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Aging milestonesChanges in old age depends on attitude as much as person to person. In young old age some changes begin to take place in a person’s appearance. Wrinkles, warts, age spots begin to form on the body. Hair begins to thin or becomes grey and even height lessens because the bone density decreases. While in ‘old‘ old age these changes are already permanent. Men might look distinguished if in good health, but women all look grandmotherly. In ‘young’ old age, cells begin to decay and muscle mass declines and immunity is no longer as strong as it used to be. People lose energy as the age progresses.  ‘Old’ old age brings in a lot of physical decline, profound changes in appearance and motor abilities, as also in sensation. Skin gets less elastic and becomes thin and blood vessels can break under the skin. The senses also begin to become dull. Eye lenses get affected and color perception and reading ability becomes very low. Hearing loss may lead to paranoia and ‘old’ old age people begin to think everyone is plotting against them because they can’t hear properly about what others are saying. Sense of smell also declines, but the taste remains almost intact. In ‘young’ old age, reflexes also slow down and so do the motor abilities. By the time they reach ‘old‘ old age most adults find that their response time has become quite reduced. This can be seen most in driving situations where it is difficult for ‘old‘ old aged adults to operate their vehicles as they have poor spontaneous responses. The ‘young’ old adults do not lose as much of their motor abilities as the ‘old‘ old adults, especially when holding small things like needles and pins. Of course, there are changes in sexuality and there may be a decline in the ability to have sex as men may not have an erection and women become dry due to lack of female hormones. Cognitive decline in 40% to 60% of older adults can be arrested with remedial training. Despite all the changes, most people even in their 70s remain comparatively active if they do not suffer any illness. Mental, physical, and social activity is necessary to maintain the quality of life. Old people begin to withdraw from work and other important roles and allow the younger people to take over. They are a lot happier as is also advised in Vedic literature as vridhashram. While activities are important, disengagement is equally important. Memory loss becomes aggravated and other cognitive abilities begin to decline and there are many ‘old‘ old adults who get Alzheimer’s and lose the ability to look after themselves. Old people also dwell on questions of death and sometimes go through a phase of denial and then anger that they have so little time left. Acceptance of death comes, but after a struggle and the idea of losing the family saddens them. Old people require support in their declining years as they begin to lose their faculties.
Absent father, violent kids!When children are growing up, they undergo a lot of hormonal changes and have varying emotional requirements. If these requirements are not fulfilled by the presence of both parents, they can develop into violent adults. Single parenting for a mother, is extremely difficult; it is simply impossible for her to fill the void left behind by an absent father. When a couple cannot live under the same roof due to major differences, they separate or get divorced. However, the requirements of the children remains the same; they still need the care and love of their mother and the support and guidance of their father, to grow up without any complications or insecurities. Children usually look up to their father as a symbol of strength and security and in his absence, they might not receive the same support and may feel inadequate and insecure. If during their childhood kids do not get the support and security that only a father can provide, they might bottle up the feelings inside; and these feelings usually explode when they grow into violent adults. A Father's Absence is Critical Due to whatever reasons, if the father is not present in the family during the most important growing periods of the kids, they have more chances of turning to crime and drugs, than the children who have a father by their side. According to a research conducted by the Research Institute of the McGill University Health Center located in Quebec, a father's absence, especially during the child's prime growing period, can lead to behavioral problems when they grow into adults. The research was carried out on mice raised only by their mothers and showed that the mice that were brought up in the absence of their fathers, were  abnormal and aggressive in their social interactions. Gabriella Gobbi, who is an author and a senior associate professor at the McGill University - Faculty of Medicine, says that even though the experiment was carried out on mice, the findings are highly relevant to the behavior of humans, under similar circumstances. Role of Fathers and Fatherhood Another research carried out by Dr. David Popenoe, a renowned sociologist, throws light on the role of fatherhood and fathers. According to Popenoe, fathers should not be treated as mere second adults in the family. Fathers, who are more involved in their family, have a certain positive impact on the children, which no other person is capable of. Fatherhood is an important responsibility and the presence of fathers in a family, directly influences the well-being of the growing children. In the absence of fathers, mothers may try their level best to provide their children with the right kind of upbringing and education. However, they might fail to give the kids the support and strength that only a father can provide. Due to this, children fail to face the challenges of life head on and are unable to handle their problems with an open mind. When a lot of emotions get bottled up inside, in most cases, they find their release in the form of violence. Sometimes, children also lack the right kind of guidance in their growing years and mothers fail to handle their changing emotional requirements, due to which these kids become increasingly frustrated and violent as they grow up.  
Breast lumps- myths busted!The rise in the occurrence of breast cancer in women, since past decade or so, has made women, especially in the urban areas, very cautious about lumps in their breasts. Whenever there is a small lump in the breast, the first thought that comes to mind, is may be this is cancerous. However, instead of taxing your brain with worries, it is better to take action and consult your caregiver. Here are some of the myths that are regularly associated with breast lumps and the real facts related to the same. Myth: If there is a breast lump, it must be cancerous Statistics reveal that out of 10 cases of breast lumps in women, only 2 are cancerous. More often, these lumps are due to fibroadenoma or cysts. In many women, lumps are formed during the menstrual cycle and they go away after it ends. It is not simply possible to tell exactly what kind of lump it is, just by feeling through hands. However, it is important to detect the composition of the lump and to do so at the initial stages, so that if it is detected cancerous, early diagnosis and treatment can save your life. Myth: If your mammogram is normal, you are safe and the lumps are not cancerous This is not particularly true. To detect the presence of cancerous cells, you need to get more tests done; an ultrasound, an MRI and also a follow up mammogram, to get a second view of the lump. Doctors also suggest a biopsy to be 100 percent sure of the diagnosis. If the lumps persist but there is no detection, your doctor may ask you to keep doing the tests at frequent intervals, to assess the development. Myth: Malignant breast lumps do not cause any pain Although breast cancer patients do not suffer from much pain, this does not mean that if you do not have pain, the lump is non-cancerous. There are different types of breast cancers; and in some types such as the inflammatory breast cancer, the patient can suffer from warmth, tenderness, redness and swelling, followed by pain in the lumps. Myth: If you get a lump while breastfeeding, it is not cancerous It is true that breastfeeding reduces the chances of development of cancerous cells. But there is still a possibility and hence you should not ignore the formation of lumps. It is advisable to immediately get an ultrasound to confirm the condition of the lump. Myth: Lump in young women cannot be cancerous Women can develop breast cancer at any age. Hence, if you have a breast lump at a young age, or even if your teenage daughter has developed a suspicious lump in her breast, you should always get it checked, at the earliest. Most often, cancer develops in the breast when women are past their menopause period. But this, in no way means, that they cannot get it at younger age. Myth: Only a larger lump can be cancerous, not a smaller one Lumps in the breasts can be of all sizes; and the size, does not determine the presence of cancerous cells. According to breast-imaging specialist at New York's Manhattan Diagnostic Radiology, Melissa Scheer MD, you must immediately see a doctor, whenever you feel the presence of even a tiny lump, because, a small lump too may turn out to be aggressively cancerous. Most often, the lump in the breast is non-cancerous; however, it is advisable to consult your caregiver immediately, once you discover the lump for the first time.
Dehydration: Prevention and curePlaying outside is great for the child's physical as well mental development. But if your child has spent the entire day outside and comes back with fever, diarrhea, or vomiting, and is sweating a lot, then watch out for the signs of dehydration. What is dehydration? Dehydration means abnormal loss of water from the body, especially from illness or physical exertion. Under normal conditions we all lose some body water through sweat, urine, and tears. Kids lose large amount of water and salt from body during fever, diarrhoea, vomiting, or long hours of physical activity or exercise without any water intake. How do I know it is dehydration? If your child has any of the fever, diarrhoea, vomiting or is sweating a lot on hot days then watch for these signs: Sunken eyes Dry or sticky mouth Dark urine or lack of urine output Tiredness, lethargy, irritability or fatigue How can I prevent dehydration? The best way to prevent dehydration is to ensure the child drinks plenty of fluids when they are sick or physically active. Get your kid in the habit of drinking enough water before he/she even feels thirsty.If it is very hot, explain to the kids the benefits of drinking water frequently. If possible, avoid going out in the sun. Give your kids a well-balanced meal to be sure that they are getting all the adequate nutrients. What if my kid gets dehydrated? If the kid is below 1 year, care should be taken to breast feed the baby often. If the dehydration is due to vomiting, feed small amounts frequently for it to absorb in between the vomiting episodes. Give a spoonful of ORS solution every 10 minutes to replace the lost fluids. For kids above 1 year, start with plain water initially when the kid complains of thirst. Later the kids may need drinks containing sugar and electrolytes. Also, the child should be made to rest at home in a cool environment until the lost fluid has been replaced. Once the child is rehydrated, resume to normal routine and diet.
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.
How to remember everyone you meet?Now that would be quite a feat, would it not? To be able to recall the name and occupation of every person we ever encountered right down to the minutiae of how, where, and why we were introduced to them to begin with! Sometimes we raise the bar of forgetfulness to the extent of forgetting just who it was who introduced us to "Mr. what's-his-face!" If only there were ways to remember the modest and average people who leave virtually no impression on us, wouldn't that save us great embarrassment? Plus it will help us do away with those sheepish looks when it dawns upon the other person that you haven't the foggiest of notions as to who he is. Stranger: Hi! You remember me? How are you doing, Frankie? Frank: Umm! I am well (this guy's face looks mighty familiar, but for the life of me, I cannot recall ever having cast my eyes on him). Stranger: So, how was your annual bridge completion? Manage to beat the Swiss pairs this time? Frank: Atta boy! Got it! This guy happened to be kibitzing at the weekend bridge club at Aldermere. Whew! Stranger: You gave me quite a start there. You looked right through me and I was quite not pleased at the fact that just last week I happened to congratulate you. Frank: Well Martin, be tough to not remember you, of course I do! Just didn't think of bumping into you here. Martin: Well, I am Walther and I can now see that you don't remember me at all! How many times has the above scenario happened to us? While it is well-nigh impossible to remember every name or face that we come across, it would be  a good habit to at least attempt our 'mental name book' to avoid an occasion for future embarrassment! Now, how in the world does one do that? Simplest way would be to carry a small notebook with a pen to make note of someone that you have just been introduced to, at a meeting or a social do. Our friends often introduce us to people and chances are that if there is no occasion to remember that person, then the brain fades it out of its memory list, as it will only use up space on the brain's 'hard disk.' Human memory might be jogged to remember trivia from 25 years ago in great detail, but ask a simple question - remember what you had for lunch last Tuesday?  - and that would be very difficult to answer, especially if last Tuesday was just an ordinary day with no special reference points around lunchtime to help you remember. Maybe if something momentous had occurred on Tuesday last, like pretty Meg from next door, sharing lunch with you rather unexpectedly, then you can bet your bottom dollar you will remember what you had on the day in question. So create reference points! When you are introduced to someone, first and foremost, reference it with who introduced you and then try and make a reference of at least one unique distinguishing feature in that person. Now you don't really require the eye of a physiognomist, and it would be mighty impolite to stare hard for the "distinguishing feature" coin to drop. So a quick look and you got 'long nose Mary Gomez' all referenced and ready for recall at the next chance meeting. Make the reference phrases funny so that you won't have any problem whatsoever in recalling the name behind the funny phrase when you most require it. Alternatively, try associating a picture with the name if you aren't very good with phrase reminders. These techniques are called mnemonics, which is pronounced ni-mon-nics, and funnily enough the very curious spelling - Mnemonics makes you want to have a picture card memory association for the right pronunciation. A mnemonic for this could be 'knee-moan- knicks". Easy enough, i.e., if you remember the sequence right. You could also try memory exercises with names picked off from the telephone directory at random. Pick an A-lister say - 'Anderson' and then flick through to D and pick 'Dougherty' and so on until you have picked at least 10 names of a different alphabet. Now, try and write down the numbers that you must have undoubtedly memorized until now. You can consider yourself blessed even if you are able to memorize the number of the third person by the time you reach person number 10. This will give you a memory for names and numbers at least. Or, go through any university web sites and look at the photo galleries of past alumni. Give yourself 1 minute to quickly glance at all the names on the page. Then try and recall the name by applying the memory picture association or develop your own technique. With regular practice, you could well be in the employ of the local police to help identify criminals off a line up. If that's too dangerous for you, then at least that will  keep your brain alert and active with this brain gym and help avoid any boo-boos in the future.
10 bedtime beauty essentials! Here are the beauty essentials you need to take into consideration, before you hit the bed: Baby-soft soles :Before you sleep, apply Vaseline on the sole of your feet. This will adequately moisturize your soles and you can wake up to the great opportunity of wearing those heels you have been dying to try out! Healing the puffy eyes : If you are worried about waking up with puffy and tired eyes (even after 6 to 8 hours of sleep), then put on a little eye cream. You can also keep an extra pillow and make sure you sleep on your back. This will allow the fluids around your eyes to drain easily and reduce the puffiness. Trying out wavy hairstyle : Bedtime is the best time to work on your hairstyle. Before you sleep, shower and fashion your hair into the style you want. Apply a styling cream on your hair gradually, after having air-dried it. Now, decide if you would like to put them up in buns or braids. Stylize them into the pattern and wake up to wavy hair! Let your skin breathe : Those who are suffering from dry skin can apply moisturizer. A humidifier is also a great accessory for help in these cases. You can switch on the humidifier before you go to sleep. This will help your skin to retain its moisture through appropriate hydration. Keep aging at bay :Did you know that sleeping on cotton pillowcases can increase the chances of creases and wrinkles on your skin? Prevent wrinkles by using silk or satin bed clothing. This will also reduce hair breaking. Wake up, miss white smiles: If you want to take off the yellows from your teeth, then brush some baking soda and let them stay for about 8 minutes. Afterwards, thoroughly rinse your mouth. Do not perform this beauty tip more than once a week, it will negatively affect the structure of your enamel. Work on your complexion :During the day, sunlight might disable some face creams from working effectively on your complexion. Make the most use of night and apply a face cream containing retinal and vitamin C. Lengthen your lashes : Eye lashes depth and grace to your eyes. You might feel that working on your lashes will require way too much effort. But, much to your surprise, everything your lashes need is contained in a natural ingredient - castor oil. Consisting of Omega-3 fatty acids, which are highly hydrating, they will avoid your lashes from breaking and also strengthen them. Apply castor oil on your lashes before you sleep and watch them grow thick and healthy within a few weeks! Taking care of your hair : Skim leave-in conditioner through your hair in the evening and let them stay on till the morning. This will let them become soft and shiny. You can also use coconut oil as an alternate conditioner. Readying your nails for polish : Depending on the skin type, the nails of certain people become dry. If you are one of them, it would be best to apply a cuticle cream or oil on them before you sleep to wake up to polish-ready nails.
High heels can walk you to the hospital bedHigh heels make a fashion statement which makes us look tall, elegant and good but they cause injuries on a regular basis. High heel shoes have been luxury item once upon a time; today high heels have made themselves a part of every girl's life thanks to supermodels and stars. You will not find any health warning on shoes but they ought to, as they seriously put you at a high risk of numerous health problems. How are high heels and low back painrelated? High heels significantly affect your natural posture and your spine. The natural arch of spine becomes acute when walking in high heels. This poses high risk to the spine getting injured. This not only wears  and tears intervertebral cushions called discs but cause injury to the nerves too.  High heels put strain on muscles of lower back causing pain after a long day of wearing high heels. Nerve trapping, nerve pain and radiculopathy can result from wearing high heels for a long period. This is exhibited     as tingling, numbnessand pain. Arthritis, nerve pain, hammer toes, ingrown toenails and bunions are all common problems due to high heels. Calf muscle shortens and tightens after prolonged use. Jogging, playing, running with high-heeled shoes can tear and rupture calf muscles. What can you do to prevent damage? Firstly ensure your body is in top shape before you start. There is a much less chance of developing low back pain if you are strong and fit. So do activities like swimming, pilates, circuit class, box-exercise and whatever else thatmakes you feel good. Focus on activities that make the abdominal area strong includingyour deep core muscles. Secondly a regular regime of stretching will prevent a lot of problems occurring. Either get involved in a yoga class or make sure you do 10-15 minutes of stretching every day. Stretch your back, your calves and hamstrings especially. Thirdly get sports massage at leastonce-a-month. This will loosen the tightened structures, realign the spine and lengthen the hamstrings, calves and Achillestendon
All you need to know about angioplasty!Why would you need coronary angioplasty? The walls of the arteries are being constantly lined with a fatty material called plaque. This plaque increases in certain conditions like atherosclerosis. When the build-up is too high, the artery gets blocked and the subsequent tissue receives very less or no blood, causing it to die. The plaque at times may be dissolved by medicines but if it is too big, medicines prove ineffective. This is manifested outwardly as a heart attack. This is the time when the doctor would recommend the coronary angioplasty as a treatment for you. How is it done? A thin catheter with a deflated tiny balloon at one end is inserted into the affected artery. Once the exact location of plaque build-up is reached, the balloon is inflated causing the plaque to get pushed against the artery wall and creating free space for the blood to flow. A small mesh called a stent may be placed to hold the artery in place. Some stents are coated with medicines that prevent the scar tissue formation following the angioplasty procedure. The procedure may be done as an emergency or it may be planned. If it is a planned procedure: You will have to get hospitalized and stop eating or drinking 6 to 8 hrs before the procedure. Once the procedure is done, the doctor would prefer you staying in the hospital overnight to watch for any adverse events that may happen. What happens after the surgery? The surgery lasts for 1 to 2 hours and you would be allowed to go home the next day. You will be advised not to undergo vigorous and strenuous exercises and to rest adequately. Most people are fit to return to work a week after the surgery.
Winter - When your heart feels the cold too!As per a study in America, 193.6 people of every 10000 people die of a heart disease every year. 53% of the heart attacks occur in the winter months. Heart diseases have a seasonal trend as found by medical research recently. A team of medical researchers recently conducted a survey which saw 10,000 participants between the ages 35 to 80 from around seven European countries. The study was conducted to see if there is any seasonal variation in the presentation of heart diseases. The participants were measured on the parameters of blood pressure, waist circumference, body mass index, blood glucose levels and blood lipid levels. The parameters were later adjusted for sex, age and smoking. The results revealed that the incidence of heart disease shows an upward trend in the winter month [Jan to Feb] as compared to the summer months [June-Aug]. The researchers accept that there is no logical explanation to these findings. A plausible cause being the fact that the eating habits change in winter. One tends to eat more which in turn increases the cholesterol levels leading to heart diseases. Several other theories are being put forth. According to one, during the winter months the body undergoes hormonal imbalance. The day and night variation in the hormone levels, especially that of cortisol varies. This results in a lower threshold for heart attacks. Yet another theory says that the cold temperature tends to constrict the arteries narrowing the blood flow to the heart tissue and this result in a heart attack. On the basis of this study, scientists advise that more attention is to be paid to heart health during the winters.
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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