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Handling post retirement bluesYou have given the best years of your life to your career, and now it's time to say goodbye and get ready for the retired life. It is a phase laden with expectations of all things you were too busy to do while working - spending more time with family, going on that fishing expedition, or going on leisure trips around the world. However, despite the wonderful things to come, retirement can get unusually trying and mentally taxing. After all, how many of us really have the flexibility of mind to take this period as a challenge and be the master of our destinies? Just because you are retired doesn't mean you have to wither away and wait for death to claim you. So, here's what you can do to beat the retirement blues Catching up: This is really a bewildering time, as you have a lot of catching up to do, with a lot of things. Prioritize the things you want to do and proceed confidently. You may want to spend time with children, spouse, friends, etc. Go easy on yourself, as you may not be able to fit in as many things in your schedule all at the same time. Boost your self-esteem: Retirement is particularly trying for those who have occupied important positions in office. Such people are known to throw tantrums, as they feel less wanted than before. So don't ever make the mistake of treating your family like you treated subordinates at work. That was a role that you played then, and without reducing your importance or self-esteem you can now play a different role with your family as a friend, philosopher and guide. In fact, you can use your contacts and keep the old network alive by involving youth in your field of expertise and help them benefit from you. Catch up on exercise: The more physically fit you are the less likely that retirement will be a painful process. Perfect time for you to catch up on the fun times with your spouse to remind you of all the great times you have had all these years. If your spouse is not in the best of health then just being together is such a wonderful experience in the golden years. Financial health: Your peace of mind and self-esteem largely depend on how independent you are financially. You can take up a part time job or think of innovative ways to let your hobbies and interests generate money for you. This should be an enjoyable process by which your self-esteem can really benefit. Support groups: There are informal or formal associations of retired people that do various activities like travelling. Make yourself available to them. Sometimes retired people withdraw into a shell and that only makes things worse. These support groups give a fresh perspective on all things in life.
Just how sporty is your sports bra?Very few women in the world really know the right size of their bra and end up using wrong size bra all their life. A study shows that all over the world only 2 women out of 10 wear the right sized bra due to which they can never get the look they want. Since there is lot of difference in sports bra of different brands, you need time and patience to find out the most suitable one for you. You should keep on measuring yourself every year, and especially if you have added weight or lost weight. It is also necessary to check your bra-size after pregnancy.  On an average, the size of sports bra range from A to H and most women find a comfortable fit among either of this size. A good sports bra should always offer three things- support, comfort and breathability to the breasts. Choosing a Bra with a Good Fit Most of the elite bra shops offer good range of different sports bra. But it is important to know which one suits you or is of your size. A well fitting bra gives you the liberty to exercise or move with confidence and comfort. One thing you should keep in mind while purchasing a sports bra is your life style and preferences. Some like it padded, some like it embroidered, while some may like it simple. So apart from correct measurements, your style should be given preference while buying a sports bra. Moreover, you also should take into consideration the dress you are wearing on this bra. Here are some tips that can help you in selecting the right bra when you will go to the lingerie shop. Support   A good bra should offer your breast complete support, irrespective of whether they are small, medium or even big. If you have breasts ranging in between A to C cup, you should choose a compression bra that offers more comfort and support. If you are looking for a bra that also encapsulates and gives proper shape to your breasts then you should choose a bra accordingly. These bras offer more support than the compression bra. For getting both comfort and support, you can choose a compression bra that also encapsulates your breasts properly. Comfort You should feel comfortable when you wear a bra. It should stay in place and should not chafe. If possible, try one of the samples in the changing room and check whether the straps dig into your shoulders or whether the bands provide comfortable support to the breasts. The bra should hold the breasts comfortably without being restrictive. A good bra is one that holds your breasts in place even when you are performing all the jumping, running and swinging acts. Breathability The fabric of the sports bra should be good enough to wick away the sweat from the skin so that it dries quickly and allows the skin to breathe properly. The bra should allow excess heat and perspiration to pass through the fabric keeping you dry and cool during summer &  warm and dry during winter.  
Hair straightening do's and don'tsWhat's in a hair? Well when someone thought of this quote, he or she certainly did not foresee the future because in today's world hair is everything. For a woman and a caterpillar at least! Let's just talk about women! Hair not only covers your scalp, but also protects it.  Hair is known to be something that enhances the beauty of a woman, as there is nothing like the feel of smooth and silky hair caressing the shoulders. Women all over the world dream to have beautiful, strong, silky, and preferably, long straight hair. Why straight hair? Let's find out, women are born with all kinds of hair, curly, wavy, long, and short but according to some women there is nothing that beats having a straight hair and there are women in this world who could go to any length achieving that straight hair they always desired. One of those ways is straightening, a styling technique used since the 1980's, which involves the flattening as well as straightening of hair, to give it a smooth, streamlined, and a sleek look. Straightening can be of two types, temporary or permanent. Temporary straightening can be achieved by a straightening iron or relaxers and generally lasts up to the first wash. Permanent hair straightening generally requires the use of Lye and other chemicals (more commonly known as creamy crack) with the help of a hot comb, hot iron, and relaxers. Permanent straightening, with proper care, can easily last up to a year. According to documentary "Good Hair" by actor Chris Brown, African American women are known for their profound use of "creamy crack" to get that perfect straight hair they long for. They are also the women who make the cosmetic companies rich, thanks to their profound use of hair straightening and hair care related products. African American women also account for the highest amount of money spent on hair care and hair care related products. Coming in a close second are the women from Central and South East Asia. These women are also known to go to extremes to get that perfect straight hair look, which is generally shown in TV Commercials endorsed by celebrities. Now that we are aware of the statistics, it is time that we look into the do's and don'ts of hair straightening. Straightening your hair once in a while may sound like a good idea, but it is extremely essential that we understand that extreme care is required here. Hence it is always better to know the do's and don'ts before we decide to break the bank (straightening ain't cheap) for straightening treatments. Do's : Make sure your diets consist of plenty of healthy foods, water. Also doing regular exercise is advised. Always use a shampoo and conditioner that best suits you. Remember to ask your stylist about the kind of products that suit you. Always go for hair spa treatment once a month since your hair needs that extra nourishing. Don'ts : Do not wet your hair at least for three days after the treatment. Do not tuck your hair behind your ear. Avoid twisting your wet hair with a towel. Avoid extreme scrubbing of your hair while shampooing. Straightening even once can cause excessive damage, hence do not do it repeatedly. Straightening your hair once in a while is okay, but doing it continually is ill advised as it can have a lot of negative consequences. Straightening also comes with certain side effects such as heavy chemical reaction, dizziness, permanent hair damage, dryness, skin irritation, itchiness, and severe chemical burns. Hence, it's always better to have a professional do it at a salon rather than doing it yourself. Hair straightening, though done by the same method all around the world, requires different types of hair care products as the hair type is mostly related to your race and ethnicity and your geographical location.
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  
High blood pressure in the little onesIf you are asked to paint a picture of a patient of hypertension, how would it look? Leave the details aside, would you paint an old person, a young person or a child? Most likely, you will paint an old person or may be a middle-aged person. But a child, who would think of a child to have high blood pressure! It may be difficult to believe for most but not only is it possible, its incidence is also increasing gradually. In fact, hypertension in kids is becoming quite common. Studies in USA show that up to 5% children and adolescents have hypertension. What is it? High blood pressure in children and adolescents is also called as pediatric hypertension. Pediatric hypertension is defined by the blood pressure recorded on the mercury, in comparison to the given standard range. As a child grows, there is rapid development in all the milestones. For children, there are percentiles defined for all parameters for various age groups. In children, when the blood pressure is above the 90th percentile but below the 95th, it is called prehypertension. When it is above 95th percentile, it is diagnosed as hypertension. There are no distinguishing symptoms of pediatric hypertension, so it may easily be missed. Please make it a practice to get your child's blood pressure checked on routine visits for medical examination. Why does it happen? High blood pressure in children under ten years of age is usually secondary to some other health condition. It could be due to an underlying heart disease, kidney disease, hormonal disorders or genetic abnormalities. This demands treatment of the main problem. Primary hypertension is noted in older children, over 6-10 years of age and adolescents. There is no specific cause identified for this, other than lifestyle, obesity, rich foods and family history. How bad could it get? Children may show a disordered sleep pattern when they have hypertension. They may suffer from sleep apnea, reflected by snoring or abnormal breathing. Besides sleep, the other effects of hypertension are the known ones. In the long run, it could lead to heart disease, stroke or kidney disease. What to do? It is very important to control the blood pressure from a young age. Regular check-ups and monitoring of the BP is needed. Thorough examination is a must to identify whether the hypertension is primary or secondary. Treatment by medicines is recommended in secondary hypertension, where the underlying condition is to be tackled along with the management of blood pressure. In cases of primary hypertension, medication is suggested only in extreme cases. Otherwise, lifestyle management is the key. It is not a healthy option to start anti-hypertensives this early in life. Give your child healthy food, help him/her maintain the ideal body weight and make sure he/she gets enough exercise physically. The sooner we identify the problem, the better are the results with a disciplined lifestyle. The unhealthy lifestyle is creating chaos in all our lives. How long the kids would have escaped? Our lifestyle reflects on our kids. Follow a healthy routine and keep the family healthy!
Mood disordersMood disorder is a category of mental health problems, and it includes all types of depression and bipolar disorder. The cause of mood disorder is not well known. Endorphins in brain are responsible for positive moods. The neurotransmitters regulate endorphins. Depression and other mood disorders are caused by a chemical imbalance in the brain. Life events such as unwanted changes in life may also contribute to a depressed mood. Mood disorders are inherited. Children, adolescents, or adults who have a parent with a mood disorder have a greater chance of also having a mood disorder. Symptoms: Prolonged feeling of sadness Helpless feeling Low self-esteem Intense guilt Suicidal thoughts Loss of interest in daily activities Difficulty with relationships Disturbed sleep Change in appetite or weight Low energy Inability in concentrating Inability to make decisions Frequent physical complaints (i.e., headache, stomach ache, fatigue) Threats of running away from home Hypersensitivity to failure or rejection Irritability Aggressive behaviour Hostility In mood disorders, these feelings appear more intense than what a person may normally feel from time to time. Treatment Psychotherapy: It is focused on changing the individual's distorted views of themselves and the environment around them, working through difficult relationships, and identifying stress triggers in their environment and how to avoid them. Family therapy: Families play a vital supportive role in any treatment process. Antidepressant medications: Medications in combination with psychotherapy has shown to be very effective in the treatment of depression.
5 tips to reduce your salt intakeSalt is an inevitable part of our food, but added salt has harmful effects on the body. The list of benefits in reducing sodium/salt intake in our diet runs long, ranging from lower blood pressure, in turn leading to reduced risks of heart disease, obesity, and diseases of the kidney. The daily sodium intake of an individual should not exceed 1500-2300 mg per day (a table spoon of salt approximately), and this needs to be maintained in the salt added to our food, including the processed food and drinks we buy. Sodium, an indispensable component of our diet, is consumed in excess by most of us. Follow the tips, as mentioned below, to curb your daily salt intake. Avoid added salt. Do not add salt to already cooked food while eating. Keep a diary and make a list of foods with salt in them that you eat daily. Do not forget to add pickles, spices, papads, salted biscuits, and salted nuts. All of these are highly loaded with salt. Next time you go shopping read the labels. Choose low-salt options-sauces, crackers, khakhra, instead of papad. Make an attempt to eat less canned and processed foods. Choose fresh fruits and vegetables over processed food. Eat less bread. Each bread slice has about 250 mg of sodium. Do not mistake bread to be healthy. Next time, keep this in mind when you go out to eat pizza. Pizza base is like bread. While cooking food, make it a point to add salt only towards the end in the recipe. This way you will need to add lesser salt. Sodium content of some foods Bread (one slice) - 250mg Cheese pizza: 450 - 1200mg Tomato soup: 350 - 1000mg Potato chips: 100 - 150mg
Beating the weight loss plateauThere comes a stage when you stop losing any weight in spite of strict exercise and diet regimen. This is called as weight loss plateau. When calorie intake is reduced along with exercise, the energy required is obtained from stored fat which eventually leads to weight loss. This rate of weight loss slows down and eventually stops once body reaches its set point of metabolism. This set point varies from person to person. So what can you do next? Here are some easy ways to get the weighing scale budging: Modify diet pattern: Metabolism slows down with lowering calorie intake. To reset metabolism, you need to have an adequate amount of calories. This can be done by including fruits and vegetables, whole grains, and proteins in diet. More energy is needed to burn proteins than carbohydrates or fats. Eat within half an hour or hour after exercising. Add proteins and carbohydrates to diet. Sip water: Increase total water intake in a day. Drink water before, during and after exercise and throughout the day. Change the workout: Change the exercises you do daily. Muscles get accustomed to a routine workout. Switching exercises and continually challenging helps burn more fat and build lean tissue. Change the type and time or duration of exercise. Try cycling instead of running if you have been doing it for long. Running, swimming, dancing, and Pilates too are good options. Skipping and brisk walking help in burning calories too and break the plateau. In the gym, change the exercise or number of repetitions. If you have been working on machines for long, try weight training or floor exercises. Take rest: Adequate rest is essential for the body to rejuvenate. Muscles, tendons, and ligaments get slight internal and external injuries which can be healed by rest. Proper rest helps repair and regenerate the tissue and makes them strong. Make these changes and get the needle on that weighing scale to budge.
Diabetes paves the way to cancer!Diabetes mellitus is common across the world. So common, that people don't take it seriously. It appears relatively benign on a day-to-day basis. It is just a sugar level that you notice on the outward. Controlling diabetes means a change in the lifestyle. It is easy to pop in some pills to battle a disease. The difficulty lies in making long-term changes in our daily routine. We tend to get lazy and make excuses for not being able to follow a discipline in lifestyle. This happens more so with diabetes because we do not see an apparent damage that is being done by the high blood sugar. Unless the levels go really high or drop very low, there are no major symptoms that affect our activities from morning to evening. What we are unaware of is that the disease is making some serious damage insidiously. It affects multiple organs and processes. These effects cannot be directly noticed but are continuously ongoing. By the time we wake up, a lot of injury has already occurred. Here is some more bad news. A large number of scientists in all countries are working day and night to study the course of diabetes and bring new facts to light.  Recent researches have established a new link - cancer. Yes, diabetes increases the risk for breast cancer and colon (intestinal) cancer. A woman who has diabetes, is at 20 times more risk for developing breast cancer. Breast cancer A peculiar association of diabetes and breast cancer has come in the picture in the last few years. Factors contributing to these are many - sedentary lifestyle, overweight, rich food, etc. Another important contributor is hormonal imbalance due to diabetes. As a result of high sugar and high insulin in the body, twofold changes occur in the hormonal cycles which ultimately lead to excess estrogen circulation in blood. This, in turn, may act as a trigger for breast cancer. Breast cancer is relatively easy to diagnose. When detected in early stages, treatment has shown remarkable affects. Colon cancer Cancer of the intestine is one of the most common cancers worldwide. Scientists are still working on finding the exact cause but a clear relationship between diabetes and colon cancer has been proven. Patients suffering from high blood sugar have a higher risk of developing intestinal cancer than those with normal blood sugar. Colon cancer is often seen to be fatal and rate of recurrence is quite high. Worldwide several researches have shown a strong connection between diabetes mellitus and occurrence of breast and colon cancer. Suggestions If you have normal blood sugar levels, please put in your best effort to maintain the same. If you are at risk for diabetes because of significant medical history, take extra care and precaution to prevent or delay the onset of the disease. This can be done by regular and adequate exercise, along with the balanced food options. If you have been diagnosed with diabetes, work on your lifestyle to keep the sugar levels in control. Regular check-ups and frequent monitoring of blood sugar levels are a must. If you are a diabetic, please go for periodical screening of related health conditions. Specific to the topic at hand, please get regular breast examinations. Physician recommended and supervised mammograms and colonoscopies would be extremely helpful. Eyes wide open? Now, will you pay attention to all the restrictions advised by your doctor? Please do. Get that lifestyle which is recommended. Compromise on your work and cravings; focus on exercise and eating healthy. Diabetes is not a killer if managed effectively. Don't let cancer get a hold on you.
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.
Women and impotence- The facts on sexual dysfunction in womenTraditionally when one hears the word 'impotence', one tends to associate it with the male partner. Female impotence is also a reality. Sexual dysfunction in women might infact be more common in women than in men. Read on to know more The sexual response cycle has four stages- excitement, plateau, orgasm and resolution. A problem arising in any of these phases is called Sexual Dysfunction. It hampers with the pleasures of sexual activity. All in all, a healthy lifestyle is the key to getting rid of several of the causes that may cause sexual dysfunction. Be frank and express your fears to your partner. Talking and establishing a mutual respect and comfort zone helps like nothing else can! Sexual dysfunction affects females as much as it affects men. The causes can be classified as below: Physical causes: Several diseases like diabetes, heart diseases, kidney disorders, liver disorders, neurological disorders, hormonal imbalance, menopause, excessive alcoholism or drug abuse can cause sexual dysfunction. In addition to it, inability to perform or initiate or enjoy sexual activity may happen due to side-effects of certain medications. Past pelvic surgeries are also a cause for sexual dysfunction in women. Psychological causes: The mind has got a definitive effect on the body. Sexual dysfunction is the apt example to explain this. Too much of stress, work pressure, depression are factors that do not allow an individual to perform well in bed. Past sexually traumatic events may also be a cause for sexual dysfunction. Sexual causes: This is the most frequently encountered cause for sexual dysfunction in women. Vaginusmus is the leading cause here. Vaginusmus is a pain that the woman experiences due to the fear of penetration. This causes involuntary contraction of the muscles making it impossible for her to relax. The origins of this fear are due to past painful and traumatic experiences. Dyspareunia is another cause for sexual dysfunction. It is a burning pain that lasts long after the act is over. The severity of the pain is of such a nature that the woman prefers not giving in to the pleasures of sex rather than experiencing pain. Sexual dysfunction is not something to be embarrassed of and certainly not something to be looked upon derogatorily. Sexual dysfunction often leads to frustration and can affect your relations. Speak out and seek help before it is too late. And for the men reading this, be supportive of your partner. She is going through a difficult phase and she needs your love and support along with the right treatment, not your scorn and displeasure. Treatment Options: Sexual dysfunction in women is treatable once the exact cause for the condition is known. Various natural remedies, holistic approaches and psychotherapy have been used with a good measure of success. Additionally, oral medication, hormonal therapy and surgical procedures are also used to treat impotency.
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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