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Broad chest, weak lungs - Are men more prone to respiratory diseases?The long-standing, chronic afflictionof the respiratory disease is called as COPD, i.e., Chronic Obstructive Pulmonary Disease. COPD is the obstruction within the lung tissue, causing improper circulation and entrapment of air. This limits the space for air to move in and out, directly affecting the quality of inhalation. A small reminder here may be necessary - breathing is synonymous with life, why? Because that's how we get oxygen, which is vital for the functioning of each and every cell within the body. With COPD, the ability to take in oxygen gets compromised increasingly. Continued cough, sputum, and shortness of breath are the main symptoms. COPD is more common in men. Does it have to do anything with being a male? Not necessarily. No specific link has been established to say that COPD risk is higher for you solely because you are a man. Then, what could it be? A study conducted in 2011 in USA showed that the number of men who smoke is 5% more than the women who do. To understand the reason behind this, let us see the primary causes of this disease. Air pollution, some genetic predispositions, frequent acute infections, exposure to harmful chemicals for a long time (usually occupational) - are some of the main causes, and the number one cause is smoking, owing to almost 80-90% of the cases. Park this thought. Next piece of information is simply revisiting some facts you may already know: #The gender classification ofsmokers - Men are known to smoke more than women all over the world, not only in numbers, but also in quantity. Whether it is a developing country or a developed one, 2011 studies say there are more male smokers everywhere than female smokers. Not only there are more men who smoke, they smoke for longer periods and more number of cigarettes than female smokers. This may vary from country to country, like India has much less women smokers than USA does, but the difference between the two genders holds true everywhere, only the ratios differ. #Occupational exposure to harmful chemicals and gases - These are industries of mining, textile, chemical engineering, welding, etc. The number of men working in such industries is way higher than women. #Air pollution - Men are more exposed to air pollution since they are outdoors more than women. This may not apply to all countries and societies, but is generally true. Now, we can put the pieces together and understand why COPD is more common in men? Yes, they are at a higher risk because of higher exposure to smoking, pollutants and irritants. Cigarette smoking is the leading cause of lung diseases and male smokers outnumber women across the world. You can figure out the math here!
Importance of breastfeedingBreastfeeding is a natural act and that is why it is also one of the most beneficial acts for a baby. Breastfeeding provides essential nourishment and is the best food for the baby's stomach to digest. No matter how many infant formulas enriched with vitamins and minerals you provide to your baby, it can never replicate mother's milk. As for the mother, there is nothing more joyous than providing your baby with the best start that it can get in the long journey of life. The bond that the mother and the baby share through breastfeeding is one of the most special bonds. For the first six months, breastfeeding your baby is recommended for all mothers whether they are working or at home. Most working mothers are given leave, whether paid or unpaid, so they must ensure they provide their babies with regular breast milk. Breast milk protects the child against diarrhea, respiratory infections, pneumonia, ear infections, and helps to reduce chronic constipation and colic that the babies are prone to. Research also points to the fact that breastfed babies are immunized and protected against allergies, asthma, sudden death, diabetes, and obesity. They remain much healthier than those babies who are formula fed. In India, only 41% mothers begin early breastfeeding even though it has so many benefits. Mothers who exclusively breastfeed their babies help them to survive better. They also gift them with better brain development and these babies are likely to perform well intellectually. No matter which economic section of society the mother comes from, she can provide her baby with the best start in life by breastfeeding it and make sure that the child develops to its full potential. Breastfeeding is natural, simple, and cost-effective way to ensure your baby is healthy and continues to develop healthily. Since the breastfeeding campaign began on a large scale, child mortality has decreased. Immediate breastfeeding within one hour of birth has helped to significantly reduce sudden baby deaths. The colostrum, the first thick yellow breast milk is what protects babies from many diseases as it is filled with goodness. Lack of nutrition or malnutrition is another aspect that leads to infant deaths. Breastfeeding can significantly lower infant deaths from malnutrition as the mother's milk is one of the most nutritious foods provided by nature for the baby's healthy growth. A mother has the full ability to provide adequate nutrition for the baby, therefore breastfeeding needs to be encouraged fully. Employers need to create an appropriate space within their premises and should encourage new mothers to breastfeed their child. Breastfeeding also has a number of benefits for the mother. It helps to burn calories and the mother can return to her former pre-pregnancy state. Breastfeeding helps mothers to reduce their risk of breast, uterine, and ovarian cancer;high blood pressure;diabetes; and heart diseases. So for the first six months, mothers must make sure to breastfeed their baby and do not substitute it with baby food products.
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.
Boost your mood after a long day at workUp before the sun rise, rush to get ready, say hurried goodbyes to the family and crawl like a tortoise through traffic to get to work. Go through a long day of meetings, calls, deadlines, reviews, and then crawl back again through traffic at a snail's pace. Does this sound like a day out of your life? Then surely, weekends go by faster for you than you can say lickety-split, leaving with no time for yourself, your family or your hobbies. Social life is definitely a far cry from possible. This rigorous schedule eventually catches up with the mind and body and lethargy sets in, discouraging any sort of activity that breaks the monotony of day-to-day life. Is there no escape from this? Yes, there is. At the end of the day, when your mind is tired, you do not feel like taking anything more than you already have on your plate. Only the warmth of your bed allures you. However, if you were feeling fresh and enthusiastic, surely, you'd be ready to do a lot more - move mountains or at least drive to meet friends, anyway. An energetic life full of happy times with families without the constant desire of solitude after a long day's work is what you seek, then try these mood boosters to uplift your mood and get your feet tapping right away! The Aroma of Good Mood:Scents play a great role in the way we feel. They have the power to turn the mood around completely. Light a few scented candles or set up an oil diffuse of your favorite oil and you will feel lighter and De-stressed soon enough. You can also mix a few drops of rosemary and bergamot to create an energizing and refreshing infusion. Walk it Off:Most of us work in functional buildings in temperature-controlled environments. The lack of windows makes natural light and ventilation scarce and aids the buildup of gloom and tiredness. A good way to turn the mood around is to walk it off. A short walk around the block or in the building compound can bring you back in touch with nature. If you are lucky to be living in a green community, you have the added benefit of watching the trees and bird life in them. The exercise also helps release hormones in the body that uplift your mood immediately. A Good Deed Begets Good Mood:Giving is the greatest joy! So perform a good deed - if you see someone who needs help on the way back from work, stop for a few moments and help them. Or simply help your spouse, children, parents or neighbor out. And voila! You will find yourself feeling a lot better than how you did when you entered the house. Clear the Clutter:Organizing things and creating neat, clean spaces is a great mood booster. As you clean the clutter, you will find the clutter of thoughts in your head also clearing. Neat, well-kept spaces invite good vibes and energies, which again makes you feel better in turn. Petting a Furry Friend:Petting a dog for even 15 minutes releases the feel good, happy hormones. It does wonders for the stress level too. So the next time your furry friend comes rushing to the door, to welcome you back home, take time to give it some love. The Human Touch:We spend 10-12 hours a day away from our family and familiar touch. The human touch releases uplifting hormones such as serotonin and reduces heart rate and blood pressure making you relaxed. So when you get home, remember; a nice warm hug to your spouse or children will make you both feel better.Remember you work to live and not the other way. So when you get home from a long, tiring day, just boost your mood so you can thoroughly enjoy life with your family!
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.
How to say 'Bye' to split ends? Check out these 10 tips!One of the main reasons for split ends is the use of curling irons and other heat-induced styling treatments. When you go for hair products like hair colors or perms, the shield over your hair's shaft that protects it can get stripped off, thus making your hair liable to split ends. You could also be mechanically stressing your hair by pulling them too much while combing or combing repeatedly. Remember that rubbing your hair up towards the direction of the scalp does not lead to split ends. While there is no remedy to treat split ends, there are ways in which you can keep them away. Did you know that a medical research showed that the only way to keep split ends away is to put a stop on the excessive use of chemical on it? Hairdresser, Holly Kensen, says that split ends are the results of pushing out the natural process and pulling in too many chemicals. It is best to stay away from the styling products and embrace your natural hair! TIP 1 : Get hold of a piece of rosemary (fresh ones are the best!) and immerse them in a cup of hot water for 30 minutes. Once the temperature of the water is back to normal, whisk an egg into it. Mix this blend onto your hair. Rinse after 15 minutes using a light shampoo. TIP 2 : Bring home a ripe papaya and cut it into halves. Choose the part which you believe will be sufficient for your hair. Take off the skin and seeds. Mash it until it becomes a paste. Then, drop a cup of yogurt and stir them into a smooth paste. Apply it on your hair and let it hold for about 30 minutes. Use cold water to rinse it off. TIP 3 : Condition your hair with castor oil. Mix equal amounts of castor, almond, and olive oil and apply it on your hair generously. Wrap your hair in a towel and let it stay for 30 minutes. Then, shampoo your hair. TIP 4 : After you have shampooed your hair, apply a mix of cream and milk on them for about 20 minutes. Focus especially on the ends. Rinse your hair with cold water. TIP 5 :If you decide to trim your hair on your own, then don't use the paper scissors! They are called 'paper' scissors for a reason. Get hold of hair shears which will not leave your ends damaged. TIP 6 : Trim your hair every six to eight weeks at least up to ¼ to 1 inch. Due to our environment, it is natural for the hair to get damaged in a few weeks. It is important to remove the split ends and let them grow healthy. TIP 7 : Do not trust products which say that they can 'cure' your split ends. Split ends are not curable. They are preventable. The only thing that these products do is to seal up the splits which only makes your hair unhealthy. TIP 8 : Try to stay away from chemicals as much as you can. Chemicals only tamper with your natural hair and ruin their texture. If you really have to use it then make sure you condition them regularly. TIP 9 : Use coconut oil to fix your split ends. Buy an extra-virgin and organic coconut oil. Before washing your hair, apply about 2 spoons of the oil on your dry hair. Emphasize on the hair ends. If you want, you can steam your hair for some time (about 20 minutes). Then, wash your hair with a light shampoo and condition them. TIP 10 :This is one of the best ways to help your split ends stay away: Get hold of chamomile tea and brew it on a pot. Then pre-rinse your hair with it. After you have rinsed them, wash and condition your hair normally.
Exercise, a healthy way to deal with hypertensionYou have not exercised for a long time. You took it easy when it came to physical activity. Now that you are diagnosed with high blood pressure, you will do anything to control it. Even exercise! Exercise, weight management, and a healthy diet are important ways to help prevent high blood pressure and lower the blood pressure that is already high. Benefits of exercise for people with hypertension include: Improve blood and oxygen circulation in the body Promotes sound sleep Improves stamina and endurance Keeps heart healthy Reduces stress and promotes mental health Exercise enhances the effectiveness of medication So how much should one exercise? An exercise session of atleast 30 minutes per day is important. Get started Start slowly and increase gradually. Start with 10 to 15 minutes of exercise and increase it, as youget comfortable. Choose exercises you enjoy and will do consistently. Avoid sudden vigorous activities; they can cause injuries and hamper the routine. Warm up Warming up helps the body adjust slowly from rest to exercise. A warm-up will reduce stress on the body muscles, increase heart rate and respiratory rate, and body temperature slowly. It will also decrease soreness of muscles. Best exercises for lowering blood pressure Stretching: It is the best. It relaxes and helps prepare the body and muscles for activity and prevents injury and muscle strain. Stretching regularly will make you flexible and improve motility. Aerobic exercise: This helps to improve circulation to the entire body. It improves heart function. It gives maximum benefits to the heart. They also help to reduce heart rate and blood pressure by improving breathing pattern thus lowering blood pressure. Walking, swimming, jogging, and skipping are all aerobic activities. Do aerobics for at least 30 minutes three times a week. Strengthening exercises: These include exercises that have repeated muscle contractions till the muscles are tired. These include side balance crunch, climbing a rope, and push-ups. Join a gym. Here are some  exercise guidelines for a better exercising routine in the gym:  Schedule a fixed time for exercise. Find a buddy to exercise with you. Select an exercise that you like. Make variations to avoid getting bored. Boredom can make you stop exercising. Start slowly and increase gradually, especially if you do not exercise regularly. You should wait for an hour after eating before you exercise. Ten minutes of warm up and ten minutes of cool down sessions are must Keep a record of daily exercise.
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.
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!!
What, how, and why of the sex muscle answeredWhat the Penis is made up of? The penis is made up of several parts. The head: This is also called as the 'glans'. The glans is coated with soft pinkish tissue called the mucosa. The protective covering of the glans is called the foreskin. The foreskin is retractable. In circumcised men, it is the foreskin that is removed. The shaft: The shaft or the body of the penis has two surfaces. The dorsal part i.e. the upper part of an erect penis and the ventral part i.e. the lower part that faces backwards in a flaccid penis. The root: This is the attached part of the penis. Corpus cavernosum: This is the tissue that lines the shaft on two sides on the dorsal side. During sexual excitement, this corpus cavernosum fills with blood that results in the stiff erect penis. Corpus spongiosum: This is the tissue layer running in between the two layers of corpus cavernosum on the ventral side of the shaft. The urethra: This is a narrow tube that runs through the corpus spongiosum. The urethra's main function is to excrete the urine out of the body. How the Penis does what it is supposed to do? Urination: The process of expelling urine is a coordinated act involving the bladder muscles, the central and the somatic nervous systems. The urethra present in the penis serves as a tube for the urine to pass out. Erection: A erect penis is required for the successful insertion into the vagina. During the height of sexual excitement, there occurs dilatation or enlargement of the blood vessels in the corpus cavernosum causing a rush of blood into it. This elongates the penis and makes it hard and stiff. Erection angles: The way a normal penis points when erect is called the erection angle. The penis is either pointing straight to the front or it may be facing up or down to the feet. An upward angle is most common. A study published in 'Journal of Sex and Marital Therapy', shows the erectile angles in standing males from 20 to 69 age groups in the following table In the table, zero degrees is pointing straight up against the abdomen, 90 degrees is horizontal and pointing straight forward, while 180 degrees would be pointing straight down to the feet. Angles from vertically upwards: 0-3 - 5% of male 30-60 - 30% of males 60-85 - 31% of males 85-95 - 10% of males 95-125 - 20% of males 120-180 - 5% of males Ejaculation: Ejaculation is when the semen is pushed out of the penis. During the sexual act, the process of ejaculation forms the culmination with the male achieving an orgasm immediately after. At times, there is ejaculation of semen spontaneously during sleep, called Wet Dreams. Normal Variations- When you have what others don't (and it is completely normal to have them)! Curvatures: While most penises are straight, it is not abnormal to have a curved penis. Curvatures up to 30 degrees are considered normal and no medical attention is advised. Over 45 degrees may need you to get yourself checked for certain diseases, though. Phimosis: This is the inability to retract the fore-skin fully. It is harmless and occurs in about 8% of boys. The British Medical Association suggests that no medical treatment may be required till 19years of age. Pearly Penile Papules: These are small pale bumps that are found around the tip of the penis. They are very common in men aged 20 to 40 years and may be mistaken for warts. Unlike warts though, they are completely harmless and require no treatment. The human penis has one of the most advanced designs through eons of natural selection for high sperm competition. Disorders of the Penis: When you have what others don't (and it is not normal to have them)! Paraphimosis: This is the inability to retract the foreskin. It may be extremely painful when retracted. This condition occurs when there is leftover fluid accumulated n the foreskin due to some previous surgery. Peyronie's Disease: This is a condition where the penis is extremely curved. It is caused due to a scar tissue running through the shaft of the penis. There is an option of surgical correction. Herpetic Eruptions: This can happen when there is unprotected intercourse with an infected partner. It shows as painful ulcers and eruptions on the head and shaft of the penis. Absence of sensations and erection: This is a condition where one is not able to feel any kind of sensation in the penis and a total lack of erection. This occurs secondary to diabetes mellitus and also as an after-effect of past falls on the back or injuries to the groin area. Erectile Dysfunction: This is a condition that happens due to psychological stress, performance anxiety, natural ageing and diabetes mellitus. It is expressed as an inability to get aroused or inability to maintain the erection for a time enough for proper sexual activity. Priapism: This is a serious condition requiring immediate medical attention. Here the erect penis fails to return to its flaccid state and as a result may lead to potentially serious conditions like a thrombosis or gangrenous state. Severe cases may require amputation too. The causative mechanisms are not well-known but involve complex neurological and vascular factors. The condition is associated with drugs like sildenafil, commonly known as Viagra. Pudendal Nerve Entrapment: Too tight pants and underwear, arrow hard bicycle seats, accidents can lead to this condition. The symptoms include loss of sensation and ability to achieve orgasm along with pain in the penis during sitting. Infections: Common infections of the penis include balanitis, urethritis, syphilis and gonorrhea. Theya re characterized by burning, itching and foul discharge. Lasting longer in bed is every man's desire. How do you go about it is very important. Follow the right diet and exercises along with lifestyle changes to achieve the desired effect in bed. Stay away from medications that claim to make you last long. Ref: Sparling J (1997). "Penile erections: shape, angle, and length". Journal of Sex & Marital Therapy 23 (3): 195-207
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