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Dilemma of a working woman - How to stay healthy!Women want to be healthy and beautiful. But most of us are not able to find the time to exercise or plan our meals. We pay more attention and money on therapies to look good externally. But good looks come from good health, and good health is an outcome of a healthy lifestyle. Healthy lifestyle helps in preventing illnesses and makes us more efficient. Improper and irregular diet, lack of physical activity, and stress are the chief causes of poor physical and mental health. Most working women today are occupied with their desk jobs, and as a result have a sedentary lifestyle. Eating junk food most of the times makes the matter worse. So if you want to stay healthy, here are some changes you can make. Add movement to life. Activities like walking, gardening, swimming or aerobics help build endurance and relieve stress. Choose something which you think you can consistently - Yoga, aerobics, cycling or even dancing. Balanced diet plays a pivotal role in fitness. Fruits, vegetables, and whole grains are a must in your diet. Antioxidants in fruits have an anti-ageing effect. Choose to eat in order to satisfy hunger and build healthy body, and not to feed your emotions. Avoid junk and processed food. They are empty calories. Drink water. Dehydration affects metabolism. Drink 8-10 glasses a day to flush out the toxins. Add liquids like milk, fruit juices to your diet. Positive thoughts help build a healthy mind and a healthy mind ensures healthy body. Do not smoke cigarettes or drink alcohol to deal with stress. Try yoga, meditation, listen to music, or take a nice shower to relax. Rest and relaxation helps to cope with daily stress. Making these lifestyle changes as a regimen will surely help working women to live a life of health, wellness and fitness.  
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!
10 unhealthy habits in kidsNowadays, parents are too engrossed with their professional lives, and hence are unable to pay enough attention to their kids. Kids may develop unhealthy habits as a result of this neglect. Parents need to take conscious efforts to inculcate good habits in their children. Here is a list of unhealthy habits in kids, which you need to break immediately. Not drinking enough water It is very important for kids to keep their body hydrated in order to keep their skin supple and cool down the body's temperature when it's hot. Water also allows muscles and joints to work better and helps cleaning out toxins from the body through the kidney. Staying hydrated helps keep the memory sharp and the mood stable. Encourage your child to drink water before he/she even feels thirsty. Snacking on junk food Kids relish junk food. Unfortunately, there are endless options when it comes to junk food. This can cause childhood obesity and lowers the energy levels. Junk food cannot meet up the body's requirement for nutrition and vitamins. Hence, children must be encouraged to snack on healthy and tasty food like fruits, whole grain breads, or fruit breads. Missing breakfast School going kids often skip their breakfast in order to reach school in time. Skipping breakfast increases the risk of being overweight. It also leads to a loss of concentration and making bad food choices later in the day. Parents must wake their kids early, so that they have time for a healthy breakfast. Spending too much time sitting Technology has been a boon in some ways. At the same time, it has made us lazy. Watching TV and playing video games seem far more attractive to kids than outdoor games. Kids become less active which leads to various health problems, such as getting obese, becoming lazy, lacking of stamina, losing concentration and good eyesight. Parents should encourage their kids to participate in sports at their school or play various outdoor games with other kids. Not having proper sleep Falling short of sleep should be a big no to kids. Lack of sleep affects the immune system, and also causes loss of concentration, headaches and heart-related problems. Get your kids to sleep around 7-8 hours every night. Overdosing on sugar Kids have particular preference for sweet foods. But added sugar in various desserts and snacks provides a lot of calories and lacks nutritional values. Limit the sweet intake of your child, but don't force them to completely give up on it. Refusing to eat green vegetables Children generally don't like to eat green vegetables. They prefer to have chapati with jam or cheese. But that doesn't fulfill the body's requirement for vitamins and minerals. Try to cook green vegetables in different forms and make it look and taste yummy. Give them various choices of green vegetables cooked in different styles. Nail biting Though nail biting doesn't cause severe health problems, it could result in milder diseases such as diarrhea, cold, viral infections, pin worms, and food poisoning. Keep the nails of your kid clean and try to control their nail biting by explaining to them the ill-effects of nail biting. Not playing outdoor games Not playing outdoors impairs a child's social skills, as well as hampers the development of healthy body. It also causes deficiency of vitamin D. Try to encourage and accompany the kids for playing outdoor games. Eating without washing hands Kids play outside and touch various objects and surfaces, which may have lots of bacteria and germs. When they eat something with the same dirty hands, the bacteria and germs enters their body and may cause food poisoning, viral infections, and stomach aches. Keep a hand sanitizer or good hand wash at home and encourage your child to wash his/her hands before eating anything.
Your child is ready for school... but are you?It was still okay. Just 2-3 hours which you could utilize for other things while your child was away briefly. Now you will have to compete along with teachers, textbooks and homework for your child's attention. Well Mother, we know this is going to be difficult for you, but let's see if we can try and make it any easier. Think of school as an extension of the tender loving care that you provided. The only difference is that the TLC will go towards nurturing and developing his/her brain and help it learn important skills which will help gain a balanced development. At this point your child feels bad and completely unsafe in this new hostile world of teachers and uniforms and what not! If you weaken at this point your child will cop on and then will come the emotional blackmail. So explain the importance of school to your child as it will make the transition easier. It is always good for mothers to accompany their children to school but imagine watching mother walk away and all hell can break loose. So if your child's school has a school bus facility you can walk him to the bus stop and then say your goodbyes there. A lump in the throat at the bus stop is preferable any day than a scene at school with a child holding on to mother for dear life. Do not criticize your child's school or assignments given by them as children can catch on quite quickly and that can be reason enough for them not to concentrate on school activities. Always encourage your child to talk about what he did at school and ask him questions about his friends and teachers. This gives the impression that school is as important as home and gradually even you will reconcile yourself to the fact that school is here to stay.
Accepting your flawsThere are basically two kinds of 'flaws,' one that is physical and the other that is in your personality. A physical 'flaw' like being too short, fat, or darkis never a person's fault. Thus accepting what you are can only boost your self-esteem and confidence. Despite these 'shortcomings,' it is your character and your achievements that stand out in the long run and not the way you look. The first step in creating a better life is accepting if you are wrong! Personality traits and habits are mostly visible to others but not to you. These are those faults that can cause bitterness in relationships or cause problems at work or in our social interactions. Some people lose their temper easily, some are lazy, and some are rude, while some are either introverts or extroverts. If you have flaws that can cause problems for others then the best thing you can do is to change those negative traits in yourself. Character flaws might be natural, but they can affect others negatively. The first thing in making improvements is to analyze yourself. What are you so angry about ? Is it really some other person's fault or that you have had a bad day at the office? Give it a thought and once you find the answers, you will feel relieved. Accept your physical flaws and love yourself for what you are, as this is the key to lasting happiness. Major flaws like alcoholism, splurging money, borrowing money, or addictions are what one should be willing to overcome. If you accept you have any of these major flaws and need help to overcome them, then you need to seek help. There are professionals who can help out, provided you are a willing party to the process. Improvement will come only if you are willing to change. Remember that flaws are easy to acknowledge and to change;the only thing required is the desire within you to do so.
Building self confidence by improving body languageSo what have they told you? That only physically attractive people have the right to self-confidence? That you either have it in you or you don't? Let's face it, confidence is the key to anything and everything. Right from driving a car to handling work to dating, confidence is what separates the proverbial wheat from the chaff. What you need to remember is that the mind speaks the body language. Conversely if you change your body language, then it has an impact on the mind as well. Mr.Hunched Over This guy is the classic example of a person who just doesn't like himself. The world is a mighty dangerous place for him. Just look at the way he walks. Shoulders all hunched over, head down as he shuffles rather than walk. Mr. Hunched Over generally finds it difficult to look people in the eye as he speaks and he last is handshake is as limp as his mind. He crosses his arms tightly, touches his nose all the time to see if it has grown since he lied through it. Mr. Walk the Walk and Talk the Talk This chap is diametrically the opposite of the first kind. He exudes an air of confidence in his walk, manner and speech. He has a confident stride which is helped by the fact that he stands to his height with his head held high, chin tucked in and shoulders squared back. This is what gives him the confidence as this posture is designed for efficiency. Mind you, he isn't ram rod straight, just straight enough so that his ears are in line with his shoulders and hips. The chest is also out since the shoulders are drawn back towards the hip. This facilitates deep, even and diaphragmatic breathing which prevents anxiety. His hand shake is firm. As he offers his hand, he exerts just the right pressure on the other person's hand to indicate a strong grip. This is no wrestling bout, so the confident man always exerts just the right kind of pressure in a hand shake.  He maintains eye contact with the person he is talking to; not a staring about, but normal eye contact, one which won't make the other person conscious of being stared at. He looks away from time to time to give his eyeballs a rest. This is why he comes across as genuine and not shift eyed and restless. To be Mr.-Or- Ms. Walk the Walk Always square your shoulders and keep your head held high when you walk. You might seem imperious or high handed at first, but then it will work wonders on your self-esteem and you will begin to feel differently about yourself. You needn't even be a tall person to come across as cool and confident-just stand up to your own height and see the miracle. Breathe slowly steadily and deeply. Use your abdominal muscles to draw in your breath rather than engaging your neck muscles which end up making you a shallow breather and plus you also tend to hunch easily if you don't feel your rib cage and stomach expand as you breathe in. Practice standing and speaking in front of the mirror. It will show you exactly how you appear to others. Practice your walk in front of a video camera and keep a record of your metamorphosis.
5 cardinal sins for the skinWhile cigarettes may not constitute food in the strictest sense, it does have a profound effect on skin complexion, health, color and tone. We eat that we may live, but sometimes we eat way too much and consume stuff that may be extremely hazardous to our health. Since we are talking about skin, here are 5 most hazardous foods for your skin: Grease adds to the crease Since healthy skin is all about healthy blood circulation, any food which is likely to clog up the blood vessels internally is deemed bad for skin tone. Packaged snacks like potato chips may have edible oil written in bold but this contributes significantly to the slowing down of 'collagen and elastin syntheses' which in turn causes the skin to appear aged and all wrinkly. The french fries that we consume as a TV snack can also cause an acne outbreak on the skin and face. Gluten Glutton Gluten is a substance found in wheat and other food grains. We may not even be aware that some of the food grains have gluten as a main constituent. Gluten intolerance can also cause inflammations on the skin in the form of rashes or acne. Bad news is that the pizzas, pastas, cakes and bread that we get off the rack may be heavy in gluten (Surprised that they don't say that on the pack) and that may be the reason for you to lose precious skin tone. So seek gluten free foods, though that might not be the easiest of tasks, but for your skin, it certainly will be worth it. Caffeine - the skin coffin If you are one of those coffee addicts then you may as well write an obituary column lamenting the loss of your skin tone and complexion. It's not without reason that health freaks love bashing coffee beans and caffeine rich beverages, as they are truly hazardous. How? Studies have proven that just 2-3 cups stimulate pituitary-adrenocortical response. Yes, but what does that have to do with your skin? Well this leads to the hormone cortisol to increase in our bodies. Cortisol is known as the stress hormone! So now here's what it does to your skin -it accelerates the ageing process which means wrinkled skin and causes dehydration causing the skin to show an unusual pallor. So before you turn the coffee faucet on think twice. Fad to Black How fad diets are not skin friendly? Some people go on a high protein, low-carb diet which could sound the death knell as far as complexion goes. Dieting depletes calcium levels, which means your bones are going to suffer and what's the point of having skin on bad bone density? Besides low-carb diets can utterly wreck the complexion as the delicate PH balance in the skin is ruined. Some of the meat, poultry and dairy products too can have artificial chemicals injected in them which cause a hormonal imbalance in our bodies leading to skin disasters. Fruits and vegetables have chemicals injected too sometimes! Beware! Cereal Killers Cereal killers are those people who ignore the need of a proper diet for skin health. So anybody who indulges in too much sugar, caffeine and greasy food stuffs is a 'Cereal Killer' A lack of cereals in the diet can literally kill your skin. Cereal foods have high fiber and antioxidants for moisturizing the skin and protecting it from skin damage. For great skin other than cereals which are simply fabulous for keeping skin hydrated and breathing easily, one can eat fruits, olive oil, healthy fats, almonds, tofu, grains, nuts and the good old vitamin B rich products. Ceramides in raw food diets, organic foods, wheat germ and brown rice protect the epidermis of the skin and make it impervious to external attacks and pollutants while maintaining their tone and beauty.
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.
An ounce of prevention is worth a pound of cure!Small mistakes that we keep committing become, over a period of time, serious health problems that are potentially life threatening. Given here is a list of the 10 most common mistakes that we make when it comes to heart health. Ignoring the health check-up: Your last reports said you were fit as a fiddle. So you haven't gone for a check-up since then? Our health becomes the first thing we sideline in today's fast-paced lives. Most of the heart diseases do not show any signs and symptoms in the early stages and when the signs and symptoms come up, too much of damage has already been done. So it becomes very essential to go for regular health check ups. If you are in your twenties it would be advised to get your cholesterol checked every 5 years, blood glucose every 2 years. Beyond 45 years though the frequency of health, check-ups should increase. Body Mass Index is something that you should get checked every time you visit your doctor. Skipping breakfast: Breakfast is the most important part of what you eat the whole day. Most of us tend to skip breakfast due to lack of time, fear of weight gain. But starting your day without breakfast is like driving on reserve fuel. You will start fine, but end up feeling dull and sluggish towards the end of the day. Skipping breakfast has been associated with development of diabetes mellitus and obesity. These two have a strong co-morbidity with cardiovascular diseases. No wonder then it is said, breakfast like a king, lunch like a prince and dinner like a pauper. Too much of sun-blocking: We are people obsessed with fairness and it is understandable that one wouldn't want to get tanned by going out in the sun. Some amount of sunlight exposure is very vital for health. Vitamin D is synthesized by the body from cholesterol with the help of sun rays. Recent studies reveal that people with little or no exposure to sunlight tend to develop arterial plaques that end up in heart attacks, high blood pressure or strokes! Going for the fizz : Aerated drinks are loaded with triglycerides that are a part of the bad cholesterol. They thicken the blood and it becomes difficult for it to flow through the arteries. This leads to several complications. Not watching what you eat: Often we are so caught up in our work that we just grab a quick bite to eat without paying heed to what actually we are eating. Fast foods are extremely unhealthy and wreck havoc onour systems. Missing fruits and fibres: Fibrous food are extremely heart friendly. The fibres help in pushing out the cholesterol out of the body. Beans, oats and barley are all extremely fibre-rich. Fruits are a rich source of vitamins and minerals. They contain potassium that is extremely essential to neutralize the effects of sodium. By doing this they help in regulating the blood pressure. Citrus fruits too have a high amount of potassium in them. Avoiding walking: Walking is the simplest form of exercise the body can get. 10 minutes of brisk walking is extremely helpful for the heart to keep functioning efficiently. Not sleeping well: The body needs 6 to 8 hours of undisturbed sleep for it to reboot and get back its full functioning capacity.  A sound sleep at night reduces the blood pressure and regularizes the heart beats. People compromising on sleep are the ones most prone to suffer from heart attacks and high blood pressure. Not flossing your teeth: Gingivitis is the inflammation of gums. This inflammation hosts large number of germs that leak into the bloodstream and reach the heart causing a number of heart problems. People who floss daily not only have good oral hygiene, they also have a healthy heart. Forgetting the Family: Many heart diseases tend to run in the family. It is very important to know the medical history of your parents and grandparents. The risks of you developing heart diseases are high if someone in your family already has them.
7 Pains you should not ignoreWhen the body cries out in pain, most of the times, you know what is bringing that pain, and you do what will help relieve the pain. For example, a serious workout may cause sore aching muscles, for which you will rest a day or two, or take a painkiller. What does one do to know why a body part is paining? One needs to sit up and take notice! The pain could be anything, from a heart attack, to an aneurysm, and could cost you your life! Pain in the head: Headaches are the most frequent pains that we suffer from. Headache could be due to a migraine, due to staying too long in the sun, due to a cold, or simply due to working too long without a break. However, in case you have a headache, and are not able to pinpoint to an obvious cause, rush to the emergency room. Headaches with no apparent cause may be due to a brain hemorrhage, a tumor in the brain, or an aneurysm in the brain arteries! Get yourself checked as soon as possible, if you keep getting headaches for no apparent reason. Pain in the jaw: This could be due to a caries ridden tooth. But most often it is due to an impending heart attack. The classical left sided chest pain radiating to the left little finger is not always seen in all cases of heart attacks. Pains to the jaw and the back are reported very frequently. Often, people tend to take the pain in the jaw lightly, and brush it off to a tooth problem. This may be potentially life threatening, as you never know the severity of the attack! Tingling, numbness and burning of the feet: Diabetes mellitus is a silent killer. Peripheral neuropathy is often the first complication of diabetes. Tingling numbness, and burning in the feet may be attributed to wearing tight shoes and to keeping your feet suffocated in socks all day long. Dipping your feet in a tub of cold water will give you a good night's sleep. But do not let it go at that. Get your blood sugar levels checked before it is too late! Pain in the calves: Do you get nightly pain in your calves that get better with putting your feet up? This is due to long standing hours at workplace, you may say. True, it is due to that. But, it is not something to be left unattended. Calf pains are due to deep vein thrombosis that occurs when the stagnated blood in the veins starts to form clots. The danger here is that the clot could break off and travel to your lungs causing pulmonary thromboembolism that is fatal! Take a break regularly and put up your feet frequently. Let the blood flow and not stagnate! Pain in the back: Most commonly, back pain is caused due to arthritis, and improper sitting postures. But if you suffer from high blood pressure, and are an alcoholic and smoker too, do not take your back pain lightly. It could be due to a heart attack or an aortic dissection! Pain in the abdomen: You may attribute this pain to gases, over eating or indigestion. While these may be occasional causes, persistent pains need to be checked. It could be anything from a gall stone, to gastric ulcers, to a swollen liver, or maybe even pancreatic cancer! Vague, medically inexplicable pains: When you have a recurrent headache or a stomach ache or a backache and you come out with a 'perfectly healthy' report after visiting all the specialists, it is perhaps time to seek the help of a psychiatrist or a counsellor. Your pains could actually be a symptom of depression. Psychosomatic pains are on the rise. The stresses we face in our lives everyday get pushed to our subconscious, and eventually are pushed up bodily in the form of unexplained aches and pains!
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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