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Is male menopause a reality?As opposed to the sudden drop in ovulation and hormonal levels in women, menopause in men is a gradual process. The consequences in men aren't that clear. The health risks, though, are significant and it is important to recognize the symptoms of male menopause early on. Read along to know more. A testosterone level of 300-1200 ng/dL is considered normal in a healthy male. As one ages, the testosterone levels too drop gradually. After 30 years of age, the levels drop by 1% per year. By the time a man crosses 50 years of age, he is in menopause. Look out for the following signs to know if your testosterone levels are dropping : Low Libido : A low sex drive or decrease in inclination to have sex is the first sign of decreasing testosterone levels. Erectile Dysfunction : Testosterone is responsible for releasing nitric oxide that leads to erection. As the levels of testosterone decrease with age, getting an erection and maintaining it for longer periods of time may become difficult. Low Semen Level : The normal amount of semen ejaculated each time varies between 0.1 and 10 mL. This normal level is due to the efficient functioning of the testes, seminal vesicles, and prostate, all of which work under the influence of testosterone. As you age, the testosterone levels drop and the amount of semen ejaculated also drops. Orgasm Troubles : As you age, having an orgasm every time may be a bit difficult due to the dropping testosterone levels. Mood Swings : This happens in men as much as in women! The interesting thing here is that the man who suffers from it is the last one to note it and acknowledge. So, if you find yourself snapping and getting irritated at the smallest of things, get your testosterone levels checked. Depression : When you feel dull and demotivated at all times, and even doing the slightest of activity seems like a chore, it means that your testosterone levels have dropped to a significantly low level. Abdominal Fat : This is again an early sign of decreasing testosterone level. Belly fat is a sign of advancing age. Low testosterone levels are a sign of advancing age. Not all men who have low testosterone levels may show symptoms. In such cases, there is no need for any kind of treatment. Low testosterone may also be due to some other conditions like thyroid disease, excessive alcohol use, sleep apnea, etc. After 30 years of age, the levels of testosterone drop by 1% per year. By the time a man crosses 50 years of age he is in menopause. Identifying and eliminating these causes will restore the testosterone levels to normal. However, if no cause can be attributed to the low testosterone levels, it is a clear indication of normal aging and 'menopause.' As with women, men too have the option of hormone replacement therapy. However, this treatment is controversial. In some men, the testosterone replacement may relive several symptoms, but the risks far outweigh the benefits. An increased chance of heart attack, prostate cancer, and other health problems are associated with testosterone replacement therapy. Herbal supplements for problems associated with decreasing testosterone levels are generally considered safe, but they too have no proven health benefits and are known to increase the risks for prostate cancer. Male menopause isn't as dramatic and abrupt as the menopause in women, but it is a reality. It happens gradually over a period of several years.
Pregnancy myths bustedChances of getting pregnant each month gets increased by 50% in the women of the age of early 20's: This not right, for a women to get pregnant is not easy. When a woman is below 25 the chances of hitting baby bingo are only 20 to 25 %, while the women above 35 years of age the chances are 15%.   The baby's gender could be understood by the shape and size of the belly. It is believed that woman carrying a girl has high belly: False again. The shape of belly depends on original shape of the abdomen, amount and the distribution of the fat, strength of the abdominal muscles, the number of babies conceived and the position of the baby... but in no way possible can the shape or size of a belly give away the sex of the baby inside.   The best fertility lubricant to be used for conceiving is saliva: This is totally wrong, actually saliva is the sperm killer, most of the lubricants and massage oil are also not good for fertility, so it is better to go without using any lubricant.   Sperm production is impaired by laptops: This is true. Heat is not good for male fertility when laptops are used on laps they may generate heat and affect the fertility. So it is good to use the laptops as desktops.   The conceiving period of most of the couples is 3 months: This is not right, most of the couples take about 6 - 12 months of active efforts to conceive if they are not having any fertility problems.   There are more chances of conceiving, if you do more sex on the fertile days: This is true, the man having normal sperm count to have sex during her partners fertile days is good for conception. Having everyday sex was suggested in earlier days but anything which is done in excess is always more.   The egg can be fertilized within two days after it is released: This not true, an egg has the shelf life of only 12 to 24 hour, and the sperm have to meet with egg within that time, though it has the shelf life of 3 days or more.   Position during conception matters: This is not true, the sperms which are healthy are good swimmers, they can make you pregnant in any condition.   Eating oysters is good for getting pregnant: This is true, oysters are the good source of zinc, which is the most fertile mineral, it is also a good booster for libido, it can be used by both sexes.   Having cough medicine is good for getting pregnant: This is true, cough expectorants loosens up the cervical mucus as it does with the mucus in the chest, and the looser cervical mucus gives the sperm an easier and faster way to get pregnant. But some cough medicines contains an antihistamine that dries up all the mucus, which makes for a difficult swim for the sperms.   The sex of the baby is known by the glow on the face of the mother: This is not true, as the morning sickness of the mother is stopped, she starts eating well, the blood circulation also improves and in general the mother feels good, which gives the glow on the face. There is no relation between the glow on face and delivery of a baby.   The baby having lots of hair causes heartburn to their mother: Completely false, heartburn is the common complaint of the mother during pregnancy, this is due to reflux in oesophagus, in this the food particles come up through the food pipe and due to its acidic nature it causes heart burn. There is no relation between baby having lots of hair and heartburn.   The food intake of the pregnant woman should be doubled, for baby and the mother: This is not true, the pregnant woman, should take a balanced nutritious diets containing ample of proteins, vitamins, and minerals, small meals should eaten for every two hours rather than eating only 3 times the bulky meals.   Labor can be induced having sex during pregnancy: Not true, if the woman is physically fit during pregnancy can have sex as advised by the doctor only the position during sex should be taken care of, it should not cause discomfort to the woman.   Regular breastfeeding is a barrier for getting pregnant: Again a myth, the women can get pregnant even in the lactational ammenorrhea before the first menstrual cycle. You should always use contraception to avoid pregnancy.   Using computer during pregnancy can harm baby: This is not true, there may be backache if you continuously work for a long time on computer, but there is no direct effect of computer on the baby.   Source: What to Expect Before You're Expecting
Is circumcision a healthy ritual?Religious rituals and practices have been carried out since ancient times. Circumcision is a religious ritual that involves surgical removal of the prepuce of the human penis. Prepuce is the foreskin of the penis and during the procedure; the person performing the ritual opens, inspects and separates it from the glans. The process is painful and hence local or topical anesthesia is used to reduce physiological stress and pain. Circumcision is performed for religious as well as personal reasons and many times recommended medically for prophylactic or therapeutic reasons as well. Today's medical science makes use of this treatment for treating chronic urinary tract infections, refractory balanoposthitis and pathological phimosis. Circumcision is performed as ritual in many parts of the world. However, it is also recommended medically as protection against HIV infection. Circumcision-Is it Legal and Ethical? In the world over, the ritual or practice of circumcision is carried out on all types of people from neonatal stage to adulthood. While no significant risks have been noticed due to the practice of this ritual, rather some modest health benefits have come to the fore. The World Health Organization has recommended circumcision for male infants in parts of Africa where the children are more vulnerable to urinary tract infections. However, no other medical organization in the world has supported or banned the procedure. Over past few years, legal and ethical questions have been making rounds and many believe that consent should be taken before carrying out neonatal circumcision. HIV and Circumcision Benefits A Cochrane meta-analysis conducted in 2009 on sexually active African men have revealed that the ritual of circumcision reduces the risk rate of HIV infection by 38 to 66 percent among heterosexual men in a period of 24 months. That is why WHO has recommended circumcision in sub-Saharan African areas having high rates of HIV infection as a part of the comprehensive HIV program. Moreover, this process is more cost-effective as compared to other treatments and preventive measures recommended for HIV. Circumcision reduces the risk rate of HSV-2 infections and oncogenic HPV prevalence along with the risk of penile cancer and UTIs. Until now, there have been no concluding reports on the protective effects circumcision offers against other types of sexually transmitted infections. Circumcision is also recommended medically to children suffering from pathological phimosis and refractory balanoposthitis. Contraindications The literature worldwide review conducted in 2010 reveals that around 1.5 percent of the newborns face median complication when the process of circumcision is performed by trained medical providers. Only 6 percent children face severe complications with the common complications being infection, bleeding or removal of too little or too much of foreskin. However, the process does not cause any negative impact on the sexual functioning of an individual. Contraindications due to circumcision are also cited in infants having genital structure abnormalities right from the birth such as misplaced urethral opening, ambiguous genitalia or chordae. In such cases, the foreskin may require reconstruction through surgery.  It is contraindicated in premature babies and clinically unstable infants and it should also be avoided in children with family history of hemophilia (bleeding disorders). In such patients, it is important that the blood should be checked for its coagulation properties before attempting the procedure.
Obesity is not just an adult problemWith fast food chains multiplying in the country faster than you can say Maharaja Mac, there is an urgent need to monitor our diet. While most of the nutritional advice is directed at adults, kids too are exposed to the dangers of empty calories. Childhood obesity is on the rise across the world including India. How does obesity affect children? And what can parents do to ensure this doesn't happen? We will try to answer some of your questions. What are the causes of obesity in children? Lack of physical activity: Nowadays, children spend more time sitting at home - doing their homework, watching TV, and playing games on PC, console tablets or smartphones. Play time on the ground outside has shrunk. As a result, they don't get enough exercise. Unhealthy food choices: Our busy lifestyles leave us with little time to plan for or prepare every meal. The alternative is to go for quick-to-cook food like Maggi. Food ordered from outside too is invariably unhealthy. While having it once in  few days is not a problem, making it a way of life leads to problems. Overweight parents: The eating pattern and lifestyle of parents has a big influence on a child's health and weight. Obesity can be hereditary. Lifestyle and environment: When parents are unable to pay much attention on their children due to their busy schedules. As a result children rely more on ready-to-eat food or junk food. Genetic factors:  For some kids, genetic factors may be the reason behind obesity. A rare genetic disorder called as Prader-Willi syndrome causes severe weight gain in kids. What health problems can obesity cause among children? Type-2 diabetes Eating disorders like bulimia or binge eating (excessive eating or drinking) Problems with foot structure Liver problems Respiratory disorders - breathlessness during exercise Difficulty in breathing while sleeping causing snoring or poor sleep What can parents do to prevent or control obesity in children? Parents must make kids understand the ill-effects of eating junk food. They must limit their snacking on junk foods. Encourage the kids to participate in physical activities and outdoor games. Make exercising a routine for the children. Join them during exercising to make it a fun time for the family. Set an example for your kids by following a healthy diet and eating habits yourself. Limit TV time and playing videogames. Parents must include whole grains, fruits and vegetables in the diet of their children. Limit fats intake to not more than 25%-30% of total calories. Make sure to go through the nutritional label while purchasing any processed food.  
Boost your self-esteemSimply believe in yourself. Life need to be made lighter. Pulling yourself down over trivial mistakes and not reaching certain standard definitely does not help.  Your self-esteem affects the way you interpret messages from others. It affects relationships, academic achievement, and living life to the fullest. Thus, recognize your true potential in life and work towards it. Those who have a high self-esteem always have an “I think I can” or “I will” attitude! This makes life much happier for them. Ups and downs in life are inevitable, but this should not bring down your self-esteem. One should work towards maintaining a high self-esteem at all times.  You need to have the power to control your self-esteem. It should not suffer from negative messages from others; in fact, negative messages should be viewed as constructive criticism. There are many ways in which self-esteem can be given a boost. Accept yourself and increase your inner stability so that you will not need validation or attention from other people. Meet new people. Follow examples of successful people. Don’t worry about how others might judge you. Don’t be afraid to try something new. Failures may come your way, but they are the best teachers in life. Make a list of your strengths and weaknesses. Make the most with what you are best at, and strengthen your weaknesses. Focus on the positives and practice positive self-talk for encouragement. Avoid doing things just to “go along with the crowd.” Gather courage to express yourselves and ‘stand out’ from the crowd, as every new encounter is a learning experience. Develop a support system of friends. They will give due emotional back-up. Put into place good healthy habits; ensure the right kind of diet. Controlling the mind is essential for a healthy body. A stress-free mind is healthy and calm, which will incorporate positive thoughts. Give credit where the credit is due. Praise others and accept compliments in good spirit. This builds confidence. Keep criticism to a minimum, as it brings about negativity. Appreciate life. Look your best to feel your best. It is important to be well groomed. Improve your personal living space. Perfect your skills and practice your talents. Reward yourself often. It’s nice to pamper yourself once in a while. Stop comparing yourself to others; this will increase your stress levels unnecessarily. Your self-worth should not be based upon what others think of you, but how you feel about yourself. Communicate with others, colleagues, neighbors, family, and friends. Be social. Do something for someone else – a random act of kindness! They fill up the void and bring about a different level of happiness. It is beneficial to spend some time alone by yourself. Review your mistakes and analyze the experiences in your life. This should be carried out as a self-therapy, and not as a habit. Do not become a loner. Everyone is a unique. No one else is like you in the whole wide world. This makes you special already! Everything starts with you and ends with you. Remember, nobody can insult you without your permission!! A low self-esteem gives rise to health problems like depression, loss of interest in life, and stress. It is not difficult to correct this stage which comes in everyone’s life. Learn to rise above these shortcomings and improve your outlook about yourself. Confidence comes from not always being right, but learning to be wrong. - Peter T. McIntyre.
Be positive. Here's howAs someone so very rightly said, "We are the sum total of our thoughts". So the more positive thoughts you have, or are capable of thinking, the more positive will be the outcome of your life journey. Here are a few tips to think more positively and empower yourself: Have a daily positive thinking routine. Generally the time when you are just waking up, i.e., the half awake state, is best for you to start feeding positive thoughts about yourself. The mind is more accepting of suggestion at that time. You can just feed your brain with happy and positive thoughts about your situation and what you hope to achieve for yourself and your family. Creative positive visualization is another great method of positive thinking. At a set time, just picture your life in the way you want it to go. This is different from daydreaming. Creative visualization gears you up for action while daydreaming remains just wishful thinking. If you have difficulty in certain areas of your life, say at work or with your relationship, visualize a positive outcome. This will engage your mind in thinking of various action plans to get about that positive result. Positive affirmations are a great way of reminding yourself that all is well. Have patience with yourself as your mind will probably not even believe half the things that you are affirming. That's what affirmations are all about.They are statements that you feed your mind about what you are and what you can achieve. Positive affirmations can help you reprogram your mind to what your heart really desires. Let go. Feel that delicious sense of surrender as you just indulge in mentally letting go of things. As a busy person you probably end up trying to control the outcomes of every situation and feel bad when things don't go the way you expect them to. Remember things can go wrong from time to time. Like you, life is also not perfect, so why expect perfection from others? Learn to let go of that emotional baggage that you are carrying. The weight of the world needn't rest on your shoulders. Collective consciousness is where you should try to tap into. Think of situations where things can go horribly wrong for someone else. Send out a silent prayer for those unfortunate people in this world. Chances are that your prayers just might help some stranger badly in need of a prayer or two. This can only come back to you manifold. Help someone else become a positive person. This can only reaffirm your faith in positive thinking. Positive energy is what everyone naturally seeks and we can for sometime blame our friends or family for being a negative influence on our lives. This line of thinking will get you nowhere. Instead think what's the next best option? Think of how you can convert negative energy or experiences into positive ones. Initially you might meet with resistance, but remember if you are positive then positivity is yours for keeps.
Sleep tight at every good night!A good night's sleep! Oh, what would some of us give for that luxury! Sure, you can blame it on the fast paced world and the things you have to do to keep the competition off your turf, and millions of other reasons to be sleep deprived. Yes, sleeping soundly and regularly is well within our control. Maybe it has eluded you so far and you are caught in a vicious circle of staring at the ceiling for hours on end; so read on to see what simple things you can do to gently drift off in to the arms of nature's greatest restorative- beauty sleep. Do's and don'ts for beauty sleep Fix a regular bed time, so that your brain will adjust to this by sending sleep signals to the body. If your bedtime is completely at the mercy of your activities then even as fatigue sets in the body will refuse to obey. So, even as your body is screaming for rest, the mind does otherwise. This is where good old discipline comes in to play. Take in to consideration the activities which are absolutely necessary to do and note the frequency with which they are likely to interfere with your bedtime before setting a realistic bed time. Initially the mind will refuse to obey, and you are most likely to get up, after tossing and turning in bed, to switch on the computer or whatever it is that you do when you cheat your bedtime. Rest assured, in a couple of days the brain will get used to this sleep routine and prepare you for shut down. Sleeping well also largely depends on how stress free you are. If the mind is in a state of constant excitement or anxiety, sleep will elude you. So when you lie down to sleep you need to fade out and blank everything out- joy and sorrow; expectations and ambitions, all of these out for later access! Tell yourself that tomorrow is another day and what you need today, is a state of neutrality! That's what most Indian philosophers would want you to do anyway. A good eight hours of sleep may depend largely on our minds but external factors can matter too. Sleep comes easily when your mattress is comfortable and not too soft or too hard. Use a pillow that won't give you neck pain, as any discomfort in the neck is likely to throw sleep off gear. Wearing clean night clothes can give you better quality of sleep. That goes for the bed spread as well.  Try this for yourself. Tight and uncomfortable night clothing is not recommended as this will only make you wriggle about for comfort. A cozy blanket and some clean nightclothes make great bedtime mates. Some people have a nightcap to help them sleep better while others still, drink themselves to sleep. Alcohol in large doses can only numb but does not help you sleep and you will only find yourself waking up frequently. Sleeping pills can be habit forming and might have serious side effects in the long run. So try simple remedies like a glass of warm milk or hot chocolate before bedtime to help you sleep better. Avoid stimulants like coffee, tea or nicotine before bedtime as that can keep your nerves all hyper thus making sleep quite difficult to come by. Computers and television are also largely responsible for us staying up late and disrupting our sleep patterns. We often find ourselves mechanically flipping channels or browsing without any real need for it. Try and go offline before bedtime, especially if you want to be able to schedule your sleep time. Television or movies can excite the brain and then you will find it difficult to fall asleep. So about an hour before bedtime switch off the telly or computer and just sit quietly and do some deep breathing exercises. Just sit cross legged for about ten minutes and relax your body. You are now ready for a deep slumber.
4 super foods to keep you healthy this winterWinter is here. It is time for lazy mornings and blanket hideouts. It is also the time when the markets are lined up with a variety of fresh fruits and vegetables, all juicy, healthy and colorful. Discover four such super foods for the cold winter evenings. Citrus fruits: Oranges, sweet lime, lemons; bring them all and have them all. Bright yellow or orange, they are like the bright sunny mornings which you need after a cold night. Rich in vitamin C, antioxidants, flavonoids and several other nutrients, citrus fruits are the perfect measure for your daily dose. Peel it off and chew it up, or slice it off and lick it on, or squeeze it strong and drink it down - choose the way you like. Citrus fruits help in taking care of your cholesterol, as well. Potatoes: Potatoes are the victims of most diet plans. It is loaded with carbohydrates, we should not eat potato, and so on and so forth. Potato is not that bad actually. In fact, its nutritional value may come as a surprise to many. The content of vitamins B6, C and folate is high in potatoes. Potatoes are rich in essential minerals like potassium, zinc and magnesium. The starch content may be significant, but so is the fiber content. They are known to protect against colon cancer. What are you waiting for? Have some potatoes, will you? Make sure there is no guilt. Kidney Beans: Kidney bean is our favorite Indian 'Rajma'. They are a rich source of carbohydrates and proteins, are known to lower the cholesterol levels and reduce the risk of heart disease. They are particularly known for helping to replenish the iron stores of your body. It can be the food of choice even if you have diabetes, as it is almost fat-free and doesn't send a sudden rush of glucose in the blood. When combined with rice, kidney beans make a very healthy meal. So, is it rajma-chawal (kidney beans with rice) for dinner today? Green leaves: Yes, yes, you are bored of reading and listening to the benefits of green leafy vegetables. But, we have to remind you, for the advantages are too many to be ignored. They are the greenest, freshest and leafiest in the winters. Even if you are not a fan, you will feel like picking up a bunch from the grocery store. Spinach (palak), fenugreek (methi), cabbage (gobhi) are the ones that we can commonly find. Others to look for are lettuce, mustard greens, etc. The green leaves are a rich source of a variety of vitamins, mineral, fiber and water content. They are suitable for all ages and can be easily digested. Entertain that potato lying in your kitchen, cook up a dish with the green leafy ones. Alternatively, you could try it in the form of salads, soups, juices, flour fillings, and any other creative ideas that you chefs have.  
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!
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.
Busting misconceptions about homosexualityIn the past few years, homosexuality has become a subject of public discourse in India. Thanks to gay pride marches and the Delhi High Court's historic ruling decriminalizing same-sex intercourse in 2009, more people today are willing to accept homosexuality as normal. However, there are still a large number of people who are still confused about whether homosexuality is normal. Homosexuals are people who get attracted to people of the same gender. Gay is a term used for both male and female homosexuals, but some prefer the term 'lesbian' when it comes to women homosexuals. Some misinformed people consider homosexuality as a purely decadent western phenomenon which is far from the truth. Homosexuality finds its place in recorded history throughout the world. So is homosexuality abnormal? A few decades ago a gay person would have ended up on a psychiatrist's couch where attempts would have been made to re-orient him/her towards the heterosexuality. However, as the American Psychology Association notes, "No, lesbian, gay, and bisexual orientations are not disorders. Research has found no inherent association between any of these sexual orientations and psychopathology. Both heterosexual behavior and homosexual behavior are normal aspects of human sexuality." Some scientists are trying to find a genetic link to homosexuality. Results so far have not established a definite link. A whole lot of factors could play a role in deciding sexual orientation - genetic, hormonal, developmental, social, and cultural. One cannot safely conclude that being "gay" is in one's genes and is therefore, hereditary. Legalizing gay marriages Same-sex marriage is legally recognized in several jurisdictions within the United States. As of April 2013, nine states—Connecticut, Iowa, Maine, Maryland, Massachusetts, New Hampshire, New York, Vermont, and Washington—as well as the District of Columbia and three Native American tribes[1]—have legalized same-sex marriage, representing 15.7% of the US population.
Sex after 40Sexual changes in normal aging after 40: Erection takes longer time Require manual stimulation, particularly by partner Erection may subside during foreplay or coitus Decreased frequency of nocturnal erection Pre-ejaculatory fluid decrease or absent Ejaculation less forceful Seminal fluid volume decreases or absent Frequency of desire for sexual release decreases with age. Aged couples learn to cope with their own sexuality. Some are happy with foreplay and self masturbation, others insist on more usually it is the male. Frequency of sexual intercourse between 20-95 years : Sexual intercourse decreases with age as the study shows. Decreased during 5year interval after 34 years Weekly frequency: 30 - 34 years 2.2%; 60 - 64 years 0.7%; 65  - 74 years 0.4%; 75 - 79 years 0.3% Do we need to change this pattern with Viagra? I would say yes - sex can be  joyful till the last days. Nobody needs to be impotent now. Home devices like rubber bands, ribbons are also used to hold the blood back in the penis when the erection is not adequate. Vacuum pump to draw blood into penis with an application of a ring after erection is also found suitable by some. Active intervention by drugs (both allopathy, ayurvedic and unani) have been successfully developed. They may be applied topically (minidoxil), inhaled (amyl nitrate) inserted into the urethral passage, injected into the corpus cavernosa or taken orally (Sildenafil, Tadalafil, etc.). Finally if all fails silastic rods can be implanted in the penis to give permanent erection. The joy of living lasts a life time.
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