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Caught in the snore snare....A real nightmare!Snoring is caused due to obstructed air movement during breathing while sleeping. It may suggest an underlying medical problem like obstructive sleep apnea. Studies have also revealed a correlation between snoring and risk of heart attack. There are different reasons for snoring and to find out the exact reason and the right solution is important. Snoring affects the quality of sleep can cause irritability and fatigue. Snoring causes poor quality of sleep, irritability, lack of concentration the day after the deed. Snoring is a tad like fingerprints , no two sets are the same and so it is with snoring, There are different rhythms or snoring patterns and even the reasons for snoring vary. Snoring or that irritating sound which people make through their mouths and nose while asleep happens because of narrow airways failure of air to pass through the respiratory system easily. The air vibrates against the obstruction in airway causing the sound of snoring. The air is unable to escape normally through the airways and hence it causes that grating sound with each inhale and exhale. Yes that sound which makes you wish you could smother the fella with a pillow. We say fella because men are more prone to it than women. Snoring can happen due to various reasons: Habits: Those who smoke and drink regularly are likely to have a more relaxed set of jaw muscles causing them to snore readily and loudly. Weight: People with excess weight and poor muscle tone are likely to snore more. Age: The wide open mouthed gape kind of snoring usually happens in old people as the breathing muscles lose their tone somewhat. Posture: General posture and sleep posture in particular can affect snoring patterns. Especially, sleeping with the back flat against the bed constricts free exhalation. How to put a clamp on your snoring? If you have a snoring problem evaluate how serious it is and then take the necessary elimination strategies. Understand that your snoring can cause sleepless nights to your partners, family or whoever is within ear shot so instead of going in for fancy anti-snore devices which don't do a thing to help If this is a recent habit then consult your doctor and have him re-evaluate any medications that might be responsible. Try and establish a regular sleep time and ensure that you follow it to the T. Exercise to lose weight as losing flab around the throat can lead to better sleep. Ask a partner to awaken you if you snore too loudly as regular jabs in the gut can help train the mind to behave. Blow your nose out before bed time as clear air passages is what you need. Any nasal constriction or chest congestion is really what gets you started. Sleeping on your side is a better option than sleeping on your back. Before hitting the sack try and hum a few bars of the blues as singing can help tone the vocal cords and they are less likely to go into vibrate mode. According to help-guide.org there is a rather quaint method to cure snoring and that is to play on a certain musical instrument called the 'Didgeridoo' which is supposed to strengthen the soft palate and throat muscles. If you have no Australian connections then don't despair as rolling your tongue out from all sides before sleep can work just as effectively.
Make no bones about this - Men have osteoporosis tooOsteoporosis is a condition in which the bones of the body lose their strength gradually and become thin and brittle. This is most commonly seen in women who have attained menopause. The reason being the decrease in the hormonal levels, particularly estrogen. Studies reveal that 20% of sufferers are men. Falling levels of testosterone are one of the causes for men developing brittle bones. Men's bodies convert some amount of testosterone into estrogen, which is very essential in maintaining the bone mass. Genetic deficiency of the enzyme that helps the conversion of testosterone to estrogen also is a major factor for men developing osteoporosis. Calcium and vitamin D play an important role in developing the bone mass and in helping the bone grow. Exercising helps too. When you exercise, the muscle gets pulled and the bone responds by growing. Too much of indoors and sedentary work may make men get the less of all three and it eventually leads to weak bones and osteoporosis. Studies reveal that 20% of sufferers of osteoporosis are men. Certain medications like anti-seizure drugs, drugs for prostate cancer and steroids have side-effects that make it impossible for the body to use vitamin D. Using them for a long time reduces the bone mass density and leaves the bones brittle making them easily prone to fractures. Smoking is a vice that has to be quit for more reasons than one. An analysis of several major studies on the effects of smoking shows that smokers have a 55% higher risk of hip fractures and low bone mineral density than non-smokers. Nicotine has also shown to have a direct effect on bone cells. A long list of medical conditions like diabetes, rheumatoid arthritis, and digestive and blood disorders can take a toll on your bones. Long term medications for the same also have side-effects on the bones. How to prevent osteoporosis? Exercise- As young boys, men have usually been exposed to a lot of bone building exercises through sports. This helps in building up on the bone strength and comes in handy in the later years. A brisk walk for 30 minutes 5 times a week and moderate impact exercises help in maintain the bone mass and reduce the thinning of bones. Calcium intake- The daily calcium needs for men is the same as women. Hence, the dietary recommendations remain the same too. 1,000 mg of calcium a day from ages 19 to 50 and 1200 mg of calcium a day if you're over 50.Along with this, make sure you get the required dose of vitamin D too, so that the calcium you eat is absorbed properly. The standard recommended dietary allowance is 400 IU. Some doctors advise to increase the intake to 800 IU. Regular medical checkups will help you to know beforehand about the risk factors and the necessary precautions you will need to take.Osteoporosis in men is as much a reality as in women. However, there are ways to avoid it too. Awareness about the condition and about the ways to prevent it can help keep osteoporosis at bay. Bone mass matters. It could mean the difference between a hip fracture later in life - or keeping an active, high-energy lifestyle.
Smell like roses, without the thornsYou bathe regularly and use the best possible deodorants, underarm anti-perspirants, panty perfume but the bad odour just doesn't go away. Pat yourself dry Very often you have a leisurely bath with scented bubbles and what not but when it comes to drying your body thoroughly, well you just pat yourself quickly, for you are in a hurry. The moisture on your body then attracts bacteria with fungi and they cause that embarrassing mouldy kind of stench on your body. So make sure you dab yourself thoroughly dry all over your body. Especially in places like the lower back where it is difficult to reach without some really flexible shoulder joints. Use the archer's swipe (The towel extended between the right hand over the head with  the left hand extended back to form the bottom grip, which looks like an archer reaching for a bow from the quiver). In case you are endowed with love handles and folds of fat then be generous with the patting, as those are the parts most susceptible to host bacteria. Change clothes often If you wear the same set of clothes and lingerie then you are surely going to have an odour which is lingering. So for those ladies who occasionly wear the same set of clothes without washing, the sweat is going to accumulate in there and raise a stink. Remember the Celine Dion song? It's a new day, a new start! Menstruation + Stress = Bad smell There is nothing that you can really do about your periods. Instead, try and be a little more extra careful during those 4 days. You can have an extra jab at the deo bottle or perfume lotion. However stress, nervousness and fear also leave chemical traces which come out along with the sweat. This adds to the bad odour. Humble pie for dessert? What you eat also affects the way you smell. Go easy on the garlic, onion rings and fish for they can make you smell slightly worse than an open sewer. Always rinse your mouth after eating and use a good minty mouthwash if at all you choose to pepper your meal with onion and garlic to ward offthe evil eye. You can add conditions like diabetes to cause a fruity kind of odour. Well in that case make sure you exercise regularly so that the skin sweats out the toxins. In case you are the extra-sweaty types then use medicated soaps or ensure you use steam baths regularly to keep your skin pores open.
Pamper the newborn without forgetting yourselfIf you are a new mom, chances are you are busy 24/7. The baby's complete dependence on you helps you bond with him/her and makes you aware of the responsibility that is now on you. But, your own health is an equally important responsibility. So, you need to give yourself permission to take care, or even pamper yourself from time to time. Here are simple ways for you to look out for yourself. Eat your favorite breakfast: As your day starts, you need fuel to keep your energy levels high. So, grab your hands on healthy and tasty breakfast options like whole grain cereal, skim milk and sliced strawberries or a banana. The combination of lean protein, whole-grain foods, and nutrient-rich fruit allows the brain to form more feel-good chemicals. Don't let stress come near you: We know that a lot of changes in your life have transpired, due to the entry of a baby in your world. The difficulty to cope with the changes may cause stress and depression. Try to avoid stress by asking for your husband's and relatives' support. Take a walk with your baby: Walking with your baby in nearby parks will give you fresh air and it is an excellent form of exercise. Don't be sleep deprived: Having a baby doesn't mean that you have to always sacrifice your sleep. Never miss an opportunity to sleep or take rest. This will keep your energy levels high for the day. Sleep when your baby sleeps. Delegate baby care: Parenting is not your sole responsibility. Ask your husband to lend a hand in taking care of the baby for some time. Not just the husband, if you live in a joint family, you can ask other relatives for help as well. Don't be a multi-tasking person: We know a woman has so many roles to play. But, it doesn't always have to be that way. Being a new mom, you must focus on one activity at a time. You can prioritize your tasks, if you have a lot of things to do. Exercise regularly: Add exercise to your daily routine. Choose the exercise which you love and enjoy, like walking, cycling, yoga, swimming or aerobic dance. Consult a doctor before starting any exercise program.    
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.
Exercise to fight off depression in school kidsBefore concluding on the effects of different forms of exercise on children, it is important to note the distinction between fitness and exercise. Fitness encompasses most importantly a healthy lifestyle of which exercise forms a part. For this reason, when researchers examined the impact of fitness on emotional being of a child, most of them covered three main determining factors, namely the body mass index, the child's feeling about fitness, and a shuttle-run test. Depression is characterized by recurrent feelings of despair and hopelessness. The main symptoms of depression include sensations of unworthiness, dysfunctional thinking, lack of concentration, low level of sleep, anger, social isolation, crying, physical grievances like headaches which do not react to treatments, reduced interest in social activities, and thoughts on suicide. It is not necessary that every child will undergo all the symptoms. If most of the symptoms recur continuously, then it is a warning sign. The propensity towards chronic depression is higher in those who suffer from depression during childhood. A healthy lifestyle is accompanied by a range of psychological benefits. When you exercise, your body produces endorphins which stimulate positive sensations about the self. Produced by the brain, they also reduce the sensation of pain. A healthy lifestyle boosts the sleep cycle and helps in coping better with tough situations. A medical study conducted by University of Texas revealed the positive effects of physical activity on middle-school graders. It was found that there is a robust link between depression and fitness in girls. Even though boys show association, it is not explicit.  Conclusively, it was pronounced that exercise helps in reducing the chances of depression in school-going children. The best way to help your child is by introducing activities that she or he finds interesting. Initially, you might face resistance. The most important task is to communicate with your child. In the face of such resistance, you can attempt to find a hybrid therapy to reach out to your child. Apart from scheduling appointment with a child psychologist, you can also meet up with a physical health advisor. Emphasize on activities which will also help your child to meet new people. According to the Center for Disease Control and Prevention, one of the main benefits of physical activity is betterment of academic achievement and conduct in children.
Crossing the smoke screenWhy should someone quit smoking? Smoking is probably the worst sedentary lifestyle habit that we pick up. Quitting smoking changes everything right from the way you feel, taste and smell, your breath smells better and even your cough goes away. Quitting smoking cuts down the risk of cancer, stroke, neuropathy, heart disease and breathing disorders like bronchitis, pneumonia, and emphysema. Not just that, quitting saves money too... just one of the many financial rewards of quitting. Quit Smoking Tips Write down the reasons you want to quit for, and how it will benefit you: for e.g. live longer, feel better, family safety, save money, smell better, find a soul mate easily, etc. You know what's bad about smoking and you know what you'll get by quitting. Read the list daily. Ask for help from your family and friends. Help and support of family and friends without being judgmental helps a lot. You need their support when you become irritable and even irrational while you withdraw from your smoking habit. Set a Deadline. Set a quit date when you will extinguish forever. Prepare a plan. Talk with doctor and take his support and guidance. Exercise. Exercise helps relieve stress and recovers body from damage caused due to cigarettes. Start slow and increase up to 30 to 40 minutes. Begin to breathe. Daily deep breathing for 5-15 minutes will help cleanse the respiratory system and provide more oxygen repairing the damage caused to respiratory system and help cope with withdrawal symptoms. Do not quit abruptly. Cut down on cigarettes gradually. Plan everything about number of cigarettes you will smoke each day till the quit date, reduce the number each day. Buy single cigarette at a time. This helps a great deal to limit smoking. Change brands. This way you won't enjoy smoking as much. Undertake social commitment. Keep your packet of cigarettes with someone else, so that you have to ask for them each time you want to smoke. This way you'll feel guilty about asking and hence smoking; hence lowering the number of times you smoke. Find a mate who is trying to quit. This will boost the morale and keep up the positivity. Try finding a quitting chat room. Learn what triggers desire to smoke - like stress, the end of a meal, arrival at work, entering a bar, etc. Avoid these triggers or if that's impossible, plan alternative ways to deal with the triggers. Now, after you have read this, sit down and write your own list suitable to your personality and way of doing things and create your own plan for quitting.  
Have that chocolate without any guiltYou may find this hard to believe, but chocolate is actually good for your health. Hold on, before you faint. Let's first get to the crux of the matter. Chocolate can actually be good for you if you eat it in moderate quantities. So what about all the bad effects of chocolate that people always talk about? Let's fume them all one by one:  Chocolate causes dental caries: Dear mummy, dental caries (cavities) are caused due to poor oral hygiene and consumption of foods rich in fermentable carbohydrates. When these carbohydrates are left in the tooth for a long time, they release an acid. This may damage the tooth enamel and cause tooth decay. In fact, chocolate contains tannin which actually prevents cavities from forming. So next time, dear mommies, let your child enjoy a small piece of chocolate. You can also join them in the treat.  Chocolate is loaded with fats and sugar:Yes, chocolate comprises of both saturated and unsaturated fats, but a majority of themare in the form of oleic acid and stearic acid. Now, oleic acid (present in olives) and stearic acid are good to lower the blood cholesterol levels. Also, the fat that is found in chocolate is added later, after the chocolate has been processed. So the higher content of cocoa in any bar ensures that there is less fat in the chocolate. So, what about the sugar?Sugar is bad, but the darker variety of chocolate has less sugar compared to the regular sweet chocolate. Dark means higher cocoa content and hence no room for other fillers likes cocoa butter, sugar, nuts, etc.  Chocolate contains no nutrients: On the contrary, it is rich in antioxidants.What is the work of an antioxidant? They scavenge the body of free radicals, which roam in body and cause ageing and diseases. Antioxidant flushes these free radicals out of your body. So, if you want to stay young, bite on a piece of chocolate once a week. Secondly, diets rich in antioxidants have been proven to lower the incidences of heart attacks, strokes, cardiovascular diseases, hyperlipidemia, and arthritis. Hence, I stand by the bar full of antioxidants;it's actually good for you.  Chocolate contains caffeine: Caffeine content in chocolatesis low as compared to your tea, coffee, or cola drinks. Now, having counted the amazing health benefits of chocolate, it is important to tell you which chocolate is healthy for you. The one which is in its purest form - thebittersweet one, which is high in cocoa content, is the clue to your healthy bar. So next time you crave a dessert, indulge in a small piece of chocolate to satisfy your sweet tooth and forget that guilt.  
Fruit diet can be dangerousFruits are healthy and provide lots of nutrition, vitamins, antioxidants, carbohydrates, fibre and bioflavanoids to the body.These things together protect your body from different health conditions and heart disease. However if you only eat fruit, you miss many other essential nutrients such as fats and protein. This can upset your stomach and lead to indigestion. Hence it is very important to take a well-balanced diet to remain healthy. Check out why you should not rely solely on fruits for living. Fruits do not provide protein Protein is highly important for your growth and development. By eating only fruits, you are restricting your intake of proteins that can stop your overall development process. Your body requires calories and energy on a regular basis. Each cell of your body contains protein. To keep your body cells in top working condition it is important that you include protein-rich foods such as lentils, soy products,  nuts and beans in your regular diet. You can also consume low-fat dairy, lean meat, fish and skinless poultry to provide required amount of protein to your body. Fruits do not provide fat Although excess of fat is not good for health, it is essential that your body requires on daily basis to ensure smooth functioning of your immune system and also to help your body absorb various minerals and vitamins provided by other foods like fruit. If you continue being a fruitarian for long duration, the chances of stroke due to brain haemorrhage increases. According to health experts, you should get around 20 to 35 percent of your daily calories from fat. To provide your body with good fats you should include soybean, sunflower, olive or canola oil in your diet. Fish and poultry also provide good amount of healthy fats to the body. Too much of fruits can lead to digestive problems Fruits provide fibres to the body in large amounts. Although your body needs fibre as it is one of the essential nutrients, getting too much of fibre can lead to side effects. Fibre works as broom to clear of your abdomen and aid in the digestion process. However, too much of fibre leads to stomach problems and cause symptoms such as gas, cramps and bloating. Sometimes it may also lead to chronic diarrhoea, dehydration and loose stools. On a regular basis, a woman requires only 22 to 28 gm of fiber per day and a man needs 34 to 38 gm. Apart from fruits, seeds, vegetables and whole grains also provide fibre to the body. Other considerations If you limit your intake to fruits, you may not get enough calories required for producing the required amount of energy. Consuming calories less than 1100 per day can lead to lot of side-effects such as intolerance to cold, gallstones, hair loss and fatigue. So although fruits taste wonderful and are very tempting, being a fruitarian is not the best thing for your health. Your body needs all the nutrients for carrying out its different activities and hence you should include variety of foods in your diet.  
Hypertension and Vitamin DVitamin D is one of the essential vitamins that are required for strong and healthy bones. The body synthesizes it in the skin from cholesterol when there is adequate exposure to sunlight. Over the past decade, vitamin D has been intriguing medical researchers the world over. Several studies were conducted and interesting results found. One of them being that vitamin D may be implicated in influencing blood pressure levels. As per studies conducted, it was found that low levels of vitamin D lead to high blood pressure levels. People living in high altitudes where sunlight is at a minimum level were found to be hypertensive. Also, the winter season showed an increase in hypertension cases which was again attributed to the low sunlight levels. What exactly does vitamin D do to affect the blood pressure? Renin is an enzyme secreted by the kidneys that constricts the blood vessels and increases the blood pressure. Vitamin D acts by inhibiting this renin. Insulin resistance causes high blood pressure, which is why hypertension often has co-morbidity with diabetes mellitus. Vitamin D helps in improving the body's sensitivity to insulin. Calcium deposits on the arterial walls harden them and make them lose their elasticity leading to an increase in the pressure of blood flowing through them. Vitamin D helps the body to better absorb and metabolize the calcium. The role of vitamin D in strengthening bones is very clear. Though the studies have shown that people having deficiency in vitamin D tend to develop hypertension, the role of vitamin D in this case is still not very clear. Also, whether vitamin D supplements help in lowering blood pressure levels is still to be found out! But all said and done, the research findings cannot be ignored. Moreover, a morning walk is beneficial in many other ways as well! So, get up early, put on your walking shoes and say Hello to the sun! Vitamin D alone will not help you control your BP. You need to keep taking the medications along with the other dietary and life-style changes! An early morning walk is a blessing for the whole day!
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
Female circumcision - Health EffectsThe procedure is carried out by either snipping off a piece of the clitoris or removal of all external genitalia for non-medical reasons. The procedure is carried out outside hospitals and the environment may not be effectively clean and could lead to infection. The painful procedure causes a lot of fear and distress. Some countries have begun to use healthcare personnel to cut the genitals, which reduces pain, bleeding and infection but it does not mean that it is acceptable by the United Nations. Even though the United Nation has termed female circumcision as a violation of human rights, there are millions of girls suffer because it is a requirement for girls so that they remain pure. It is supposed to lower female libido so that they do not indulge in any kind of sexual activity before marriage. Immediate complicationsGirls are likely to suffer severe pain besides the fear that accompanies such a procedure. It can cause them more pain when they try to urinate. If there is severe bleeding, it can lead to haemorrhage. The tissues that form the genitals are severely damaged and healing may not take place immediately and sores can form leading to more pain. Girls can retain urine for fear of the pain. There is always a chance of contracting tetanus or other bacterial infections like sepsis which lead to formation of pus. Besides cutting, procedures can include pricking, piercing, incising, scraping, and cauterizing the genital area. Long term health problemsBesides the immediate problems, female circumcision can lead to long term effects including infertility. The girls can be subjected to urinary tract infections and bladder infections that can recur again and again. Sometimes cysts may also form. There are chances that there could be increased risk of problems during childbirth which could in extreme cases result in the death of the newborn baby. According to UN estimates more than 125 million girls and women are living with female circumcision. Women may be subjected to continuous surgeries especially in those cases where the vagina has been stitched to make it narrow as part of the circumcision process. Once the girls are married, the vagina is unstitched to have sexual intercourse. During childbirth, the vagina may need to be cut again to deliver the child and then stitched up again. This is a continuous problem and women should be spared from this pain and trauma.
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