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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.
Fairness scream: The new male obsession"Mirror, Mirror on the wall, who's the fairest one of all?" The words at once evoke images of the evil queen as she strikes a vain pose at the looking glass. However, these days one needs to be more accommodating and make way for a preening gent to put forth the above query. All these days, fairness would be a quality an Indian male would look for in his wife. Just see the Fair & Lovely ads to know what we mean. But today, this very obsession has turned on itself. More and more men are being just as exacting about their own skin color, complexion and tone as their female counterparts. Just take a look at all those TV commercials where celebrity endorsements dangle the bait of fairness creams, lotions and body wash specially designed for teenagers and young men seeking to take them to the promised land of social and sexual success. But before you rush to buy that cream, here's what that fairness is all about Fairness is skin cell deep Fair, ruddy, dark or wheatish is all determined primarily by the melanin content in our skin cells. Some races like the Africans have a high melanin content thereby giving them a dark colour while Europeans are of a lighter skin colour due to low melanin content. So whether you use an expensive fairness cream or go in for beauty treatments at luxurious beauty spas, genetics will have a final say on the matter. How fairness creams work...or do they? Fairness creams contain chemicals which block the production of melanin in the skin and thus enable a lighter skin tone and a fairer complexion. Mostly melanin production in men is more than females, which is why women's fairness creams don't have so much of an effect on men. The cosmetic industry recognized this factor and thus developed products designed for the male skin. However, some of these "men's only" fairness brands are glorified sunblock creams which block the harmful ultra violet radiation of the sun which blackens the skin. The dark side of fair Some of the beauty treatments and fairness creams contain chemicals like hydroquinone, mercury, and even steroids, which could do more harm than good. If you are obsessed about fairness, the least you could do is use a branded product (though that is no guarantee of its efficacy!). First sample it to check of it suits your skin. If a rash breaks out, consult a skin specialist immediately. Finally, it is the health of the skin which is more important than colour. So exercise regularly or use natural skin treatments like orange peels, cucumber patches to enhance your skin tone. Don't give in to peer pressure. The obsession for fairness can lead to low self-esteem and needless rivalry. Cosmetologists and marketers of fairness products are the only ones who will laugh their way to the bank at your cost. So, if you have a darker skin colour you don't have to go in for expensive remedies just because men in your age group find it cool. Self-acceptance is much better remedy than any beauty treatment in the world.  
Fitness mantras during pregnancyYou must be wondering how Shilpa Shetty maintained her fitness even after bearing a child. The simple answer is that she never gave up exercising. Exercising during and after pregnancy is the best way to stay in shape and ensure your mental and physical healthiness. It also helps you in preparing for labour pain and delivery, and quick recovery postpartum. However, there are some things you need to keep in mind while exercising during pregnancy: Measure your fitness You need to determine how fit you are. This will help in determining the type and duration of exercising during pregnancy and post pregnancy. Also, before you continue your old exercise routine or begin a new one, you should talk to your doctor about exercising while you're pregnant. Pregnancy is a balancing act After the fourth month of pregnancy, it's likely you will lose balance while you exercise. Though your baby is well protected with amniotic sac, it is better to be safe than sorry. Safe exercises Activities such as swimming, walking, yoga, pilates, and low-impact aerobics are good choices. Pregnancy is not the right time to start any new intensive exercise, but it is safe to continue with most types of exercise if you're used to them. The things you should avoid Avoid exercises where you are likely to lose your balance or could make you fall or slip. Vigorous or extreme activities such as horse riding, skiing, mountain climbing are out of the question. They carry too high a risk of injury to your tummy. Avoid exercises such as: Sit-ups Standing on one leg Separating your legs widely You should also avoid most contact sports, such as football, basketball and so on. Finally, give racket sports a miss if you're not a regular player as they can be tough on your knees and ankles. Check with your doctor Consult the doctor before starting with any new or unusual exercise. Check for any complications or unusual conditions. Also, discuss for any concern such as: Pregnancy-induced high blood pressure Early contractions Vaginal bleeding Premature rupture of your membranes, also known as waters (the fluid in the amniotic sac around the fetus) breaking early The best outfit for exercise Clothes should be comfortable and loose fitting while exercising. Wear a supportive bra which protects the breasts and is also relaxing. If your shoe size has changed because of mild swelling, you may want to buy a new one. Duration of the exercise Exercising three to four times a week is necessary. This reduces stress, fights fatigue, and stabilizes emotions in early pregnancy. Start gradually, may be with only five minutes a day, if you were totally inactive before. Add five minutes each day till you reach 30 minutes. Also keep in mind to avoid exercise on an empty stomach. Eat a snack 30 minutes before exercise. Never over do Listen to your body when it says 'stop'. Over exercising causes overheating. Raising your core temperature too much can affect the baby adversely. Always sip water before, during and after exercising. Listening to your body when something hurts or doesn't feel right - that means stop. Drink a lot of water Try to drink about two glasses of water two hours before you begin exercising. Take a sports bottle of water with you when you exercise and take frequent sips from it. It's important you don't get dehydrated. This may raise your body temperature, which may not be good for you or your baby.  Keeping these points in mind, exercise to stay healthy and fit. We hope you soon give birth to a healthy kid.  
Teenage troubles for autistic kidsTeenage brings along with it a lot of physical and psychological problems. Your body undergoes a lot of changes, the way the world looks at you is changing and you are not in the position to accept all this. Teenage is one of the most painful periods in one's life.  For an autistic child teenage can be compared to living a nightmare day in and day out. Here is a look at the problems of teenage from an autistic kid's point of view: Social Interaction The ability to interact socially is absent in autistic kids. They are loners who prefer to be left alone and undisturbed in their own worlds. Such a child is a natural target for bullying and ragging by other kids of his age group. At times even if the autistic child wants to come out and make friends, he is not able to do so due to lack of the required skills. Teenage is a period where you need at least one friend to confide in. It can be an extremely difficult phase when you are all alone. Puberty This is the dramatic time in life dilled with hormones and emotions. Your body undergoes lots of changes and you are confused about so many things. You don't know whom to ask or whom to turn to for guidance. Autistic children do not have the maturity to understand this phase. Special issues for autistic teens and sexuality include: Knowledge of physical changes in body. Knowledge of 'good' and 'bad' touch. Ability to communicate about a 'bad' touch or action. Keeping 'safe' distance from others. Handling menstrual cycles. Avoiding 'self-touch' in public. It can be a phase of emotional turmoil for the parents. They need to work closely with their child's special teachers to chalk out a plan that will be best suited to the child in handling puberty successfully. Self-help skills Simple self-help skills like hygiene can be a challenge for teenagers with autism. Improper motor skills, compliance, and sensory problems may interfere with a teen's progress. The proper training of hygiene and grooming can help to add these elements into the daily routine. The right approach is to simplify each task into simple small steps. The positive reward system is a great source of encouragement, as positive motivation always help the teenagers. Higher Functions Autistic teenagers are socially awkward. They lack the power to comprehend and process complex social cues which includes sarcasm, body language, humor, emotional responses and facial expressions. What complicates the problem is that the autistic child lacks empathy and hence may appear rude. Such kids are likely to be teased a lot in school settings.
Academic pressure in children and young peopleUnderstandably, parents, educators and politicians consider this topic a high priority. Exam preparatory businesses are found in every street and parents are willing to invest huge amounts of money to further their child's education. Another result, though, is childhood and teenage stress and anxiety. Signs of anxiety from too much pressure to succeed at school may show itself in sleep disturbances, erratic/poor eating, low mood, excessive worrying, low confidence levels and fear of failure - all eventually heading towards premature burnout. Younger children may experience nightmares, show bad behaviors or refuse to go to school. Teens may engage in destructive behaviors like drinking or drugs. They may struggle to concentrate or lose interest in their day-to-day activities and hobbies. They may gradually withdraw and isolate themselves. Anxiety and stress maybe linked to queasy tummies, headaches, and flaring up of skin conditions like rashes and eczema. The school and college admissions process has become more difficult than ever before. Competition is fierce. Many apply to a handful of good institutions hoping to get a much-wanted place. The stress does not stop after the exams - the wait for a decision is excruciating. Only a small proportion of eligible candidates succeed. Rejection can feel devastating. Highly capable and hardworking young people who spend many hours studying and preparing for assignments and exams, find the whole experience undermining and frustrating. Increasing external pressure from competitive peers, higher thresholds of parental expectations in a fast-paced world and the increasingly selective, goal-based focus of educational institutions will not feel supportive to a fragile child. Education should lead us from darkness to light. However, high and unrealistic expectations from parents and schools can affect a child's overall development. Whilst there is evidence that the parent's role supports or facilitates the child's achievements, there have also been concerns that a parent with unrealistic expectations can create unnecessary pressure - this worsens stress and fosters performance anxiety in children. Schools may put pressure on parents and the child to ensure that the child is meeting school targets and is not deficient in any area, rather than understanding that every child has a different potential and ability to manage stress. Children may perform better at school and feel more confident about themselves if they are told that failure is a normal part of learning, rather than being pressured to succeed at all costs, according to new research published by the American Psychological Association (2012). Recognizing this key concept and intervening early is vital. Parents and teachers need to communicate better with each other and the child. Understanding the child's strengths and interests but accepting the child's limitations at the same time is important. Supporting the child's efforts and self-esteem is the surest way to motivate them in a healthy manner. A simple conversation at the end of the day about how things are going on and giving positive feedback on the child's efforts go a long way. Where degrees and educational attainments are seen as the passport to financial success, are we losing sight of educating minds and supporting children's emotional, psychological, social and spiritual growth potential?
Be positive. Here's howAs someone so very rightly said, "We are the sum total of our thoughts". So the more positive thoughts you have, or are capable of thinking, the more positive will be the outcome of your life journey. Here are a few tips to think more positively and empower yourself: Have a daily positive thinking routine. Generally the time when you are just waking up, i.e., the half awake state, is best for you to start feeding positive thoughts about yourself. The mind is more accepting of suggestion at that time. You can just feed your brain with happy and positive thoughts about your situation and what you hope to achieve for yourself and your family. Creative positive visualization is another great method of positive thinking. At a set time, just picture your life in the way you want it to go. This is different from daydreaming. Creative visualization gears you up for action while daydreaming remains just wishful thinking. If you have difficulty in certain areas of your life, say at work or with your relationship, visualize a positive outcome. This will engage your mind in thinking of various action plans to get about that positive result. Positive affirmations are a great way of reminding yourself that all is well. Have patience with yourself as your mind will probably not even believe half the things that you are affirming. That's what affirmations are all about.They are statements that you feed your mind about what you are and what you can achieve. Positive affirmations can help you reprogram your mind to what your heart really desires. Let go. Feel that delicious sense of surrender as you just indulge in mentally letting go of things. As a busy person you probably end up trying to control the outcomes of every situation and feel bad when things don't go the way you expect them to. Remember things can go wrong from time to time. Like you, life is also not perfect, so why expect perfection from others? Learn to let go of that emotional baggage that you are carrying. The weight of the world needn't rest on your shoulders. Collective consciousness is where you should try to tap into. Think of situations where things can go horribly wrong for someone else. Send out a silent prayer for those unfortunate people in this world. Chances are that your prayers just might help some stranger badly in need of a prayer or two. This can only come back to you manifold. Help someone else become a positive person. This can only reaffirm your faith in positive thinking. Positive energy is what everyone naturally seeks and we can for sometime blame our friends or family for being a negative influence on our lives. This line of thinking will get you nowhere. Instead think what's the next best option? Think of how you can convert negative energy or experiences into positive ones. Initially you might meet with resistance, but remember if you are positive then positivity is yours for keeps.
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.
Benefits of meditation: How daily meditation helps you lead a wholesome life Sharper memory: One of the most important cognitive capacities we use daily is our memory. With higher amount of stress on your brain and body due to demands at workplace and home, there is high probability of negative effect on your memory. This can be countered by mindfulness meditation where the focus of attention is a particular physical sensation. This lets you quiet your mind and learn to be attentive solely to the matter at hand, thus allowing your brain to be able to remember more sharply and quickly. Dealing with stress: Stress is the buzzword for anyone who is leading their life in busy cities. Starting from the hurried walk into the office to the pressure of meeting deadlines and reaching home exhausted only to find oneself engrossed in another set of tedious jobs is the condition of daily life for most people. Meditation will allow you to cope with stress in a stronger way by bringing the energies of your body under your control, thus giving you the power to channelize them effectively. Giving up painkillers: Recent medical studies, especially ones conducted in Montreal in 2010, showed how the practice of Zen meditation structures the brain in such a manner that its capacity to sense and deal with pain increases. Primarily practiced by Buddhist monks, Zen is the form of meditation where you focus on your breathing and posture while watching and letting your mind gradually turn quiet. In this way, you can put those pain killers away and increase your innate capacity to deal with pain. Happiness quotient: Prefrontal cortex is the part of brain concerned with positive emotions and feelings. Those who meditate have been seen to have greater activity in this area. Major journals and research institutions focusing on depression and role of meditation in reducing it have found that meditation helps the person to feel in control of their life by subtly changing the working of their brains and thus, resulting in greater capacity to cope with depression and negative feelings. Good for your heart: Two kinds of meditation which are greatly beneficial for smooth working of your heart are Zen and Transcendental meditation. Transcendental meditation, taking after its name, helps you to transcend your worries through attention on chanting. It has been found that meditating daily helps to reduce the chances of stroke and heart attacks by over 40%.
5 cardinal sins for the skinWhile cigarettes may not constitute food in the strictest sense, it does have a profound effect on skin complexion, health, color and tone. We eat that we may live, but sometimes we eat way too much and consume stuff that may be extremely hazardous to our health. Since we are talking about skin, here are 5 most hazardous foods for your skin: Grease adds to the crease Since healthy skin is all about healthy blood circulation, any food which is likely to clog up the blood vessels internally is deemed bad for skin tone. Packaged snacks like potato chips may have edible oil written in bold but this contributes significantly to the slowing down of 'collagen and elastin syntheses' which in turn causes the skin to appear aged and all wrinkly. The french fries that we consume as a TV snack can also cause an acne outbreak on the skin and face. Gluten Glutton Gluten is a substance found in wheat and other food grains. We may not even be aware that some of the food grains have gluten as a main constituent. Gluten intolerance can also cause inflammations on the skin in the form of rashes or acne. Bad news is that the pizzas, pastas, cakes and bread that we get off the rack may be heavy in gluten (Surprised that they don't say that on the pack) and that may be the reason for you to lose precious skin tone. So seek gluten free foods, though that might not be the easiest of tasks, but for your skin, it certainly will be worth it. Caffeine - the skin coffin If you are one of those coffee addicts then you may as well write an obituary column lamenting the loss of your skin tone and complexion. It's not without reason that health freaks love bashing coffee beans and caffeine rich beverages, as they are truly hazardous. How? Studies have proven that just 2-3 cups stimulate pituitary-adrenocortical response. Yes, but what does that have to do with your skin? Well this leads to the hormone cortisol to increase in our bodies. Cortisol is known as the stress hormone! So now here's what it does to your skin -it accelerates the ageing process which means wrinkled skin and causes dehydration causing the skin to show an unusual pallor. So before you turn the coffee faucet on think twice. Fad to Black How fad diets are not skin friendly? Some people go on a high protein, low-carb diet which could sound the death knell as far as complexion goes. Dieting depletes calcium levels, which means your bones are going to suffer and what's the point of having skin on bad bone density? Besides low-carb diets can utterly wreck the complexion as the delicate PH balance in the skin is ruined. Some of the meat, poultry and dairy products too can have artificial chemicals injected in them which cause a hormonal imbalance in our bodies leading to skin disasters. Fruits and vegetables have chemicals injected too sometimes! Beware! Cereal Killers Cereal killers are those people who ignore the need of a proper diet for skin health. So anybody who indulges in too much sugar, caffeine and greasy food stuffs is a 'Cereal Killer' A lack of cereals in the diet can literally kill your skin. Cereal foods have high fiber and antioxidants for moisturizing the skin and protecting it from skin damage. For great skin other than cereals which are simply fabulous for keeping skin hydrated and breathing easily, one can eat fruits, olive oil, healthy fats, almonds, tofu, grains, nuts and the good old vitamin B rich products. Ceramides in raw food diets, organic foods, wheat germ and brown rice protect the epidermis of the skin and make it impervious to external attacks and pollutants while maintaining their tone and beauty.
Bile block - Understanding gallbladder problemsRavi was a young intern working the night shifts in a government hospital when he was asked to examine a patient who had just been brought in. The patient was a 45-year-old, a fat man, who was complaining of pain in the right side of the abdomen along with nausea and vomiting. On inquiry it was revealed that he had eaten a very heavy fat-laden dinner. Remembering what his surgery professor had taught him about cholelithiaisis, Ravi immediately guessed what the diagnosis could be. He, however, sent the patient for a blood test and an abdominal scan. The reports confirmed Ravi’s suspicions- cholelithiasis, gallstones. The gallbladder is a tiny pear shaped organ that lies just below the liver. It is responsible for storing the bile that is produced by the liver for digesting food. It ensures the smooth outflow of the bile from the bile ducts. When the bile components aggregate in the gallbladder, they build up to form gallstones, similar to kidney stones. The gallstones are usually small enough to pass on to the intestines and be eliminated without causing too much trouble. At times, these stones may be big enough to block the outflow of the bile and give rise to a variety of symptoms depending on the size of the stone and severity of the block. The symptoms include -  Intermittent colic. A bloated sensation with constant nausea. Inability to tolerate fats. Vomiting.  Fever with chills if the stone becomes infected. Gall stones though found in both sexes, is more common in females. The risk factors for developing gallstones include - Diabetes. Organ transplant. Diseases like hemolytic anemia, sickle cell anemia. Liver cirrhosis. Failure of the gallbladder to empty properly, e.g., during pregnancy. Rapid weight and nutrition loss due to any reason. Gallstones are confirmed by a blood test to check the liver function and by an abdominal scan. Medications to dissolve the stones, and surgery in case of large stones that do not dissolve with medications, are the treatment options.
A primer on heart attacksIndians around the world have one of the highest rates of heart diseases. Heart attack, also called as myocardial infarction, is mainly caused by a blockage that prevents oxygen-rich blood supply to your heart muscle. In other words, it is the death of the heart muscle. What causes a heart attack? When cholesterol deposition, plaques of calcium and proteins on the walls of your coronary artery cause blockage of the artery, your heart fails to receive sufficient nutrient-rich blood. This leads to the permanent death of heart muscle, and it is unable to pump the blood to your vital organs. Symptoms that signal a heart attack   Chest pain is a symptom of a heart attack.  This pain can feel like tight ache, pressure on the heart as if an elephant is sitting across the chest. However, you may get confused with the symptom chest pain - whether it is a heart attack or an angina pain. Chest pain lasts for a longer time in heart attack whereas the chest pain in angina lasts for few seconds and goes away after rest. The pain experienced during a heart attack sometimes feels like indigestion or heart burn. Other warning signs of heart attack are: Shortness of breath. Lightheadedness or fainting. Upper body discomfort in arm, the back, neck, and jaw. Nausea, vomiting, dizziness. Sleep problems or fatigue. Not every person will have the same symptoms of the heart attack. But if you have any of these warning signs, you have to act fast and get the right treatment.
The link between oral sex and cancerSymptoms of oral cancer: The common symptoms of oral cancer include: Red and white spots on the tongue or the lining of the mouth, inflammation of the mouth which continues well over two weeks, mouth ulcers which take over three weeks to heal, discomfort and pain during swallowing food, and lastly, sensation that something is stuck in the throat. HPV types and their nature: There are over 100 different types of HPV. Out of these, 15 have been found to cause cancer. These 15 types of HPV are called high-risk HPV. The HPV types which are found in the mouth are sexually communicable and the primary means for its transference is considered to be oral sex. It could also be carried through anal and vaginal sex, causing laryngeal cancer, anal cancer, cervical cancer, tonsil cancer, vulval and vaginal cancer, and penile cancer. Some of the HPV types get passed through skin contact. These cause warts, especially in the genital region. These types of HPV which cause the warts are less likely to escalate and cause cancer. Though there is no determinate answer as to how common the HPV mouth infection is. Advanced studies during the 21st century have put forward the role of HPV16 in new types of cancer. This was done using DNA testing. Through a medical study, it was found that the most vulnerable groups are: People in the age group of 30 to 34 and 60 to 64 years old. People who have had over 20 sexual partners in their lifetime, around 20% suffer from HPV oral infection HPV leads to cancer?: HPV does not directly cause cancer. It stimulates modifications in the cells which it has infected, like those in the mouth or cervix and due to the modifications the cell becomes cancerous. In only 10% of the cases where the patient suffers from HPV infection does cancer develop. The infection generally treats itself and is removed naturally within 2 years by the body. The chances of progression of the HPV infection into cancer is increased by smoking and drinking. Smoking injures the immune surveillance cells. Due to this injury, they are not able to fight the virus and the virus continues to persist over 2 years, leading to cancer. Vaccinations: In the United Kingdom, girls (aged 12 and 13 years old) are vaccinated against HPV. This vaccination protects the women against cervical, vulval, and vaginal cancers. Men and boys also take vaccinations against HPV, though it is not pursued as strongly as in the case of women. This leaves men who have sex with other men at a greater risk of getting oral and anal cancer. Even though the link between oral sex and cancer is not completely proven, what we do know is that oral sex causes many other infections like gonorrhea, herpes, syphilis, and chlamydia. Did you know that a very low percentage of people (only 10%) who are infected with HPV virus develop cancer? In 90% of the cases, the infection is naturally cleared by the body within two years. The natural process is, however, obstructed in those who smoke and drink.    
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