex: Know your safe period!Having sex is a pleasurable thing; and the nicest way to enjoy it, is to give in without being bogged down by the fears of getting pregnant. Not every act of sexual intercourse will result in pregnancy. There are days when your chances of conception are very high, just like there are days when the chances of getting pregnant are almost nil. Identifying these days will help you enjoy a better and a more stressfree sex life! A woman's menstrual cycle starts from the first day of  bleeding and ends about 28 days after that, on an average. Ovulation occurs on the 14 day of the menstrual cycle. The 14th day is the ideal day, theoretically. Since every woman's menstrual cycle differs, the day of the ovulation also differs. Hence doctors calculate the fertile period from the 12th to the 18th day of the menstrual cycle. This is the period when the chances of ovulating and hence getting pregnant, are optimal. The 1st to the 7th day and the 19th day to the start of the next cycle, are the days when the ovulation chances are very low. This means if you make love during these days, there are very little chances of you getting pregnant. This is the case with women who have regular period cycles. In case your cycles are not regular, then you would need to do a bit of math to calculate your safe period. For example, if your shortest cycle is of 26 days and the longest cycle has been of 31 days, then: 26-18= 8 and 31-10=21, which means the 8th to the 21st day of your cycle, are the most fertile days. The 1st to the 7th day and then the 21st day to the start of your next cycle, are the days that are safe for you to enjoy sex, without fear of getting pregnant. Opting to have sex during the 'safe period', isn't always fool-proof though. A lot of women have irregular cycles and the cycle length can vary from woman to woman; which is why the so-called 'safe period', is in truth, not 100% safe. It is always better to use condoms or other contraceptive methods like the oral pill to prevent unwanted pregnancies.
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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