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Making the 30 the new 20 - Some healthy tips for men over 3030s for most men is the age of making money, a firm career and preparing a good and luxurious retirement plan. But in this race of minting money, getting a house, buying a new car, don't you feel you lose the verve to be young in body, health and spirit? Result, you are in the lap of one or the other lifestyle diseases. Well guys slow down and ponder a bit.Your age can be on your side when you try to maintain it not when you extract all energy and fill it with monotony and laziness. 30s can turn into new 20s for each one of you but that can't happen by sitting in front of the TV set watching your favourite game and gulping down a beer. So you need to put your mind and heart together and try to work out options to keep your mental and physical health optimized. Let's discuss few such ways which can be the key to your health post your 30s. Be a part of the maddening crowd Post 30s men have a habit of engaging themselves totally into their work, that very little time remains to socialize and meet people. Studies prove that people who are part of a big social group have fewer chances of heart diseases as they are supposed to be happier and stress-free compared to their counterparts who spend their time in their office files and TV. Be healthy, wealthy and always wise with exercise Hitting the gym would be a trend amongst teens and those in twenties, but you need it the most at 30 as this is the age staying fit is essential to keep all diseases away. If you are not a gym fan then you can try any of the other methods of exercise: Morning walks Joggings Yoga Aerobics Options can be innumerable but you need to choose what suits you and your lifestyle best. Avoid the idiot box Do you spend your evenings in front of the television set? Well that is definitely one of the unhealthy habits you are nurturing then. Television sets make you dependent, which mean very few body movements. The only exercise you get is when you reach for the popcorn or when you fiddle with the remote for the mute button in-between commercial breaks. Also it takes up your time which is meant to be spent with family and friends. So next time you get home from office, try and grab a game with your kid or a nice chat with your wife or walk down the road to your friend's house and go out for some fresh air instead. Say NO to the puff A very common habit which catches hold among men especially since their teenage is smoking. Men who have been smoking since their teens don't feel a need to change their ways and it just seems to get worse. Now in your middle-age you don't smoke for effect but rather as a refuge from all tensions and tribulations or sheer force of habit. You are aware that smoking and nicotine dependence whether through smoking to chewing tobacco can put you at risk of lung cancer, hypertension, heart valve blockages and much worse? Being a bit more sober than you were in your 20s is essential here. Stop the smoke and try to look into the clear air around you. Less alcohol, more life Alcohol not only hits your liver and takes you away from the real pleasures of your life but also makes you prone to all the diseases which starts showing its symptoms in the middle-age only. Increase in anxiety, blood pressure, high cholesterol or other cardiovascular diseases come into forefront more with age. Does that mean you should stop this within a day or two? No, you need to limit the number to one or two pegs maximum a day and you will be fit for a healthy life. Go fishing Now this does not mean you need to hunt for your own food or dangle the bait or go hungry. Just make fish a part of your daily diet. Fish or sea food after stepping in your 30s makes you able-bodied and increases immunity to fight diseases. The necessary proteins, vitamins, essential oils, zinc, selenium etc. can be had through just one source-fish! Bone mania Calcium deficiency a common disease in women in their 30s causes joints pain primarily, now this should never be neglected by men as well because with changing lifestyle, men also are falling prey to it. Declining calcium concentration in your bones post 30s makes them prone to more fractures and bone damages. The right balance between physiotherapy and food habits makes you more agile and keeps the joints squeaky clean! More sunshine Research prove that spending 15-20 min in the sun everyday helps one to keep away from diseases like osteoporosis, back pains, arthritis etc. Requirement for Vitamin D is fulfilled and all readily bodily deficiencies get mitigated. Thus step out in the sun for some time and experience the results yourself. Avoid the junk Pot bellies are a common sight among men as they hit their 30s. You don't have to live with it! Obesity is the starting point of most diseases. Thus what you require is just focus on a healthy diet plan. The burgers and pizzas which might be irresistible to you in your teens should be only looked at dispassionately without bringing your mouth a mile near them. Extra cheese and butter are now not to be served on your platter. A bit hard-hitting but to stay healthy needs to be done without any second thought. Thus the above mentioned pointers can be followed by guys at any age but should be followed rigorously when you hit 30! So, live your life healthiest and to the fullest!  
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.  
What to eat when you breastfeedAlmost everyone around you will advise you to eat a calorie-rich food that will aid in milk production from your body. But did you know that your body is quite capable of producing enough milk from whatever you eat? Your body has stocked up on all the fats during your pregnancy days itself. You don't really need the extra calorie rich food just to produce milk for your baby. However, how much calories you need cannot be predetermined. Let your body determine your needs. Eat as often as you want, as often as you feel hungry, but remember to eat foods that will give your body the nutrients and not just satiate the hunger. Opt for whole grains, pulses, fresh fruits, legumes, fresh vegetables and nuts. Choose natural drinks like buttermilk, coconut water, and fresh juices. Remember that the foods that you choose must nourish your body with proteins, calcium, and iron other than carbohydrates. Dried fruits and nuts like cashews and almonds and walnuts are the traditional foods given to new moms to enhance breast milk confinement. They are a very rich source of calories and definitely improve the quality and quantity of milk. However, keep a bottle of water or some juice nearby when you breastfeed. The body releases oxytocin when you breastfeed and it makes you thirsty. So, have some refreshing drink before you breastfeed. Most new moms are advised to drink lots of water as it aids in breast milk production. However, breast milk production doesn't really need extra water. It is best to avoid alcohol when you are breastfeeding. The amount of alcohol in blood and breast milk reaches its highest level about 30 minutes after you have a drink and it lowers down only after about four hours. Drinking alcohol is not advised when you breastfeed, however, if you feel like having alcohol, do so after you feed your child. Also, wait for a minimum of four hours before you feed next. Ghee is another item that new moms are encouraged to consume for milk production. However, if you are eating a balanced diet there is no real necessity to eat too much of ghee. Avoid aerated drinks, tea, and coffee while you are breastfeeding. Similarly, junk food and foods that are not cooked at home are best avoided. These types of foods fill you up, but provide no real nourishment. Herbal teas are considered safe drinks during breast feeding. However, consult your doctor before you consume any herbal medicines. Do not forget to take your prescribed supplements of iron, folic acid, and calcium regularly during breastfeeding. Your body also needs more amounts of vitamin C, vitamin B12, zinc, and vitamin A. These, you may obtain by eating foods that are rich in them or your doctor might prescribe supplements. Weight gained during pregnancy may be a concern now and you may want to lose it to regain your pre-pregnancy shape. Remember to lose weight gradually with the help of a balanced diet and moderate exercise. Do not starve yourself. Also heavy exercising may release toxins into the bloodstream and breast milk. Keep in mind that you will gain your original weight back only after your baby has completely weaned off breast milk and has started eating solid foods. Breastfeeding is the best option for your baby. It gives your baby everything that it needs and keeps it free of all diseases. Do not shy away from breast milk, do it the right way! Your body is quite capable of producing breast milk from the well-balanced diet that you eat and there is no real need for a calorie-rich food that new moms are fed.
Your bundle of joy comes with bundles of fascinating facts Blue-eyed wonder: Most babies are born blue-eyed. The melanin pigment that decides the color of the eyes is not developed at the time of birth. So the babies are born with blue/light eyes irrespective of the genetic makeup. By the time the baby is 6-7 months old, the pigments start developing and the baby's eye colour changes as per the genetic makeup of the parents. Marked for life: One in every three infant is born with a birthmark! No tears: That is true! New born babies do not shed any tears. The lacrimal duct and the tear glands are well developed but they produce just enough tears for lubrication. Actual tears start appearing after one month of age. Crawling wonders: New research has found that babies can crawl almost as soon as they are born. When left to themselves, they are quite capable of using their limbs and find their way to food i.e. the mother's breast.And we thought that they are tiny helpless creatures! Temperature sensitivity: Babies are much more sensitive to temperature changes and body heat.Though the baby can't throw off the clothes to cool down, it is smart enough to do other things. When the baby is cold, it will move around more and if it is too hot it may just lie still as if sunbathing. Touch therapy: Touch is the most highly developed sensation in babies, even in premature ones. The touch sensation develops from head to toe with the mouth being the most sensitive. No wonder they tend to put everything in their mouths. Short-sighted: Babies are short sighted at birth. Their vision is set to a limit of 8-to-12 inches. They can see people and objects clearly only if they are within this range. Brain size: The brain grows at such a rate in newborns that by the end of the first year,the brain is double the birth size and half its final size! Palmar Grasp: New born babies have a strong grip, as strong as a monkey's. The grip is so strong that if you dangle them on one hand, they can support their own weight. This probably originated from the primitive survival instinct. This strong grasp reduces after a couple of months. Taste buds: Babies have more than 10,000 taste buds situated all over the tongue and even at the roof and sides. As they grow, these extra taste buds disappear.
Mood disordersMood disorder is a category of mental health problems, and it includes all types of depression and bipolar disorder. The cause of mood disorder is not well known. Endorphins in brain are responsible for positive moods. The neurotransmitters regulate endorphins. Depression and other mood disorders are caused by a chemical imbalance in the brain. Life events such as unwanted changes in life may also contribute to a depressed mood. Mood disorders are inherited. Children, adolescents, or adults who have a parent with a mood disorder have a greater chance of also having a mood disorder. Symptoms: Prolonged feeling of sadness Helpless feeling Low self-esteem Intense guilt Suicidal thoughts Loss of interest in daily activities Difficulty with relationships Disturbed sleep Change in appetite or weight Low energy Inability in concentrating Inability to make decisions Frequent physical complaints (i.e., headache, stomach ache, fatigue) Threats of running away from home Hypersensitivity to failure or rejection Irritability Aggressive behaviour Hostility In mood disorders, these feelings appear more intense than what a person may normally feel from time to time. Treatment Psychotherapy: It is focused on changing the individual's distorted views of themselves and the environment around them, working through difficult relationships, and identifying stress triggers in their environment and how to avoid them. Family therapy: Families play a vital supportive role in any treatment process. Antidepressant medications: Medications in combination with psychotherapy has shown to be very effective in the treatment of depression.
Faking illnesses - An illness in itself?In 2008, a 28 years old woman in the US shared some shocking news with her friends. She had been detected with cancer. She posted updates on social networking sites and wrote blogs on her illness. Sympathy poured in from all corners. Some even sent in monetary help to cover her expenses. The saddest part of the incident though was not her cancer; it was the fact that she had faked it! Police investigations revealed her little trick when no evidences or records were found at the hospitals! Apparently, this isn't a unique case;  faking illnesses or malingering is a very common occurrence. All of us have done it at some point in our lives. While we may have done it to escape a school punishment or to take undue advantage of the office 'sick leaves' for personal purposes, it is usually done on a harmless level. But faking illness can be a chronic disorder too and  medical professionals even have a name for it-; Munchausen's Syndrome. People suffering from this syndrome fake illnesses that they don't actually have, to gain sympathy or simply to be the center of attention. Usually gaining sympathy is the main reason why people fake illnesses. It gives them a chance to be in the spotlight. Everyone calls and visits, expresses concern and fusses over them. Lots of love is showered upon them. Another common reason for faking illnesses, is money and at times, the monetary benefits are higher than the emotional ones. No one hesitates to fulfill the last wish of a dying person, however expensive it may be. Often there are mixed motivations and the person faking an illness has many reasons to keep up the pretense of being sick, for as long as possible. Some people really do have a disease — a mental illness known as a factitious disorder. People with this disorder pretend to have an illness, which is usually a terminal one and often go to great lengths to maintain their hoax. Munchausen syndrome by proxy, is another form of faking illness. People with this disorder, fake illnesses of people under their care; and they usually do this, for monetary benefits. Children are the most common victims in this disease. When you tell someone that your child has cancer, you will receive a great amount of sympathy and all the money you want, no questions asked! People with these disorders are extremely cunning. They go to great extents to maintain their lies. They will build grand stories, complain of fake pains and aches, get admitted to hospitals and undergo a battery of tests, numerous times. Interestingly, they never allow and frequently discourage medical professionals, from talking to any of their family members. Since they know they are faking the illness, they will refuse to undergo treatment, for obvious reasons. . If you think a loved one may be exaggerating or faking their health issues, attempt a gentle conversation, voicing your concerns. Avoid anger, judgment or confrontation, while offering support and care and if possible, help them in finding a treatment. Treatment includes empathy, helping in identifying feelings and issues that led to the development of the disorder and finding  alternative healthy ways to deal with those feelings and issues.
10 best and worst appetizersWhen you are munching on appetizers before your meal, the idea is to eat something that can trigger off the production of your digestive juices in the intestine, so that what you eat next, the food is easily digested. However sometimes, the appetizers are much more complex and heavier on your tummy and can actually reduce the metabolic activity and imbalance the digestion process. Here are some of the best and worst appetizers that are commonly served: Best Appetizers Vegetable Kababs: These highly nutritious and low calorie appetizers are a good alternative to fried items. Grilled vegetables or kababs are prepared by skewering red and green bell peppers, onions, tomatoes, mushrooms and zucchinis. To add to the taste, you may brush over some low-fat herbs and even garlic marinade. Two delicious vegetable kababs, will get you only 75 calories. Crab Cakes: Seafood offers you high nutrition and the best way to include the properties of seafood in your diet, is by choosing crab cakes as appetizers since these offer only 20gms of fat and 300 calories, while providing you with a high level of sodium (960mg). Spinach Salad: The best thing about good appetizers is that they are low calorie foods and provide great flavor and satisfaction while eating. One such fulfilling appetizer, is spinach salad. You can also use other green leafy vegetables to add more nutrition to the recipe. If you eat this appetizer before your meal, chances are, you will eat 10 to 15 percent less of the main course, which is certainly a great way to cut down on the calories. A cupful of fresh salad gives you only 80 calories. Beef Skewers: If you are in the mood to pamper your taste buds, but still want to stick to eating healthy, then beef skewers is the right option for you, in the appetizers section. These are usually served with peanut sauce in restaurants. You can opt for lean beef along with soy, garlic, hoisin, onions and barbeque sauce to make this dish yourself. Quarter to the pound is the recommended serving, which consists of 5 gms of fat, 130 calories and a high sodium content of 803 mg. Stuffed Mushrooms: Potato skins are a common appetizer people go in for, but these add more calories. Instead, you should opt for stuffed mushrooms that are way more delicious. The caps of mushrooms are stuffed with breadcrumbs and the cheese of your choice; and they provide only 50 calories per cup. This means that even if you eat six stuffed mushrooms, you are still within the limit of 300 calories. The worst appetizers are deceptive yet tempting in their looks and taste. But you should always keep a check on the ingredients before gorging on them, for your own benefit. Worst Appetizers Onion Blossom: Fried onions are certainly bad for your waistline. It is always better to eat a starter stuffed with more vegetables, instead of fried things. A restaurant preparation of onion blossom consists of 161 gms of fat, 1,049 calories and around 4100 mg sodium, which is more than double the limit required by an adult, making this appetizer a completely unhealthy choice. Cheese Fries: Cheese fries are one of the worst appetizers; these can be even more overwhelming than your meal itself, which is why health experts advise not to include this appetizer in any type of menu. Sometimes cheese fries actually come with more melted cheese on top, which is obviously worse. Spinach Artichoke Dip: Although this starter starts with the word 'Spinach', it is in no way a healthy appetizer. One dip of spinach contains loads of calories-1600, fat-100 g and 2500 mg sodium. It is certainly not the spinach but the cream base that is rich in saturated fat. Potato Skins: Potato skins have all the high calorie foods such as meats, sour cream and cheese. When you take one pop of these, you will be adding 150 calories, which is quite a big number. Moreover, these appetizers are not filling. A plateful of potato skins adds 1,340 calories, 1,850 mg sodium and 94 gm fat and yet leaves you hungy. Cheeseburger Skins: Although these appetizers look small, there are loads of calories packed in them. One order of Cheeseburger skins can total up to 1270 calories, with an added 2310 mg sodium and 82 gm of fat.
5 tips to reduce your salt intakeSalt is an inevitable part of our food, but added salt has harmful effects on the body. The list of benefits in reducing sodium/salt intake in our diet runs long, ranging from lower blood pressure, in turn leading to reduced risks of heart disease, obesity, and diseases of the kidney. The daily sodium intake of an individual should not exceed 1500-2300 mg per day (a table spoon of salt approximately), and this needs to be maintained in the salt added to our food, including the processed food and drinks we buy. Sodium, an indispensable component of our diet, is consumed in excess by most of us. Follow the tips, as mentioned below, to curb your daily salt intake. Avoid added salt. Do not add salt to already cooked food while eating. Keep a diary and make a list of foods with salt in them that you eat daily. Do not forget to add pickles, spices, papads, salted biscuits, and salted nuts. All of these are highly loaded with salt. Next time you go shopping read the labels. Choose low-salt options-sauces, crackers, khakhra, instead of papad. Make an attempt to eat less canned and processed foods. Choose fresh fruits and vegetables over processed food. Eat less bread. Each bread slice has about 250 mg of sodium. Do not mistake bread to be healthy. Next time, keep this in mind when you go out to eat pizza. Pizza base is like bread. While cooking food, make it a point to add salt only towards the end in the recipe. This way you will need to add lesser salt. Sodium content of some foods Bread (one slice) - 250mg Cheese pizza: 450 - 1200mg Tomato soup: 350 - 1000mg Potato chips: 100 - 150mg
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.
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
Female circumcision - Health EffectsThe procedure is carried out by either snipping off a piece of the clitoris or removal of all external genitalia for non-medical reasons. The procedure is carried out outside hospitals and the environment may not be effectively clean and could lead to infection. The painful procedure causes a lot of fear and distress. Some countries have begun to use healthcare personnel to cut the genitals, which reduces pain, bleeding and infection but it does not mean that it is acceptable by the United Nations. Even though the United Nation has termed female circumcision as a violation of human rights, there are millions of girls suffer because it is a requirement for girls so that they remain pure. It is supposed to lower female libido so that they do not indulge in any kind of sexual activity before marriage. Immediate complicationsGirls are likely to suffer severe pain besides the fear that accompanies such a procedure. It can cause them more pain when they try to urinate. If there is severe bleeding, it can lead to haemorrhage. The tissues that form the genitals are severely damaged and healing may not take place immediately and sores can form leading to more pain. Girls can retain urine for fear of the pain. There is always a chance of contracting tetanus or other bacterial infections like sepsis which lead to formation of pus. Besides cutting, procedures can include pricking, piercing, incising, scraping, and cauterizing the genital area. Long term health problemsBesides the immediate problems, female circumcision can lead to long term effects including infertility. The girls can be subjected to urinary tract infections and bladder infections that can recur again and again. Sometimes cysts may also form. There are chances that there could be increased risk of problems during childbirth which could in extreme cases result in the death of the newborn baby. According to UN estimates more than 125 million girls and women are living with female circumcision. Women may be subjected to continuous surgeries especially in those cases where the vagina has been stitched to make it narrow as part of the circumcision process. Once the girls are married, the vagina is unstitched to have sexual intercourse. During childbirth, the vagina may need to be cut again to deliver the child and then stitched up again. This is a continuous problem and women should be spared from this pain and trauma.
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