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Handling post retirement bluesYou have given the best years of your life to your career, and now it's time to say goodbye and get ready for the retired life. It is a phase laden with expectations of all things you were too busy to do while working - spending more time with family, going on that fishing expedition, or going on leisure trips around the world. However, despite the wonderful things to come, retirement can get unusually trying and mentally taxing. After all, how many of us really have the flexibility of mind to take this period as a challenge and be the master of our destinies? Just because you are retired doesn't mean you have to wither away and wait for death to claim you. So, here's what you can do to beat the retirement blues Catching up: This is really a bewildering time, as you have a lot of catching up to do, with a lot of things. Prioritize the things you want to do and proceed confidently. You may want to spend time with children, spouse, friends, etc. Go easy on yourself, as you may not be able to fit in as many things in your schedule all at the same time. Boost your self-esteem: Retirement is particularly trying for those who have occupied important positions in office. Such people are known to throw tantrums, as they feel less wanted than before. So don't ever make the mistake of treating your family like you treated subordinates at work. That was a role that you played then, and without reducing your importance or self-esteem you can now play a different role with your family as a friend, philosopher and guide. In fact, you can use your contacts and keep the old network alive by involving youth in your field of expertise and help them benefit from you. Catch up on exercise: The more physically fit you are the less likely that retirement will be a painful process. Perfect time for you to catch up on the fun times with your spouse to remind you of all the great times you have had all these years. If your spouse is not in the best of health then just being together is such a wonderful experience in the golden years. Financial health: Your peace of mind and self-esteem largely depend on how independent you are financially. You can take up a part time job or think of innovative ways to let your hobbies and interests generate money for you. This should be an enjoyable process by which your self-esteem can really benefit. Support groups: There are informal or formal associations of retired people that do various activities like travelling. Make yourself available to them. Sometimes retired people withdraw into a shell and that only makes things worse. These support groups give a fresh perspective on all things in life.
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.
Making babies, the best way!Some couples get pregnant easily. But many couples have to wait months before the baby is conceived. There are several factors that affect conception right from fertility to the position during intercourse. Some believe that positions have nothing to do with conceiving a child. This is not true. Some positions are ideal to help the sperm meet the ovum. Let's see what some of these positions are. Missionary position:The best position for getting pregnant fast is the missionary position.Here the man is lying on top of the woman allowing for the deepest possible penetration, making it possible for the sperm to get deposited closest to the cervix. It is also the most common and comfortable position preferred by couples. Raise your hips high: Your hips have a lot to do in helping you get pregnant. Raise your hips high during sex by placing a pillow below you. This helps to expose the female cervix to as much semen as the male can release. Doggy position: Considered to be the most erotic and pleasurable position,this rear-entry position where the man enters the woman from behind is also recommended for increasing the chances of getting pregnant. In this position too, the sperm is deposited closest to the cervix, thereby increasing the chances of conception. Side-by-side: You can also try having intercourse while lying side by side. This position, likewise, causes the most exposure of the cervix to the male sperm. While these positions certainly improve your chances of getting pregnant, there is no guarantee that you will conceive. The most important thing is to enjoy this special time and have fun with your partner. So keep enjoying and keep trying!
Breast lumps- myths busted!The rise in the occurrence of breast cancer in women, since past decade or so, has made women, especially in the urban areas, very cautious about lumps in their breasts. Whenever there is a small lump in the breast, the first thought that comes to mind, is may be this is cancerous. However, instead of taxing your brain with worries, it is better to take action and consult your caregiver. Here are some of the myths that are regularly associated with breast lumps and the real facts related to the same. Myth: If there is a breast lump, it must be cancerous Statistics reveal that out of 10 cases of breast lumps in women, only 2 are cancerous. More often, these lumps are due to fibroadenoma or cysts. In many women, lumps are formed during the menstrual cycle and they go away after it ends. It is not simply possible to tell exactly what kind of lump it is, just by feeling through hands. However, it is important to detect the composition of the lump and to do so at the initial stages, so that if it is detected cancerous, early diagnosis and treatment can save your life. Myth: If your mammogram is normal, you are safe and the lumps are not cancerous This is not particularly true. To detect the presence of cancerous cells, you need to get more tests done; an ultrasound, an MRI and also a follow up mammogram, to get a second view of the lump. Doctors also suggest a biopsy to be 100 percent sure of the diagnosis. If the lumps persist but there is no detection, your doctor may ask you to keep doing the tests at frequent intervals, to assess the development. Myth: Malignant breast lumps do not cause any pain Although breast cancer patients do not suffer from much pain, this does not mean that if you do not have pain, the lump is non-cancerous. There are different types of breast cancers; and in some types such as the inflammatory breast cancer, the patient can suffer from warmth, tenderness, redness and swelling, followed by pain in the lumps. Myth: If you get a lump while breastfeeding, it is not cancerous It is true that breastfeeding reduces the chances of development of cancerous cells. But there is still a possibility and hence you should not ignore the formation of lumps. It is advisable to immediately get an ultrasound to confirm the condition of the lump. Myth: Lump in young women cannot be cancerous Women can develop breast cancer at any age. Hence, if you have a breast lump at a young age, or even if your teenage daughter has developed a suspicious lump in her breast, you should always get it checked, at the earliest. Most often, cancer develops in the breast when women are past their menopause period. But this, in no way means, that they cannot get it at younger age. Myth: Only a larger lump can be cancerous, not a smaller one Lumps in the breasts can be of all sizes; and the size, does not determine the presence of cancerous cells. According to breast-imaging specialist at New York's Manhattan Diagnostic Radiology, Melissa Scheer MD, you must immediately see a doctor, whenever you feel the presence of even a tiny lump, because, a small lump too may turn out to be aggressively cancerous. Most often, the lump in the breast is non-cancerous; however, it is advisable to consult your caregiver immediately, once you discover the lump for the first time.
Is circumcision a healthy ritual?Religious rituals and practices have been carried out since ancient times. Circumcision is a religious ritual that involves surgical removal of the prepuce of the human penis. Prepuce is the foreskin of the penis and during the procedure; the person performing the ritual opens, inspects and separates it from the glans. The process is painful and hence local or topical anesthesia is used to reduce physiological stress and pain. Circumcision is performed for religious as well as personal reasons and many times recommended medically for prophylactic or therapeutic reasons as well. Today's medical science makes use of this treatment for treating chronic urinary tract infections, refractory balanoposthitis and pathological phimosis. Circumcision is performed as ritual in many parts of the world. However, it is also recommended medically as protection against HIV infection. Circumcision-Is it Legal and Ethical? In the world over, the ritual or practice of circumcision is carried out on all types of people from neonatal stage to adulthood. While no significant risks have been noticed due to the practice of this ritual, rather some modest health benefits have come to the fore. The World Health Organization has recommended circumcision for male infants in parts of Africa where the children are more vulnerable to urinary tract infections. However, no other medical organization in the world has supported or banned the procedure. Over past few years, legal and ethical questions have been making rounds and many believe that consent should be taken before carrying out neonatal circumcision. HIV and Circumcision Benefits A Cochrane meta-analysis conducted in 2009 on sexually active African men have revealed that the ritual of circumcision reduces the risk rate of HIV infection by 38 to 66 percent among heterosexual men in a period of 24 months. That is why WHO has recommended circumcision in sub-Saharan African areas having high rates of HIV infection as a part of the comprehensive HIV program. Moreover, this process is more cost-effective as compared to other treatments and preventive measures recommended for HIV. Circumcision reduces the risk rate of HSV-2 infections and oncogenic HPV prevalence along with the risk of penile cancer and UTIs. Until now, there have been no concluding reports on the protective effects circumcision offers against other types of sexually transmitted infections. Circumcision is also recommended medically to children suffering from pathological phimosis and refractory balanoposthitis. Contraindications The literature worldwide review conducted in 2010 reveals that around 1.5 percent of the newborns face median complication when the process of circumcision is performed by trained medical providers. Only 6 percent children face severe complications with the common complications being infection, bleeding or removal of too little or too much of foreskin. However, the process does not cause any negative impact on the sexual functioning of an individual. Contraindications due to circumcision are also cited in infants having genital structure abnormalities right from the birth such as misplaced urethral opening, ambiguous genitalia or chordae. In such cases, the foreskin may require reconstruction through surgery.  It is contraindicated in premature babies and clinically unstable infants and it should also be avoided in children with family history of hemophilia (bleeding disorders). In such patients, it is important that the blood should be checked for its coagulation properties before attempting the procedure.
Bow legsCauses: Physiological - As mentioned before, bow legs are normal below 18 months of age. Thereafter as the child continues to grow the bowing begins to improve slowly. By the age of 3 to 4 the deformity usually gets corrected. Blount’s disease - This disease results in bowing of legs due to abnormality of the growth plate of the upper part of shinbone known as tibia. Growth plates are the growing end of the bones. It is diagnosed after the child is 3 to 4 years old. Rickets - Rickets is a group of diseases that occurs due to deficiency of vitamin D. Rickets is characterized by bow legs and other bony deformities. Most commonly rickets occurs in children due to deficient intake of vitamin D. Signs and symptoms: The bony deformity becomes visible when the affected child walks or stands. The uncommon walking pattern of the child is the commonest symptom. Bow legs usually do not cause any pain. However, persistent and severe bow legs cause discomfort to other bony structures like spine and hip. Test and diagnosis: The doctor at first asks questions to the parents regarding the development of the child. This is followed by physical examination of the child. Physical examination often suggests bow legs. If the doctor suspects an underlying disease, necessary laboratory tests are done. The doctor always asks for an x-ray of the affected legs to evaluate the severity and extent of bowing. Treatment: If the bow legs persist after 3 to 4 years or an underlying disease is detected, treatment is undertaken. Medical and non-surgical treatment- In cases of physiological bow legs, no treatment is required. The parents are reassured by the doctor and spontaneous resolution takes place by the age of 2 years. Continuous followup is advised for borderline cases. Children with Blount’s disease need treatment with a brace. Children with rickets need medical management by a specialist doctor. Additionally, they need advice and regular followup by an Orthopedic surgeon. Surgical treatment  - If the bony defects persist in children with bow legs even after medical and nonsurgical treatment, surgery is required to correct the bowing. Two types of surgery is advocated to correct bony deformity of the legs. Guided growth:  Growth of the healthy part of the growth plate is stopped and that of the abnormal part is promoted. This allows straightening of the legs. Tibial osteotomy: The shinbone (tibia) is cut and reshaped to correct the deformity. Then bone is fixed with screws and plate. In both surgeries a cast is applied to promote healing of the bone. Crutches may be required for a few weeks to prevent weight bearing on the limb. Later, physical therapies are advised for complete recovery of range of movements and regular activities. Prevention The parents need to be vigilant about appearance of any bony deformity in legs of their child. The child must be given adequate amount of vitamin D in diet or vitamin D supplementation to prevent development of rickets.
Crave for non-food substances to put in your mouth? Go ahead take your pica!We all have strong cravings in some form or the other, especially for food. Just thinking of a chocolate cake or ice cream can set the mouth watering and the hand creeping to open the refrigerator. However, some people have an unusual craving and it is to consume non-food items. Everyone knows that children are known to eat chalk, dirt or lick walls but at times, even adults have this unusual craving for non-food items. This condition is termed as 'Pica'. One can understand a child popping something into its mouth as it's discriminatory skills are not developed, but what about fully grown adults who have this habit? Is it a mental ailment? One can't really call it a full blown mental condition as it occurs commonly in pregnant women. The cravings are as strong as any other food craving and sometimes these people go out of the way to satiate their cravings. So, right from paint thinner, to chalk to ink, ice, plaster, paint, linoleum to plastic bits can form the obsession or craving. Pica is a combination of psychological and biochemical processes and is generally a deficiency which sets about these intense cravings.  When pica strikes pregnant women, then it could be a cause for much concern and the doctor should be kept informed. While it is easier to indulge a pregnant woman's ice cream cravings if she also develops a thing for iron fillings on top of her ice cream, then obviously it can be a rather dangerous thing to do. Ice and chalk are comparatively harmless and other than affecting the teeth and the taste, do nothing much else, but what about turpentine and toxic materials? They can definitely interfere with the body's digestive processes and can even spread harmful toxins in the body to cause blood poisoning, intestinal infections, bowel blockages and lead poisoning or arsenic poisoning.  If you have such strong non-food cravings then before you give in to them talk about it to a medical practitioner. It could well be an iron deficiency or perhaps even anemia which is attracting you to chew pencils up or making you pop dirt in your mouth. If you are pregnant then certainly the doctor will need to address the underlying issue and ensure that the pica goes away before you deliver. Wouldn't want you chewing up the baby's soother now would we?
The male ego: Fragile male self-esteemIn a world where men are constantly competing with one another, adding a woman to this dynamic changes the perception for majority of men. The fact that a woman is doing better than a man can largely affect relationships at a personal and professional level. Simple things like opening a door for men or even pulling a chair for him can make him feel self-insufficient. The whole concept of a woman doing something/anything better than him brings down his self-esteem. In a relationship the roots go deeper and men who are making less money or not doing as well as their partners have a more fragile self-esteem. The mental insecurity that a woman may be a better provider for the family and has more potential than he does, changes the dynamic of his relationship, while for women this does not seem to be the case. Fragile self-esteem alters your everyday determination and persistence. Without being determined, the only way to go is downwards. When self-esteem is affected by women doing things that he can do, men seem to take it in a negative manner and lower their self-esteem. Small examples of this in our day to day life are - driving your own car as compared to having a driver, being physically weaker than a woman, etc. Men are creating rules to ensure that women who are considered lower than them cannot perform or do better than them. Systems and frameworks are made which ensure that situations never come up where a "lower person" does better than a man can, all out of the fear that they can't perform! From the day we are born to the rest of our lives, we are drilled with the fact that men are better, stronger, and smarter than women. So when situations arise where she is doing or has done better than you, the male self-esteem is questioned and, most of the time, drops. Being the person you are meant to be, you would automatically create a system by your choice and influence it to reduce the possibility of any other to be able to achieve what you have, in turn increasing your self-esteem. However, when the other overcomes or surpasses this obstacle, your self-esteem will be hit hard causing a drop in your self-esteem like the stock exchange does on its bad days. Self-esteem is a very personal topic and completely dependent on the situations you have encountered across your life. However, when majority of these are leaning in one direction then there is no question of failure. Consider a world dominated by women, What would happen to your self-esteem? Do you think you would survive in this kind of world, a world in which all your thoughts are limited by restrictions and rules you have to adhere too, to ensure things like your family name is kept out of shame. So let us all do as the women have been doing for centuries, embrace it, and learn to maintain our self-preservation and esteem irrespective of our surroundings. This may sound hard but let us work towards a world where women and men are equal. Don't let your self-esteem be affected by your surroundings, if you know your surroundings are not the best for the future.
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.
4 super foods to keep you healthy this winterWinter is here. It is time for lazy mornings and blanket hideouts. It is also the time when the markets are lined up with a variety of fresh fruits and vegetables, all juicy, healthy and colorful. Discover four such super foods for the cold winter evenings. Citrus fruits: Oranges, sweet lime, lemons; bring them all and have them all. Bright yellow or orange, they are like the bright sunny mornings which you need after a cold night. Rich in vitamin C, antioxidants, flavonoids and several other nutrients, citrus fruits are the perfect measure for your daily dose. Peel it off and chew it up, or slice it off and lick it on, or squeeze it strong and drink it down - choose the way you like. Citrus fruits help in taking care of your cholesterol, as well. Potatoes: Potatoes are the victims of most diet plans. It is loaded with carbohydrates, we should not eat potato, and so on and so forth. Potato is not that bad actually. In fact, its nutritional value may come as a surprise to many. The content of vitamins B6, C and folate is high in potatoes. Potatoes are rich in essential minerals like potassium, zinc and magnesium. The starch content may be significant, but so is the fiber content. They are known to protect against colon cancer. What are you waiting for? Have some potatoes, will you? Make sure there is no guilt. Kidney Beans: Kidney bean is our favorite Indian 'Rajma'. They are a rich source of carbohydrates and proteins, are known to lower the cholesterol levels and reduce the risk of heart disease. They are particularly known for helping to replenish the iron stores of your body. It can be the food of choice even if you have diabetes, as it is almost fat-free and doesn't send a sudden rush of glucose in the blood. When combined with rice, kidney beans make a very healthy meal. So, is it rajma-chawal (kidney beans with rice) for dinner today? Green leaves: Yes, yes, you are bored of reading and listening to the benefits of green leafy vegetables. But, we have to remind you, for the advantages are too many to be ignored. They are the greenest, freshest and leafiest in the winters. Even if you are not a fan, you will feel like picking up a bunch from the grocery store. Spinach (palak), fenugreek (methi), cabbage (gobhi) are the ones that we can commonly find. Others to look for are lettuce, mustard greens, etc. The green leaves are a rich source of a variety of vitamins, mineral, fiber and water content. They are suitable for all ages and can be easily digested. Entertain that potato lying in your kitchen, cook up a dish with the green leafy ones. Alternatively, you could try it in the form of salads, soups, juices, flour fillings, and any other creative ideas that you chefs have.  
Advantage of the average - Automated continuous blood pressure monitoring technologyAlthough mercury sphygmomanometers (though a deadline is set for them to be phased out due to environmental concerns) are still considered the gold standards, the Aneroid and Digital counterparts represent the future of blood pressure monitoring. The need of long-term blood pressure monitoring arises with disorders and health conditions that demand more attention from the medical teams. Experts say that the fluctuations in BP in conditions like cardiovascular diseases, pregnancy, etc., if tracked at regular intervals, can reduce 22% of risks due to delay and no treatment. This necessity pushed the invention of invasive arterial blood pressure to be used during surgical procedures and further a continuous noninvasive arterial pressure measurement (CNAP) system. There have been multiple researches to overcome some of the roadblocks in measuring the arterial blood pressure in the noninvasive and external approach. Among these developments, the need for measurement of mean blood pressure was felt and the 24-hour BP variation in the patient was taken into account. The 24-hour model eliminates the errors in readings taken during clinic visits due to factors such as fluctuations as a result of white coat fear or after-effects of some stress or exertion. Trendsetting New-age Technology : In 2004, the medical world received the BpTRU non-invasive automatic blood pressure monitoring device. BpTRU devices proved to be a superior and more precise alternative when compared to other manual BP assessment techniques and even other 24-hour ABPM alternatives. The automated oscillometric devices precision and accuracy of assessed BP and heart rate is earmarked with a unique automatic technique - the device records 6 consecutive BP readings of the patient, discards the earliest, and the rest of the five values are put to average function and instantly the resultant mean BP reading flashes on the screen. Compatible with guidelines of American National Standard/Association for the Advancement of Medical Instrumentation (ANSI/AAMI EC13:2002) this is a time-saving, portable, and user-friendly device. A compact and automatic wrist cuff BP monitor, the smart blood pressure monitor that can be synchronized with with Apple’s iOS devices and a Bluetooth connectable and Android compatible blood pressure monitor marks the revolution of CNAP in modern times.
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.
Is sex linked to self esteem?Man is a curious creature, full of quirks and contradictions. Sexual intercourse, something that most people consider an intimate and private experience, is spoken about in hushed tones and often, with some discomfort. We don't reveal or talk about our sexual desires, as readily we discuss our salary packages or food habits. This is quite ironic seeing how sex is an important gauge for a person's self esteem and also an indicator of his/her social desirability. The very thing that we do under covers, we somehow choose to "keep under cover". The Link between Sex and Self Esteem: Self esteem is an important factor that determines the mental & physical well-being of an individual. All of us have a craving to be understood, liked and appreciated; and these form the equivalent of our basic needs on the inverted pyramid- Food, clothing and shelter. For a human being to flourish and prosper, consumable food, without the mental food of appreciation, is not enough; and sexual intercourse or an intimacy with the opposite sex, is one way of validating that need. Sex therefore, ceases to be just a physical need instilled by nature for the perpetuation of the species, but goes into the larger emotional cum psychological dimension of self actualization and realization. Though some of us might be embarrassed to broach the topic of 'whether or not we are getting enough', the truth is that every human seeks to achieve his sexual potential, even while he or she might, not be aware of it. Most of us have the ability to get the foods matching our taste preferences onto our plates, but with sex, this could be a little difficult, since sex, is a complex subject with a lot of social, moral and religious links. The truth is evident in the number of marriages (the very cornerstones of civil society) that fail on the basis of sexual compatibility, either by setting unrealistic sexual expectations or by not owning up to, or even identifying, one's sexual needs. This has repercussions on the psyche and self-esteem of a person, and this is especially true in the case of men in particular, as they may feel completely inferior for not being able to attract a sexual partner matching his desires. In some people, this also leads to a case of self-loathing, for having sexual needs which a partner doesn't understand, or much worse, needs which are considered taboo and sinful (Homosexuality, Anal Sex, Group Sex, Fetishes, etc.) These complex emotions can wreak  havoc on a person's self-esteem, by creating severe internal conflicts and serious self-doubts. Now socially, sex can either liberate a person, or hold him prisoner. At times, the unfulfilled needs may get repressed and banished to the shadows, only to be played out later, in the form of sexual adventurism and crime. Just one look at the sexual crimes in our society today, and we can clearly understand just how healthy our collective self esteem is! The very society that frowns upon prostitution, is actually responsible for creating it, though everybody would like to pretend otherwise. The crux of the matter is that "sex" and "self esteem" are closely related; and one should not shy away from addressing any issues one might face regarding one's sexuality. Physical love is necessary for the survival of a relationship and one needs to make time and efforts to successfully create one's own sexual space. The positive effects of a good sex life can be seen in an increased work productivity, fewer illnesses and an increase in one's overall efficiency. Some people are haunted by sexual guilt and confusion and when they keep it all locked up, they suffer from unexplained physical pains and feel 'down in the dumps' mentally. Another problem with appreciation from the opposite sex, is the addiction to  external validation. Some people feel utterly worthless until they receive positive feedback about their looks or abilities on a regular basis. This can be downright devastating, as in these cases, there is a great dependence on external factors for one to feel good. While no one denies the "feel good factor" of sexual appreciation, it is up to each one of us, to decide just how much of control one must be giving to external factors, to determine our personal self-esteem. The appreciation may be theirs, but the esteem is entirely of the self and only the self can decide how much of appreciation and sex is enough.
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