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Aging milestonesChanges in old age depends on attitude as much as person to person. In young old age some changes begin to take place in a person’s appearance. Wrinkles, warts, age spots begin to form on the body. Hair begins to thin or becomes grey and even height lessens because the bone density decreases. While in ‘old‘ old age these changes are already permanent. Men might look distinguished if in good health, but women all look grandmotherly. In ‘young’ old age, cells begin to decay and muscle mass declines and immunity is no longer as strong as it used to be. People lose energy as the age progresses.  ‘Old’ old age brings in a lot of physical decline, profound changes in appearance and motor abilities, as also in sensation. Skin gets less elastic and becomes thin and blood vessels can break under the skin. The senses also begin to become dull. Eye lenses get affected and color perception and reading ability becomes very low. Hearing loss may lead to paranoia and ‘old’ old age people begin to think everyone is plotting against them because they can’t hear properly about what others are saying. Sense of smell also declines, but the taste remains almost intact. In ‘young’ old age, reflexes also slow down and so do the motor abilities. By the time they reach ‘old‘ old age most adults find that their response time has become quite reduced. This can be seen most in driving situations where it is difficult for ‘old‘ old aged adults to operate their vehicles as they have poor spontaneous responses. The ‘young’ old adults do not lose as much of their motor abilities as the ‘old‘ old adults, especially when holding small things like needles and pins. Of course, there are changes in sexuality and there may be a decline in the ability to have sex as men may not have an erection and women become dry due to lack of female hormones. Cognitive decline in 40% to 60% of older adults can be arrested with remedial training. Despite all the changes, most people even in their 70s remain comparatively active if they do not suffer any illness. Mental, physical, and social activity is necessary to maintain the quality of life. Old people begin to withdraw from work and other important roles and allow the younger people to take over. They are a lot happier as is also advised in Vedic literature as vridhashram. While activities are important, disengagement is equally important. Memory loss becomes aggravated and other cognitive abilities begin to decline and there are many ‘old‘ old adults who get Alzheimer’s and lose the ability to look after themselves. Old people also dwell on questions of death and sometimes go through a phase of denial and then anger that they have so little time left. Acceptance of death comes, but after a struggle and the idea of losing the family saddens them. Old people require support in their declining years as they begin to lose their faculties.
Self grooming tips for men Get rid of unnecessary body hair:Hair on your ears, back, underarms, or uni-brows does not appeal at all. If you have them, then try and get a hair removing gel or wax away gently. Nose hairs can be trimmed from time to time, so that it's not visible. Hair in the underarms can either be waxed, or removed by using a razor. Hair on the back can also be removed through proper waxing. Shave properly:Keep a beard if it suits you, but do trim it regularly. If you do not want a beard, but just a moustache, then that requires customary trims as well. Try and keep yourself clean shaven, if you can't easily manage the styles mentioned above. Avoid bad breath:Bad breath can really get you into trouble, especially during office presentations, client meetings, or even at a date with your girlfriend. Use mouth washes to avoid this problem, and floss after every meal. Mouth fresheners can also come handy, so maintain a regular stock at all times. Brush regularly:Maintain a brush and floss routine twice a day to avoid awkward situations. Cut and clean your nails:Long nails look great on girls, but they are a big turn off in guys. Men need to keep their nails small and trimmed always. Use nail clippers to cut them properly, and cleaners to keep them clean. Take care of your skin:Buy a good sun care and moisturising lotion, and use it always, after a face wash and shower. This shall give you a nice glowing skin. Exercise regularly:A good body can attract everybody's attention. Eat healthy food and exercise regularly to be active and healthy. Get rid of body odour:Instead of colognes, try using deodorants and talcum powders to get rid of body odour. For underarms, always keep a roll-on with you, and apply it regularly. If the issue persists, then consult a doctor for help. Wear well fitting clothes:Wearing unfit or loose clothes will make you look older than you are. Hence, wear clothes which fit you the best. Correct your posture:While standing, walking, and even sitting, keep a straight back. This shall give u a better posture. You will look more pleasing and charming. Grooming is not just a thing for women. It is all about looking after yourself. So, read on to know some self grooming tips for men These were a few tips which can help you look after yourself better, and also give you that much needed edge over others. So, try them out right away!
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.   
Mammary duct ectasiaSigns and Symptoms In most of the cases, female patients do not have any symptom. In few cases, women may present with nipple discharge, tenderness or inflammation of the surrounding region. In some cases, there may be a lump over the breast or the nipple may get inverted. Causes Exact cause of mammary duct ectasia is unknown. But few possible cause or risk factors have been proposed by the doctors : Increasing age - Probability of developing mammary duct ectasia increases with age. With ageing, the breast changes its nature. Glandular tissue is replaced by fatty tissue. This change may lead to duct ectasia. Smoking- Milk ducts are widened due to smoking. This increases risk of inflammation which may lead to duct Ectasia. Inverted nipple - Inverted nipple obstructs the milk duct. It may lead to inflammation followed by duct ectasia. Complications Complications of duct ectasia may be may be of varying severity. They are usually minor, but sometimes become serious. Localized discomfort- Discomfort occurs due to pain and swelling around the nipple. Nipple discharge - Ectasia is frequently associated with discharge of thick and sticky fluid from nipple. Infection- Bacterial infection may develop due to stagnation of fluid in the milk duct. If it is neglected, it may lead to localized collection of pus known as abscess. Abscess requires surgical treatment. Abscess is drained surgically. Diagnosis The doctor usually diagnoses duct ectasia by clinical examination. However, few investigations may be required. Mammography- X-ray of the breast tissue is known as mammography. It helps the doctor to evaluate the breast tissue. Ultrasound- Ultrasound enables the doctor to evaluate milk ducts beneath the nipple. Treatment Duct ectasia is usually relieved by treatment. Following are the treatment options : Medications: The doctor prescribes antibiotic therapy for 10 to 14 days. It may be accompanied by mild painkillers like ibuprofen, etc. for initial few days till the remission of the disease sets in. Most of the cases are usually relieved by medications. Surgery: If duct ectasia is not controlled with medications then the doctor chooses to remove the duct ectasia surgically. Surgery is required very rarely.  Self care measures Following self-care measures often provides relief to the patients. These remedies can be adopted at home. The patient may wear a breast pad or support bra. The patient may apply warm compression to the affected region. The patient must stop smoking. The patient may be advised to sleep on the opposite side of the affected breast. Female patients should be educated regarding mammary duct ectasia so that they can detect possible symptoms of duct ectasia themselves. This will help to prevent possible complications of mammary duct ectasia and early diagnosis will provide early cure.
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.
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.
Balancing marriage and work: The top 5 tricksFor women juggling between home and work is very difficult. Yet, the number of women choosing to go out and work, while managing their homes, has increased over the years. This is because a successful career helps a woman establish her identity in society, gain respect and do justice to her inherent qualities, passions and dreams. So, a successful working woman, is a happy woman and statistics show that such women also keep their kids and spouses happy. More stable marriages During the seventies, when women started entering the workforce in large numbers, there was an instant rise in the divorce rates. However, over the past decade, the divorce rates among working couples have actually declined. Today, men have extensively adjusted to the idea of having a working woman, as a partner. In many countries, men actually share the domestic chores and devote time to childcare, so that their women can successfully handle both, work and home. However, the main responsibility of the home and the kids is still primarily, in the hands of the women. Here are the six keys to manage your work and marriage successfully: Find the right job You can ease out the stress of managing the work and home front, if you make the right decisions. Studies indicate that couples having access to less demanding work, have better sex and better relationships and hence, are less likely to be stressed out. However, in case the working hours are long, the situation can become the opposite. Hence, it is important to find an exciting job, over which you can still have control, especially when you have small kids at home. Adjust the working hours Most women have to leave their careers halfway because their husbands work for long hours and there is no one available to care for the kids. If the wife too is good at work then, the couple should take up jobs that provide an opportunity for both of them to work, since doing this will keep both of them satisfied. There is a possibility that the husband, or the wife, may lose a bit on the income in this adjustment, but ultimately it increases the chances of having a happier marriage. The negative impact of leaving work If a career-oriented woman leaves her job due to family demands, it can shake the very base of the marriage, while also leaving her, depressed. Also taking a break, means you have to catch up very fast when you want to restart your career, which in reality, is quite difficult. In these situations, there is also a huge wage gap, between what you used to get before your break, and what you are getting after, that can lead to depression. Working moms help fortify the relationships between kids and their fathers When the father spends time babysitting the children, a closer bond develops between the kids and the father, which is usually not possible in families where the dad goes to work, full time. Studies show that children raised with equal devotion from both father and mother, have higher goals and aspirations and are even more empathetic. Feel less guilty A working woman usually feels guilty because she cannot spend as much time with her children, compared to the dedicated housewives. However, if the husband shares the duties related to bringing up the children both parents can be happy while playing their parts well for their kids. A woman with a successful career is positive and confident about everything she does, which ultimately makes her family happier.
Muscle build up dietYou may think that you need fatty foods to bulk up, but this is not true. Fatty foods will do just that make you fat. Lean meats, fruits and vegetables will actually build muscle. Take a balanced diet of vegetables and lean meats to achieve your muscle building goals. Changing your diet to build muscle will help with your overall health. Eating food that helps build muscle will ensure that you are not wasting all that hard work you are doing in the gym. Workout utilizes considerable energy. Food is the only way to replace this energy. So what happens if you fail to eat the right type of food to build muscle mass? It will take longer to build muscle, and it may even prevent muscle building altogether once you reach a certain point. Is protein important or not? You bet it is. Protein provides the building blocks to build that muscle. What types of protein are best? Chicken, eggs, steak (with the fat cut off), fish, cheese (especially cottage cheese), and nuts are all great sources of protein. Finding out how much protein to eat when you are interested in building muscle fast is actually not difficult. First, you will need to find out your lean body mass weight in kilos, and then you simply multiply that figure by 2.75 to determine your daily protein requirement. Calculating your lean body mass uses some complex formulae, so ask a professional at the gym if you do not already have this figure. Carbohydrates, in moderation, are also essential when finding foods that build muscle. Do not eat too much, though, unless you choose high fibre carbohydrates, and then you can indulge in much larger amounts. High fibre carbs include rice, potatoes, oatmeal and bananas. Reducing fat in your diet is of course necessary to build bigger muscle on a body that appears lean and has a low body fat ratio. If you are focusing on what foods build muscle mass, you also need to bear in mind that it pays to reduce fat as well. Although proteins are essential, it is really important to select proteins that are low in fat, or that you can cut the fat off. So eat your chicken without the skin, and go for lean steaks rather than more fatty cuts of meat. Opting for cottage cheese or other reduced fat cheeses, and low fat milk also helps reduce your fat intake. You may argue that drinking has no effect on what to eat to build muscle. But you would be wrong. Hydration is critical to general health and wellbeing. Two litres of water a day is what most experts recommend for maintaining optimal health. To drink that amount, you need to drink up to 12 glasses of water a day, which is quite a lot. So start early in the day, and space your water consumption out throughout the day. Foods that build muscle are great and an essential component of your bodybuilding program. But do not be lulled into a false sense of security and think you can slow down on your workouts. Both bodybuilding exercises and bodybuilding diets are required to get a body to die for as quickly as you possibly can. Even if you are working on improving your physique slowly, you should combine a bodybuilding diet with bodybuilding workouts for best results. Sample Diet: 7:00am: Breakfast: 4 eggs + toast or oatmeal + milk with protein powder mixed in (a lot). 9:30am: Snack: 1 Meal replacement supplement + milk. 12:00: Lunch: Tuna sandwich (1 whole can) + green apple. 3:00pm: Snack:  2 Meal replacement supplement + milk. 5:30pm: Workout: Have water (or carb drink if you want), within 30 mins of end of workout (on workout days only) Meal replacement supplement + milk. (If you are going to have Creatine - put it in this Meal replacement supplement at the end of your workout). 8:30pm: Dinner: A chicken breast (aprox 8 oz + some rice or other starch carb + if you want also eat some veggies) Before Bed:  Meal replacement supplement + milk.
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%.
Thyroid may make your heart flutter!Thyroid is a small gland situated in the area of neck. In Greek, thyroid means the shape of a shield. Yes, thyroid gland is vital to a variety of important body functions and does act as a shield. But what happens when the shield is disturbed and goes weak? Thyroid dysfunction is recorded in approximately one to four people out of hundred Thyroid link to heart A research study was conducted in 2009 by Weill Cornell Medical College researchers. It was done to investigate and analyze the genetic link behind rhythm control of heartbeat. They found that the genes that are responsible for synchrony and rhythm in the functioning of heart are also closely connected to the thyroid hormone synthesis and could cause dysfunction of the thyroid. Thyroid activity directly influences the metabolism, blood flow and electrical activity of the heart. When there isn't enough thyroid hormone (low levels), the patients complain of low energy levels, fatigue and reduced heart rate. On the other hand, with increased thyroid hormone levels in the blood, patients report symptoms of hyperactivity of systems. There is diarrhea, palpitations, increased heartbeats and advanced cases show arrhythmias of heart, where normal beating rhythm of heart is disturbed and becomes irregular. Thyroid hyperactivity can be appropriately controlled with regular medication. Understanding arrhythmias When the rhythm of the heart is disturbed, it becomes irregular - this is called cardiac arrhythmia. There are various types of loss of rhythm - heartbeat is too slow (that is, the cycles are taking too long to complete), too fast (the cycles are repeating too quickly), too early (that is, before a cycle is even completed, another starts), too irregular (this is called fibrillation, where no specific pattern may emerge). The patients who have arrhythmia will often come with complaints of dizziness, shortness of breath, suddenly feeling weak or lightheaded, fainting and feeling of a flutter in chest (flutter can be understood as light but quick flapping of wings by a bird). Arrhythmias are usually harmless and most people would continue to live a healthy life for years with arrhythmias. But that does not mean it can be ignored. There is a battery of tests available to diagnose and indicate the seriousness of arrhythmias and let your doctor take a call on the line of treatment. If you have a thyroid dysfunction, get your heart checked immediately. And if you have faced arrhythmias, get your thyroid checked immediately. Both the conditions are controllable and treatable; there is no cause to worry over what could go wrong. Just be vigilant and informed.
Sex after 40Sexual changes in normal aging after 40: Erection takes longer time Require manual stimulation, particularly by partner Erection may subside during foreplay or coitus Decreased frequency of nocturnal erection Pre-ejaculatory fluid decrease or absent Ejaculation less forceful Seminal fluid volume decreases or absent Frequency of desire for sexual release decreases with age. Aged couples learn to cope with their own sexuality. Some are happy with foreplay and self masturbation, others insist on more usually it is the male. Frequency of sexual intercourse between 20-95 years : Sexual intercourse decreases with age as the study shows. Decreased during 5year interval after 34 years Weekly frequency: 30 - 34 years 2.2%; 60 - 64 years 0.7%; 65  - 74 years 0.4%; 75 - 79 years 0.3% Do we need to change this pattern with Viagra? I would say yes - sex can be  joyful till the last days. Nobody needs to be impotent now. Home devices like rubber bands, ribbons are also used to hold the blood back in the penis when the erection is not adequate. Vacuum pump to draw blood into penis with an application of a ring after erection is also found suitable by some. Active intervention by drugs (both allopathy, ayurvedic and unani) have been successfully developed. They may be applied topically (minidoxil), inhaled (amyl nitrate) inserted into the urethral passage, injected into the corpus cavernosa or taken orally (Sildenafil, Tadalafil, etc.). Finally if all fails silastic rods can be implanted in the penis to give permanent erection. The joy of living lasts a life time.
How to talk about STDsThese are dangerous times that we live in. Just the sheer number of people affected by sex related problems, diseases and conditions all over the world is simply terrifying. AIDS, venereal infections like syphilis and gonorrhea, herpes, HPV etc. are rampant and it calls for some responsible sexual behavior. However, that's a utopian world where humans will be monogamous and will behave responsibly. Even single people might get exposed to these diseases through indulging in risky sexual contact. Imagine doling out $750,000, as a woman in the US got from her husband because he gave her herpes. Even if you are not held legally accountable, what about moral responsibility to own up and discuss a possible STD infection with your partner! Take the case of Jack a happily married man for ten years who had casual sex when out of town on an official trip. He showed no obvious symptoms of any infection but in a month, his wife showed signs of herpes and his marriage crumbled as his wife struggled to come to terms with her husband's obvious infidelity and his callous manner in exposing her to a serious sexual infection. Call it ignorance but sometimes a person might engage in sexual intercourse and contract a disease which he might even not be aware of until the symptoms start appearing. (Refer article on Syphilis on www.topdoctorsonline.com) By then, he might have, in all probability, passed it on to his regular sexual partner or spouse. Or perhaps, there is another possibility that the person knows that he has contracted a sexual infection but doesn't know how to break the news to his partner.  If a person is aware of his infection, yet exposes another person knowingly, it is akin to premeditated murder. Yes, it is going to be a difficult thing to tell your partner which might even signal the end of the relationship or cause severe strain on it. So, if you are caught in a situation like this, what would you do? The option would be to visit a sex therapist and confide in him and then take an appointment for both and let the professional break it to the partner. That is of course if you are in a stable relationship. For those who both party to casual sex, the infected person generally won't be that open about his infection and may even choose not to care particularly if the other person is a complete stranger. A report in MedlinePlus news reveals some more shocking statistics: Many people said they occasionally, rarely or never got tested before having sex with casual partners (50 percent) or long-term partners (39 percent). Of the people who did discuss STD testing, very few discussed concurrent sexual partners or when partners' testing occurred in relation to their last sex act. Only half explained what types of STDs their partner had been tested for. These issues are important components of assessing STD risk, the researchers said. About one-third of participants reported telling a partner they didn't have an STD even though they hadn't been tested since their last sexual partner. One U.S. woman was awarded $750,000 in court from her ex-husband because he gave her herpes, and the legal trend is to make people accountable. (http://www.dummies.com/how-to/content/how-to-talk-to-a-partner-about-stds.html) Remember even wearing a condom is not a 100% guarantee that the infection won't pass on to the other person but that's the least that you can do if you don't have the courage to spill the beans about your condition. If you feel that your partner may be indulging in sexual activity with multiple partners and if you feel he might be infected, then you are well within your rights to decline to have sex with him until he/she gets tested. If you notice sores around the genitals do not indulge in oral or anal sex or any kind of sex and insist on a condom always; it could save your life.
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