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Urinary tract infections in menUrinary tract infections are most commonly seen in the bladder in men. The symptoms include: Pain or burning during urination The urge to urinate often Pain in the lower abdomen Urine that is cloudy or foul-smelling Fever with chills and vomiting If the infection has spread to the kidneys, there may be pain in the back in the region of the kidney along with high grade fever, nausea and vomiting. UTI occurs very commonly and is not a medical emergency, but it is advisable to see the doctor immediately to avoid further complications. Elderly people and people suffering from diabetes should report instantly as they are at a higher risk for complications. The main risk is of the infection spreading up and affecting the kidneys. This could result in severe damage to the kidney and in people already suffering from any kidney disease, it could mean even kidney failure. There is also a small chance of the bacteria entering the blood stream and reaching other organs. Risk Factors for developing UTI: Not drinking enough water Holding in urine for long Kidney stones Taking frequent baths These factors may increase your chances of developing UTI A urine test is the only way to diagnose UTI. It not only checks for bacteria in the urine but also for abnormal cells like pus cells and red blood cells. Dipsticks are accurate. Home test kits are also available but they do not boast of 100% accuracy. Stealth or Asymptomatic UTI is the same as UTI, except that the symptoms are not seen. The bacterial infection is revealed in a routine urine test. This is serious and since it affects elderly people and immune-compromised people, needs immediate treatment. UTI is treated symptomatically. Specific antibiotics are prescribed for killing the bacteria. Symptomatic treatment is offered for the fever and pain if present. Along with this you will be recommended to drink plenty of water and fluids and regularly empty your bladder. Men with diabetes need to take special care due to several reasons. Since their immune system is weak, they are prone to infection easily. The high amount of sugar in the blood and urine may encourage the bacteria to flourish. Also, the diabetic neuropathy affects the nerves of the bladder and there may be no proper signals for emptying the bladder fully. All these add up as potential risk factors for UTI. Urinary Tract Infections are easily preventable. Here's how: Drink Plenty of water Empty your bladder at regular intervals Take showers instead of baths Visit the toilet before and after sex Avoid strong smelling soaps and washes to wash the genitals Wash from front to back.
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.
Pregnancy and HIVMothers with higher level of viral load have been found to deliver infected babies. However, no amount of viral load can be safe as infections can occur any time during pregnancy. A high level of precaution is necessary during this phase. Mostly infection occurs during delivery but that's not the only way through which it can spread. HIV-infected mothers should not breast-feed, as virus can transmit through breast milk too. Antiretroviral medications are used to reduce chances of transmission of HIV. Keeping delivery time shorter can reduce the risk of transmission. Most of the times babies born to positive mothers are positive for HIV. Babies infected with HIV will have antibodies made in their system and will continue to test positive. But if babies aren't infected, the mother's antibodies in baby's blood will eventually disappear and babies will test negative after about one to one and half year. HIV positive women should consider possible problems with antiretroviral medications for HIV before getting pregnant. Talk to the doctor about choice, indications, and contraindications of these drugs. There's a risk of missing doses due to nausea and vomiting during early pregnancy, hence giving HIV a chance to develop resistance. Some doctors prefer the practice of stopping or modifying medications during pregnancy to lower the risk of birth defects. Short course of treatments can help eliminate or reduce risk of transmitting HIV to a newborn; but, short treatments increase the risk of resistance to the drugs used too. There is a risk of birth defects due to antiretroviral drugs during the first 3 months of pregnancy. Pregnancy does not worsen mother's HIV disease, but any HIV positive woman planning to get pregnant should discuss treatment options thoroughly and all the pros and cons with her doctor.   
LBW - Babies that don't throw too much weight around!You'll hear this term if your baby weighs less than 2.5 kg (5.5 lb) when born. About six in 100 babies who are born in the UK have a low birth weight. There are a number of reasons for LBW in babies, with premature birth topping the list as far as reasons go. Babies born prematurely could have extremely low birth weight as compared to babies that are born between the natural term of pregnancy, i.e., between 36-40 weeks. So what are the other reasons behind LBW babies? Descent is an important factor that could also determine birth weight. A survey conducted in the UK showed that children born to people from the Indian sub-continent (Indian, Pakistani, or Bangladeshi) or African parents are more likely to be born with LBW as compared to babies born of white Caucasians. In case of twins or triplets, there are chances that one or all offspring might have LBW due to lack of space in the womb. The mother's health would largely determine the healthy weight of the child as well. Emotional problems faced by the mother during pregnancy could have a link with LBW. Same goes for addictions like smoking, alcohol abuse, designer drugs, and at times, health conditions like high blood pressure which cuts off healthy blood supply to the fetus. Even damage to the placenta can cause LBW, as the fetus does not receive vital nutrients, blood, and oxygen which can cause stunted growth or low weight at birth. Any congenital or hereditary conditions can also affect the baby's weight. There is much uncertainty with regard to the future of a baby with low birth weight. There have been instances where LBW babies have developed conditions like obesity, diabetes, or heart disease in later years. It is a common fear that LBW babies develop behavioral or emotional problems in schooling years and they are likely to have low intelligence. Of course, there isn't any concrete evidence. The pivotal factors here would be to find the cause for LBW and what trimester of pregnancy was it detected. Providing a stable family environment and taking special care of a LBW baby can also go a long way in keeping it healthy in subsequent years. Not to forget that the parents' size and genetic predisposition would have a lot to do with the baby's health and even weight. If the parents are small in size or underweight, then the chances are that the baby will be born small or with LBW. Breastfeeding the baby is the best strategy that a mother can adopt to ensure that the baby grows up well. While growing up, the parents will have to ensure that the baby receives a balanced nutritious diet to ensure healthy weight.
Avoiding nappy rash - A few words of adviceNappy rash is a skin condition that takes its name from the nappy in which a baby is wrapped. It is a reddish rash, or tender skin around the buttocks and inner thighs of babies, which occurs due to prolonged wetness from either urine, or stools, or both. Nappy rash may be in the form of an unusually tender bottom on a child, or an inflammation around the genitals, and inner thighs, or folds of the skin. It generally occurs in really small babies, less than a year old. Most times, nappy rash is not a very serious condition, provided care is taken. No matter what type of nappy you use, whether promising complete dryness, or absorbent nappies, your baby is likely to develop 'nappy rash' at least once. The rash can make the baby feel uncomfortable, and cranky as a result. Steps to avoid nappy rash: Always ensure that your baby's bottom remains dry by changing nappies at regular intervals. Use a mild medicated baby soap which will help in keeping the skin around the inner thighs and buttocks soft. Give your baby some nappy free hours. You will be the best judge to know when she is likely to have comparatively dry spells, which can allow the skin and parts below the waist some breathing space. Regular bathing should take care of most rash related problems. Use an emollient, or medicated soap for bathing. Sometimes, nappy rash is a result of a thrush or yeast infection. The baby's resistance at these times is low so that it allows the yeast to thrive in the form of ugly red patches. Always show a medic to rule out the possibility of bacterial infections. Anti-fungal creams should also take care of normal nappy rashes.    
Causes and treatment of sleep talkingIt is usually believed that sleep talking is associated with dreaming, but there is no scientific evidence available to support this hypothesis. In few cases, it may be associated with sleep disorders or any other diseases. Sleep terrors and REM sleep behavior disorder (RBD) are two sleep disorders associated with sleep talking. Sleep terrors are associated with frightening scream, kicking, and thrashing. It is commonly seen in children. Awakening becomes difficult during sleep terror. Patients with RBD utter a sudden loud cry, grunt, shout, or act out their dreams, usually violently. Other causative factors of sleep walking are emotional stress, mental health illnesses, substance abuse, fever, and certain medications. Treatment: Evaluation of the patient Patients with sleep talking should be evaluated by a specialist doctor especially if it is seen in adults or associated with violent actions, screaming, or intense fear. If children with sleep talking have disturbed sleep pattern, they should be evaluated by the pediatrician. The doctor asks questions to the parents, roommates, and bed partners about the nature and the extent of sleep talking. There is no definitive treatment available for sleep talking, although the doctor may test to record the sleep pattern of the patient to identify any sleep disorder. This test is known as polysomnogram. Management Sleep talking usually does not require treatment. Avoidance of stress and plenty of sleep at night may help to decrease sleep talking. However if any sleep disorder is identified by polysomnogram, it is treated accordingly by the doctor. If underlying causes like mental illnesses, substance abuse, or medications are identified, they are also managed accordingly. Mental illnesses like depression should be treated with proper counseling and medications. The patients should refrain from alcohol, heavy meals, fatty meals, etc. The patients are advised to follow regular sleep schedule, get adequate amount of sleep, and practice proper sleep hygiene so that severity and frequency of sleep talking is decreased.
Not very chummy! Menophobia - The fear of periodsMenstruation or periods begin as female reaches puberty. This is the time when there are hormonal changes which occur in the body as nature takes the girl and makes her ready for womanhood. The onset of periods can be distressful with lots of mood swings accompanied by abdominal cramps, bloated feet as the menstrual blood flows. This is also a time when the girl needs to be comforted and educated the most, as it can be truly a terrifying experience. Normally mothers or elder women in the family ensure that they take complete care of the girl in this transition phase. For some women, their initial experience with periods may not have been particularly pleasant, causing them to actually dread those 4 days and this fear can then take the shape of a full blown phobia -Menophobia! The reason could vary. For some the pain factor could be the reason for menophobia, while for others, it could be the memory of embarrassing red stains on the clothes which could set it off. In menophobia, just before the onset of the periods, the person starts getting anticipatory anxiety and the pain which could be normal period pain, is then imagined to be ten times worse. This brings on panic attacks and feeling of utter dread which while is entirely psychological can be utterly distressful and downright crippling. Counseling can help greatly along with pain medication to manage the pain and the fear of this natural phenomenon called periods. In therapy, this is what is iterated. That menstruation is a completely natural process and if there is a fear of menstrual blood then gradually, the woman is encouraged to accept it as a natural body function which plays a major part of her being a woman.
Arthritis friendly workoutsRheumatoid arthritis is more common in women over 60, and is the inflammatory type of arthritis where the synovial fluid functioning is disrupted. The synovial fluid maintains the health of joints, bones, and cartilages. Osteoarthritis is the most commonly occurring type in both men and women, and in this type there is gradual wearing away of the bone cartilages, which, in turn, causes stiffness, and pain in the muscles, joints and tendons. There is a classic catch 22 situation in arthritic patients and that is they avoid exercise or are advised extreme caution while exercising. The pain and soreness which comes from exercising can be extremely discouraging, so some shun exercise altogether. Now, the lack of exercise is going to precipitate the condition further, and could even increase the soreness, and lead to deformity. This is what challenges most arthritic patients. Should someone with arthritis be allowed to exercise? And if yes, then what type of exercise will prove to be most beneficial? Main question is: Are there any arthritis friendly workouts? Doctors now recommend that exercising could actually work wonders for arthritis patients. The right method and type of exercise can help ease the inflammation and soreness of the joints, and build overall health, strength and flexibility of the bones, and joints as well. What would be a good exercise routine? The arthritis foundation recommends routines which exercise the flexibility of the joints, and build muscle mass, for better shock absorption, coupled with physical endurance should be specially designed for arthritics. Regular walking: Walking is a great exercise for arthritics. Walking at a steady pace for about 30 minutes, thrice a week, can help keep the limbs active, and could reduce the swelling at the knees, and hip joints. Warm up is absolutely essential in any work out, and here it is of paramount importance that you go through a warm up routine before you begin your walk. Simple leg raises, hand to toe stretches, and light back bends can be done to warm up the muscles and joints for your walking activity. That will also reduce the possibilities of strain or sprains of the ankles along the way. Choose your exercise route to ensure that you don't walk up a gradient, and put unnecessary pressure on your knees and ligaments. Aquatic Exercises: Exercising in water is perhaps the best possible alternative, as water is absolutely low impact. This is great for arthritic patients to reap the benefits of a swimming pool workout. The easiest for chronic arthritis patients would be to simply walk, or wade in water for about 20-30 minutes. This can help greatly with building strength, and endurance in the extremities. For enhancing co-ordination you can even try walking backwards in water, or simply float and relax the body. Avoid water which is too cold, as that might adversely affect your condition. Stretching and Yoga: All easy stretches for the limbs and joints will be helpful to facilitate ease in movements, and dealing with joint pain. Standing leg raises, shoulder raises, wrist rolls are exercises which can be done quite easily, and can help keep the body supple. Though yoga also enhances flexibility, it goes way beyond just that, and actually aims at harmonizing the life force in the internal and external organs as well. No matter what type of exercise suits you, always remember: Proper warm up exercises are a must for the arthritic patient, as that can help reduce, and eliminate the possibility of injuries while working out. Do not force your body into an exercise regimen, if you are experiencing pain. It is quite ok to take a day off if the joints are sore. Get into an exercise routine slowly as your body might take a little longer to recover from it. Always seek the advice of an expert or a doctor before making any alterations to your regimen.
Sunburn: Overview and treatmentSunburns could also be accompanied by allergic responses to medicines, exposure to sun and sunscreen products, sight-related issues like reduced or complete loss of vision, as well as heatstroke. Over a long period of time, frequent cases of sunburn can result in cold sores, cataracts, skin cancer, and lupus.  The factors which will decide the vulnerability to sunburns are: Type of skin - The type of skin determines the vulnerability and intensity of the sunburn. The most vulnerable groups are those with freckled and fair skin as well with blonde or red hair. Regardless of the color of the skin, all skin types are vulnerable to skin cancer and proper sun protection must be used during times of sun exposure. Season - Summer days carry with them a higher probability of burning the skin. UV Index - This refers to the forecast of the strength of UV light on a particular day. This will let you know the cautionary measures you need to take in order to avoid skin damage. This is put forward on a scale of 0 to 11+ with 0 being the lowest exposure. Latitude - As you move to locations closer to the equator, the sunlight directly passes through the atmosphere to a greater extent. Age - Those who are younger than 6 years of age and those over 60 years are at a greater risk of getting sunburns. Altitude - As you climb higher and higher, the chances of sunburn are also greater since the amount of Earth's atmosphere to keep away the sunlight reduces. Every elevation of approximately 1000 feet, the UV exposure is amplified by about 4%. Location - If you are close to reflective surfaces like snow, water, ice, concrete and white sand, rays of the sun which get reflected off these might harm you. Time of the day - The rays of the sun are strongest between 10 in the morning and 4 in the evening. Though, the probability of getting sunburn are lower on cloudy days, it is possible for the UV rays of the sun to pass through the clouds and negatively affect your skin health. Here are the precautionary steps you can take to avoid getting sunburn: Avoid staying in the sun for a long period of time. Make use of sunscreen and choose clothing which cover your skin. In case you are suffering from sunburn, here are ways to treat it: An over-the-counter pain reliever: In order to lower the inflammation and relieve pain, use ibuprofen or aspirin. Anti-inflammatory condiment: Cortisone cream and aloe vera are two primary ways of reducing the inflammation. Cool bath: Take bath for about 10-20 minutes in water of cool temperature (make sure the water is not too cold). This will cut back the pain and irritation in affected area.  Do not use any bath oil, soap or detergent as this might increase the chances of allergic reactions and irritation to the injury. When drying yourself after the bath, do not rub with towel. Cold compressions: Try application of cold and wet compressions on the concerned region for about 20-30 minutes. Adequate hydration: Make sure you drink at least 8-12 glasses of water to help your skin to recover from the sun damage. Moisturizer: Once your skin begins to heal, use a gentle moisturizer without any scent. Blister treatment: In case you have blisters, do not try to pop them. This will lead to infection and marks.However, if you have large blisters which require to be drained, then pop them using a sterilized needle. Follow this by cleaning the area dry with gauze. After applying ointment to the area (Aloe vera or antibiotic ones like bacitracin and polymyxin B), wrap the area loosely using a gauze bandage. Make sure you do not tie it tightly and change the gauze daily to avoid infection. Medical attention: In case you feel nauseous along with fever, rashes and chills, then make a visit to the doctor. The following symptoms also require you to seek medical attention immediately: Pain in eyes with sensitivity to light, dizziness, high thirst without proper urination, painful blisters, and pale/cool skin.
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.
A guide to earwax impactionBiologically, the earwax which builds up over time moves through the ear canal from movement caused by chewing or other jaw motions. It is also extricated through the inside-out motion of the skin of the ear canal - it reaches the outer ear and peels away. The cerumen is produced in the outer regions of the ear and not in the inner recesses. Earwax impaction refers to the condition where the ear wax builds up to such an extent or in such a manner that it causes discomfort to the entire body. In many cases, earwax impaction occurs when patients use cotton swabs or safety pins to clean their ears, only causing the wax to drop deeper into the ears. The main symptoms of earwax impaction include difficulty in hearing, faintness, ache in the ear, foul smell in the ear region, ringing or sound in the ear (also known as tinnitus), a sensation of fullness in the ear, and lastly, discharge from the affected ear. The most vulnerable groups for this condition include those who use hearing aids or ear plugs, elderly people, and those who insert cotton swabs or other items into their ears, as well as those who have an odd ear shape which could negatively affect the discharge of the earwax and those suffering from development incapacities. Did you know that one of the most common methods used by people to clear excessive earwax is ear candling where a candle (in shape of a cone) is placed inside the ear canal and set alight to warm up and remove the wax? This is one of the most dangerous methods causing burns, worsened blocks, and damaged eardrums; this should be clearly avoided. The diagnosis of this condition can be done by an ear specialist using an instrument called otoscope. Earwax impaction is treated in many ways. While at home, you could try to clean the outer region of the ear by wiping with a cloth, the physician could irrigate or syringe the ear to wash out the ear canal with saline. This procedure is generally done once the wax has been softened by the use of cerumenolytic solutions aimed at dissolving the wax like mineral oil, peroxide-based ear drops, and hydrogen peroxide. Physicians also use special instruments to remove the built-up earwax like forceps, cerumen spoon, and suction tool. The best way to prevent cerumen impaction is by not inserting anything into the ears to clean it up. Cotton swabs should only be used in the outer part of the ear. In case you feel that the buildup is regular, then you can fix an annual appointment with your physician for cerumen removal.
Know your safe period for low-risk sexNot every act of sexual intercourse will result in pregnancy. There are days when your chances of conception are very high and days when the chances are almost nil. Know these days to help you enjoy a rocking sex life! The menstrual cycle starts from the day the bleeding starts and ends about 28 days after that, on an average ovulation occurs around 14th day of the menstrual cycle. The 14th day is the ideal day theoretically. Since every woman's menstrual cycle differs, the day of the ovulation also differs. Hence doctors calculate the fertile period as the 12th day to the 18th day of the menstrual cycle. This is the period when the chances of ovulating and hence getting pregnant are very high. The 1st to the 7th day and the 19th day to the start of the next cycle are the days when the ovulation chances are very less. This means if you make love during these days, there are very less chances of getting pregnant. This is the case with women who have regular period cycles. In case the cycles are irregular, then you would need to do a bit of math for calculating the safe period. For example, if your shortest cycle is of 26 days and the longest cycle has been of 31 days, then- 26-18= 8 and 31-10=21 The 8th day to the 21st day are the fertile days; 1st day to the 7th day and then the 21st day until the day the next cycle starts are the days that are safe to enjoy sex without fear of getting pregnant. Opting to have sex during the 'safe period' isn't fool-proof though. A lot of women have irregular cycles and the cycle length can vary from women to women. That's why the so-called 'safe period' is, in truth, not that safe! And it's better to use condoms or other contraceptive methods like the oral pill to prevent unwanted pregnancies.
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.
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