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"Why are you staring off into space??" He loved to pull on my hair. "You're so ugly when you're doing nothing. But you're also not pretty when you smile." In other words, I'm really ugly.

"You're the one who's ugly!" I pull back my hair. "If you think I'm so ugly, why do you visit me??"

"Can't help it. My home is right next to your home." He argued.

"Then I'll move!" The next day, I drew a line in the ground using some white chalk. A line that I forbid him to cross.

That year, we were both in the 5th grade. We couldn't stand each other and hoped the other would move away. But 5 years passed, and neither of us moved. Not only that, we got into the same high school and into the same class.

"You're that infamous couple." All the students and teachers in the school would say whenever they saw us.

"We're not!" I always tried to explain. "We're only neighbors." At that time, I hated my parents for making us live next to him.
"My standard is not that low." He would say. "Who wants her to be a girlfriend?? It's not like I don't have eyes."

"Yes, I know your eyes are on top of your head." I really disliked him. "Better than having eyes on the bottom of my head like you." He implied that I couldn't judge guys. At that time, I had a crush on a senior.

I didn't think that his sarcasm had a hidden meaning. After a while, I found out that the senior student had lots of girlfriends. When I cried about it, he silently passed me a handkerchief and awkwardly held me in his arms.

"I told you he wasn't any good." He roughly comforted me. I cried in his arms the whole night, and began to see him in a different way. Things began to change between us. We still fought all the time, but he started to look at me differently. And I blushed and my heart beat faster when he was near. We both knew: we fell in love with each other.

Even with this knowledge, neither of us said anything. Even though we would
not be able to resist and kissed each other constantly. Even though we cared about each other's every moves. Both of us refused to admit our love.

Time flew by quickly, and it was time to face separation. I chose to study medicine, and he chose physics. Yet we still couldn't separate from each other. Our parents worried that we didn't know anyone in Taipei, so they forced us to live in the same apartment building. Once again, we became neighbors. We still fought, but sometimes we fought into the bedroom. Alright, we became lovers, but we still wouldn't say we loved each other. We didn't even spend Valentine's Day together until he saw me share dinner with a man one Valentine's Day. That night, he waited for me in front of my door and said that he would take me out to dinner on Valentine's Day from then on. I have to say that he was very arrogant. But I nodded and accepted his request. Since then, we spent every Valentine's Day together. After graduation, I became an intern. He started a small computer company with some friends and became a programmer. We were busy with our own lives and had no time for a relationship. Three years later, I became a doctor, and his business began to boom. We separately moved to bigger
apartments and stopped being neighbors. On the surface, we left each other. In reality, we were still together. We spent every Valentine's Day together but each year became more dreary than the next because he never told me he loved me even with all my hints.

Facing the empty in-box, I suddenly grew very angry. He wouldn't say it and wouldn't send me a card. What did he mean? Who did he think I was? I called his cell phone.

"Hello." He picked up the phone.

"I didn't receive the card." I immediately showed my displeasure.

"You didn't receive it?" He seemed really busy. "But I sent it."

He was really busy but I didn't care. "I didn't receive it. Send it again."

"Okay, I'll send you 100 times. Is that good enough??" He said with impatience. His tone further infuriated me. Is that how lovers speak to each other?

"Don't bother sending it to me. And you don't have to pick me up tonight.

I'll eat dinner by myself."

"Don't be childish, ok? I'm really busy."

"I AM childish!" I hung up the phone and tears rolled down my cheeks.

Childish?? Why didn't he consider the situation? We've gone out for so many years and spent countless Valentine's Day together. I never received any flowers nor cards from him. Now, I just want a little e-card. Is that too much to ask for??

I unplugged the phone from the wall and turned off my cell phone. I didn't want to hear his explanations. After I returned to the hospital, I instructed the receptionist not to forward me any phone calls. I wanted to concentrate on work.

Because there were so many emergencies today, I was sweating 1 hour later and forgot about our argument.

"Dr. Shu, please take a look at that patient."

As I was collecting my equipment, the shrill sound of an ambulance sounded outside the ER. When I stepped out the door, the emergency medics hurriedly wheeled in a gurney.

"What happened to him?" I asked the 1st medic. Everyone else were trying to help put the patient on the gurney. He was covered with blood.

"Car accident." The medic replied. "Very serious. He may die."

I nodded and ran to the operating room with them. When I arrived, the nurses told me that the man had already stopped breathing and also his heartbeat also stopped

"Prepare for shock." I calmly instructed the nurses. Saving people is our duty. We can't lose our calm.

But when I saw who laid on the operating table, I lost my calm. That person was my boyfriend!

It's a cold February night. People are bustling through the streets, either pulling up their coat collars or wrapping scarves around their necks, trying to stay warm.

It's so cold today.I'm standing at my window, looking at the people moving like little dots. Standing in a heated room, I'm beginning to pity those people. Why don't they go home? Do they plan on wandering until morning?

"Almost time to go home! My boyfriend must be going crazy." One of the nurses breathe a sign of relief. "Still needs to work overtime on Valentine's Day. It's so unfair!"

"You are fortunate." Another nurse says. "Some people don't have anyone waiting for them."

"You mean Dr. Shu?"
Like Sherlock Holmes, my ears perk up when I hear my name.
"Do you remember how she lost control on this day last year?"
"Of course I do." A nurse shudders. "I've never seen Dr. Shu like that. Crying and yelling, like she was crazy."
They are talking about how I was last year. They are correct. I was out of control, like they said.
"You can't blame Dr. Shu. If my boyfriend died in front of my eyes, I would probably go crazy as well."
"Keep it down. She hasn't left work yet. She might hear you."
The two nurses are too late. I heard the entire conversation through the canvas wall.
"Dr. Shu, what are you doing standing here?"

Just as I was deciding whether or not to reveal myself, another nurse exposed me. I awkwardly step out. The 2 nurses who discussed me start to blush. Their faces became redder than the bow on Valentine's Day chocolates.

"I'm waiting to go home." I pretend that I didn't hear anything.
"Dr. Shu, you must have gotten too involved in your work. It's already past time to go home. See you tomorrow. Happy Valentine's Day!" She waves goodbye.

"Happy Valentine's Day." I wave back and watch the 2 nurses hurry away.

That's fine. I was ready to go home anyway. Even though no lover is waiting
for me, at least there's a lazy cat waiting for me to feed.

After I come home, the first thing I do is feed the cat. I forgot when I first had the cat. Probably since last year's Valentine's Day. At that time, I was like an abandoned cat, with eyes filled with despair. Cats don't cry, I do. That's the only difference.

"Better drink all the milk or I'll skin you." I threatened the cat. Her name is Christine, my least favorite English name. I don't know why I named the cat Christine. Christine meowed once to let me know she heard me, but her eyes are complaining about my severity. Her eyes remind me of someone I used to know, standing in front of me with eyes of rebellions.

An year ago today, I had lunch with my boyfriend and took the opportunity to complain to him.

"Today is Valentine's Day. Why didn't you give me any flowers?"

He raised his eyebrow. "Why should I give you flowers? You are not my anyone."

"Then... you should at least give me a card!" I pouted my lips, hurt by his tone.

"I know, I know. After lunch, I'll send you an e-card."

E-card. That sounds so impersonal, but that's the way he is. "You have to e-mail it to me. I'll be waiting." I excitedly smiled and planned to sneak home after lunch to check e-mail. Even though he wouldn't use any romantic words, I still looked forward to the card.

"I can't stand you women. Why do you make such a big deal out of Valentine's Day??" He grumbled while eating his food. His comment induced me to fight with him again.

"You are not romantic at all!! Don't you watch any Japanese drama?"

"Japanese drama? I only watch Discovery Channel."

"Your life is so boring." I made a face at him. "One recent drama was really good. You should have watched it."

"What's that drama called?" He didn't believe in the love portrayed in TV and movies. He always thought they were lies.

"It's called 'Story of A Century'." I gladly answered.

"What kind of trashy plot did it have?"

"What do you mean trash?? Show some respect!" I was so angry. "That drama was very touching, and the theme song was beautiful as well. It's called 'Only Love', performed by Nana Mouskouri." I wonder if he knew who Nana was.

"Nana, I know her. A Greek singer with really expensive albums."

"Her voice is worth it." Even though I secretly agreed with him, I couldn't bring myself to admit it.

"Whatever." He glanced at his watch. "I'll give you 5 minutes to tell me the plot. After that, I'm leaving."

I tried hard to explain 6 hours worth of story in just 5 minutes. The drama portrayed the love stories of 3 generations of women spanning 100 years, from 1901 to 2000. Each generation was portrayed by the same actress. The story was tear-jerking.

"What's so touching about it?" He asked, after listening to the story.

"Don't you think each generation's story is wonderful? If I have such great screen writing ability, I wouldn't be a doctor anymore. I would become a screenwriter."

"If you become a screenwriter, I bet no one would watch the show. The TV station can go out of business." He quickly interjected.

"I'm going back to work. Hurry and send me the card!" I was so mad that I went home immediately, not even finishing my coffee.

As soon as I walked in my door, I turned on my computer and go online.

Staring at the empty in-box, I began to reminisce about how we met. Maybe no one will believe me, but my boyfriend and I were actually neighbors. Our homes were only 1 wall away. Ever since we were kids, we liked to fight with each other all day long. I still remember when I moved to the country that year. Used to the city life, I couldn't get used to the simple life in the country. After school, I would just go home and do nothing. Whenever that happened, he would always come over to tease me.

Evidence is mounting that some tests intended to diagnose cancer also carry risks that can cause cancer. Guest columnist Eric B. Larson provides a perspective on these findings and the importance of independent groups that consider the risks and benefits of such approaches.

By Eric B. Larson

Special to The Times

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In the Indian society people have some major expectations from amarriage. The married couple is expected to have sexual intercourse(marriage being the only legalised outlet for sexual release), begetchildren and raise a family as soon as possible.

We all take for granted that every married couple will be able tohave sexual intercourse without any difficulty. We think that there isno need to educate the bridal couple and that they will manage to havesex automatically if they are sent into the bedroom on the nuptialnight. But in reality, it is not easy. While it is true that the sexualurge or drive is instinctual and spontaneous, the sexual behaviour(including the sexual act) is not instinctual but learned. Couples mayexperience difficulty in performing the sexual act on the first day ornight after the marriage. Some face problems later in life, even aftera period of non-problematic sex life.

Sexual problems, irrespective of the causative factors, frequentlycause serious psychological problems such as hostility between themarital partners and even complete breakdown of the marriage itself.

The Masters-Johnson Study

Till recently the management of sexual problems was very difficultand unsatisfactory. This was mainly due to the fact that the causativefactors were not known to healthcare professionals. Hence qualifiedmedical doctors were reluctant to prescribe remedies to these problems.This resulted in the public seeking help from unqualified people(quacks).

Thanks to Drs. Masters and Johnson, these lacunae have, to a greatextent, been overcome. Masters and Johnson’s pioneering study clearlyexplained the sexual physiology (normal functioning) of the humansexual act, which was studied in a laboratory setting. Their studieswere objective about the human sexual response. This researchstimulated many health care professionals to take up the management ofsexual problems on a full time basis. Thus sexual medicine emerged as anew discipline in modern medicine.

Common Sexual Problems

In Men

Lack of or reduced sexual drive or interest.Impotence or erection dysfunction- problem in obtaining or maintaining a penile erection.Problems in ejaculation - premature ejaculations, inability to ejaculate during intercourse, retarded ejaculationLack of pleasure in intercourse.Pain during or after intercourse or both. In Women

Lack of or reduced sexual interest.Inability to get aroused (Dry Vagina).Orgasmic dysfunction- inability to obtain an orgasm (climax) during intercourse.Vaginismus- unconscious or subconscious tightening of the vaginal muscles, preventing intercourse.Pain during or after intercourse or both. Problems that both sexes may face

Sexual orientation problems like homosexuality, lesbianism, bisexuality and transexualism.Body image concerns - under developed breasts, genitals, secondary sex characters etc.Faulty sex techniques leading to infertility.Paraphilias - abnormal sexual behaviour etcIt is a well-established fact that sexual functioning does notdepend only on physical factors. The psyche or mind plays an equal rolein sexual functioning. Moreover, sexual behaviour is not purelyinstinctual, but mostly learnt. Hence, it is very important tounderstand that, besides body organs, several other, (includingsocio-cultural) factors are involved during the sexual act.

Diagnostic Tools

Sexual medicine adopts a comprehensive evaluatory procedure indiagnosing sexual problems. The consultant obtains a detailed sexualhistory (preferably from partners, in case of couples who are married)and performs a thorough physical examination. After this, the necessarylaboratory investigations are performed depending upon the contingency.

State-of-the-art diagnostic tools are available nowadays to identify the causative factors. Some of these are:

Biochemical TestsHormone AssaysPenile Haemodynamic StudiesNerve Conduction StudiesUltrasound ScansDoppler StudiesRigiscanPsychological Assessment TestsOnce the causative factor is identified, the appropriate treatment strategy is offered to the patients.

Treatment Strategies

The treatment strategies include:

Sex TherapySex CounsellingMedication (treatment with medicines).Surgical(Corrective) Therapy Hormone Replacement Therapy Vacuum Suction DevicesPenile (Intracavernous) InjectionsPenile Implant SurgeryBehaviour Modification TherapySupportive PsychotherapyMarital Therapy

Till recently it was believed that children had no sexual feelingsuntil puberty. This mistaken notion had led people to assume thatchildren were non-sexual entities and prevented the parents and eldersfrom educating children properly in matters of sex. In fact, thefoundations of adult sexuality are largely built during earlychildhood. Children become interested in the intimacy they observebetween their parents. They want to know what happens in the parents’bedroom. However, direct observation of parental sex upsets children.They are unable to understand what they see and often conclude that sexis a form of a violent struggle.

Children’s attitudes to sex are influenced by the environment athome. Parental disapproval is absorbed into the child’s personality andbecomes an internal watchdog, a type of conscience.

Stages of Childhood Sexual Development

According to Freud, childhood sexuality develops in the following stages:

Oral Stage: Persists through the first year of life. Pleasure from sucking and eating is centred on the mouth. Hence the name oral stage.

Anal Stage:: Begins around two years of age. Toilet trainingbecomes an important challenge for the child. The child derivespleasure from retaining the expelling faeces. Here, the pleasure islocated near the anus. Hence the name anal stage.

Phallic Stage: Begins around the start of the third year.Interest centres on the penis. Boys fear castration (cutting off of thepenis) as a sexual punishment. Girls envy penises and worry that theyare castrated males.

Oedipal Stage: Develops when the attachment to the parent ofthe opposite sex becomes deeply possessive and passionate. The childeven fantasises about killing the other parent. In the girls, it isreferred to as electra complex.

Latent Stage: Usually sets in after the age of five, whensexual interest becomes repressed until puberty. In this stage, boysand girls form their own (gender) groups and do not mix with theopposite sex.

Genital Stage: Mature adult sexuality. Its healthy aim is intercourse with a life partner.

General Roles

General role behaviour is to a great extent established duringchildhood. Boys and girls tend to follow the behaviour patternsdemonstrated by their parents. They learn from them such things as howto relate to members of the opposite sex and what types of work andemotions are appropriate to members of each sex. In conservative Asiansocieties, the roles for each sex are clearly determined. Men are themain income earners and decision-makers. So, boys are encouraged to beoutgoing, self-reliant and dominating. Women are expected to keephouse, care for children and be submissive. Even when women in manystrata of society have become wage earners, girls are given a shelteredchildhood, and expected to learn domestic chores and be submissive.

Sexual Medicine is a discipline of medicine that deals with sexualproblems - physical as well as psychological. It is now establishedthat sexual health is an integral part of general health.

Sexual medicine has four dimensions: the promotional dimension(increases awareness and helps individuals have a healthy andfulfilling sex life); the preventive dimension (counselling); thecurative dimension (clinical treatment of specific sexual disorders)and the rehabilitative dimension (helps patients regain sexual health).

Puberty: Onset of Sexual Awareness      What happens during sexual intercourse      Childhood and Sexual Evolution      Sex and the Adolescent      Sex and the Adult      Sex and the Elderly      Menopause      Sexual Problems      Sexual Therapy      Sexual Deviations      Homosexuality      Contraception and Family Planning      Infertility      Gender Determination      Gender Identity      Sexually Transmitted Diseases      Herpes      Masturbation      Nocturnal Emissions      Circumcision: Facts and Myths      Hymen and Virginity      Pornography      Marital Therapy      Sexual Myths     

Source

Dr. D. Narayana Reddy F.I.C., F.A.C.S., A.A.S.E.C.T., PhD

Sexual intercourse is a biological reproductive device. Sensualpleasure motivates humans to have sex. Certain changes occur in bothgenders before, during and after sexual intercourse. These includechanges in the genital organs and other parts of the body.

In both males and females the sexual response cycle is divided into four phases:

Excitement phasePlateau phaseOrgasmic phase and Resolution phaseThe main purpose of these phases of the sexual response cycle is toensure effective intercourse leading to the fertilisation of the egg(ovum).

1. Excitement Phase

In Males:

When aroused, blood is pumped into three cylinder-shaped bundles ofspongy tissues in the penis. This makes the penis stiff and rigid,thereby helping it to standout of the body. The scrotal sac is raisedslightly due to its muscular contraction, thereby drawing the testesupwards.

In Females:

The walls of the vagina start secreting lubricating vaginal fluid.The walls also turn purple. The inner two-thirds of the vaginalengthens. The uterus (womb) rises in the pelvis. The labia majora(outer vaginal lips) open. The labia minora (inner vaginal lips)thicken. The clitoris lengthens and swells.

2. Plateau Phase:

In Males:

The penis grows slightly larger. The head of the penis (glans penis)develops a reddish purple colour and becomes shiny. A few drops ofsticky watery fluid (mucus) appear from the opening at the tip(meatus). The testes are drawn still higher.

In Females:

The outer one-third of vagina swells as more blood flows into it.The swollen outer vagina and labia minora (inner lips) form a longelevation known as orgasmic platform. The clitoris hides behind itshood.

3. Orgasmic Phase

In Males:

A series of involuntary rhythmic contractions in the testes and thepenis force out semen from the penis. It is these muscular contractionsthat give the sexual pleasure. This process of expulsion of semen fromthe penis is known as ejaculation. These forceful ejaculations cansquirt semen up to a distance of two feet.

In Females:

The orgasmic platform contracts rhythmically 3-15 times at0.8-second intervals. These rhythmic contractions of the orgasmicplatform along with structures in the pelvis give sexual pleasure.

4. Resolution Phase

In Males:

This phase is divided into two stages. In the first stage, the penisquickly shrinks to half its fully erect size. In the second stage, thepenis returns to its normal flaccid size from the semi-erect or rigidstage. The second stage takes a little longer than the first stage. Asthe penis shrinks, the scrotum becomes loose and the testes comedownward.

In Females:

Ten seconds after the vaginal contractions, the clitoris returns toits normal position. The entire vagina returns to its normal colour,size and position in about 15 minutes. Uterus regains its normalposition in about 20 minutes. The inner and outer lips of the vaginarevert to their original colour and size.

Duration of the Phases

The excitement phase may last minutes or hours depending on thetechniques used and the lack of distraction. The plateau phase is briefand intense. orgasmic phase is the shortest of all, which lasts formerely a few seconds. Many of the changes in the resolution phase areover in ten minutes. Renewed stimulation will arouse most women justafter intercourse, but most men have a refractory period immediatelyafter sexual intercourse when re-stimulation and achieving an erectionis impossible.

Changes in Other Parts of the Body

In both genders, apart from the changes in genitals, certainsignificant changes in other parts of the body occur. In about 75% ofwomen and about 25% of men, reddish spots known as sex flushappear on the abdomen, throat and breasts. They disappear five minutesafter the orgasm. Muscle tension occurs, causing nipple erection, tensethighs, arched back, flared nostrils etc. This tension fades withinfive minutes of the orgasm.

A thin film of perspiration may cover the entire body after orgasm.Heart rate, breathing rate and blood pressure go up in both gendersduring excitement, plateau and orgasmic phases. They return to normalsoon after orgasm.

Puberty is, technically, the time when secondary sexualcharacteristics appear. On an average, a child enters a period ofaccelerated growth just prior to pubescence. With puberty beginsadolescence, the transitional phase between childhood and adulthood.

Physical Changes

In Girls:

Spurt in height occurs around 11½ years. First menstrual periodoccurs between 11 and 14 years. The body fills out, breasts enlarge andhair grows under the armpits and on the pubis. A girl is nowphysiologically capable of conceiving a child.

In Boys:

Change of voice, increase in size of genitalia and growth of hair inthe groin occur. These changes will be completed by 15 years for boyson an average. Physiologically, a boy is now capable of sexualintercourse and impregnating a girl.

In both sexes, the process of puberty begins when the hypothalamus,a part of the lower brain, stimulates the nearby pituitary gland by achemical factor. The pituitary then starts producing two hormonesinvolved in the sexual development of both males and females. Thesehormones, known as Follicle Stimulating Hormone (FSH) and LuteinisingHormone (LH) act on the male and female sex organs. The male sex organsproduce testoterone and the female sex organs produce oestrogen andprogesterone enabling the development of the reproductive system.

Psychological Changes

Puberty is often considered to be a stormy period because the childsuddenly develops a sex drive and its horizons broaden. This generatesanxiety and may provoke defensive behaviour, which may, in extremecases, lead to delinquency. The more common reaction is conflict ordefiance towards adult authority as with parents and teachers.

Day dreaming, as a means through which gratification of frustratedneeds is achieved, increases during this period of life. It may bedifficult to accept, but this is normal behaviour. It is imperativethat there is some understanding on both sides. Teenagers must try toappreciate the difficulty which adults experience in understandingadolescents.

Because of the rapid changes inside the body and consequentemotional reaction, the adolescent has a natural inclination towithdraw from all problems and therefore, from others. This is the timewhen one's innate urge to seek human company can help greatly. Theadolescent should make every effort to take part in the socialactivities of school or college, such as dramatics, sports, debates,social service, scouts etc.

During this period, there is a strong natural desire to read lovestories and books that narrate sexual acts explicitly. Though there isno harm in reading such literature, to do so exclusively tends to makeescapism attractive. It reduces the determination to face the dailyproblems and limits the mental horizons.

Hair

It is yourcrowning glory. Nuns were required to cover it. Orthodox Hindu widowswere required to shave it. Perhaps because a good head of hair can addthat much to sex appeal. If you are blessed with hair, it is easyenough to maintain it. Keep it at a length and style at which you canmaintain it.

Wash your hair at least once a week using soap or mild shampoo.Avoid shampoos with borax or alkalis. Rinse well. This is moreimportant than working up a head load of lather.

Dry your hair after a wash.

Brush your hair three to four times a day with a soft bristledbrush or a wide toothed comb. Wash your brush and comb every time youwash your hair.

Oil the scalp, once a week, preferably an hour before hair wash.

There are no completely safe or permanent hair dyes as of now.Apart from causing scalp allergies, dyes can also cause allergic coldsand throat conditions. Perform a sensitivity test every time you usehair colour.

Skin

In VictorianEngland, modest young women were taught to wash themselves withoutgetting quite naked. In Hindu culture baths were, apart from dailyablutions, mandatory as part of observing pollution for various reasonsand occasions. But ritual bathing, or a dip, is quite different fromthe daily bath personal hygiene demands.

Soap and water are essential for keeping the skin clean. A good bathonce or twice a day is recommended, especially in tropical countrieslike India. Those who are involved in active sports or work out to asweat would do well to take a bath after the activity.

A mild soap will do the job adequately. Germicidal orantiseptic soaps are not essential for the daily bath. You can use abath sponge for scrubbing. Back brushes and heel scrubbers areavailable. But do not use abrasive material.

The genitals and the anus need to be cleaned well because ofthe natural secretions of these areas, in unhygienic conditions, cancause irritation and infection.

Wash off well after soaping. Drying with a clean towel is important. Avoid sharing soaps and towels.

Change into clean underwear after bath.

Around middle age the skin tends to go dry a bit. A moisturisingoil or cream can be used. It is better to use this at night, because ifyou go out in the sun or commute on dusty roads when the skin is wet,dust sticks to it and oils may also give you a tan.

Teeth

Have you heardof the sixty-second battery operated wonder brush? It has been analysedthat it takes only that long to give your teeth a good brush. You haveto hold the brush to your teeth and say cheese (and then perhapsS-A-U-C-E for the brush to get a good scrub inside!).

Well, whether it is a neem twig or battery brush, you cannot give brushing a miss.

Brush teeth twice a day and rinse well after every meal.Brushing before going to bed is important. (Especially recommended forpeople with a sweet tooth). For normal teeth this is adequate.

While brushing, pay attention to the fact that you are gettingrid of the food particles stuck in between the teeth and in thecrevices of the flatter teeth at the back, the molars and pre molars.Brush down on the upper teeth and brush up on the lower teeth. Use acircular motion. Pay attention to the tongue and the inner surface ofteeth as well.

The brush should have resilient bristles. It should be rinsedwell and left to dry after use. There are no perfect toothpastes orpowders. Use one without harsh abrasives or strong antiseptics.

Hands

The worldaround us swarms with micro-organisms. Some bacteria are found on ourbodies. In countries where food is eaten and prepared with bare handsextra attention has to be paid to the cleanliness of hands. Besides, apermanent layer of dust or grime reduces the sensitivity of the hands.

Wash hands thoroughly with soap and water before and after everymeal and after visiting the toilet. Soaping and rinsing should coverthe areas between fingers, nails and back of the hand. Hands should bedried with a clean towel after wash. The towel at the wash stand has tobe washed and changed everyday.

While cooking, especially when packing lunches, you can preventfood from spoilage and minimise contamination by keeping your handsclean. While handling food avoid scratching, or touching the ears,nose, mouth or other body orifices. If you need to use a handkerchiefor tissue, wash your hands after that. Keep your nails short.

Nail Polish users should see that it does not chip off into the food.

NailsFor horny, largely vestigial growths at the tips of your fingers,they are pretty important. For reasons of hygiene and for the multimillion dollar cosmetic industry.

It takes five months for nails to replace themselves. Grownails only if you can keep them clean. (Sridhar Chillal has clawedhimself into the Guinness Book of World records with nails on eachfinger of his left hand measuring about 3½ feet. With nails like thatthe hand must be pretty useless). Short nails make less trouble. Clipnails short, along their shape. Don't cut them so close that it pinchesthe skin.

A healthy body ensures healthy nails. Brittle or discoloured nails show up deficiencies or disease conditions.

Do not keep your nails painted continuously. It causes thekeratin, of which nails are made, to split. Pamper your hands and nailsonce every three weeks with a manicure. This requires soaking yourhands in warm water for ten minutes, massaging of hands, thoroughcleaning and shaping of nails. Choose your manicure kit with care. Insome kits, the instruments are crudely made and they will do more harmthan good.

FeetGive your feet a good scrub with a sponge, pumice stone or footscrubber that is not made of very abrasive material when having a bath.Dry after bath between toes. Keep toenails clipped.

In many Indian households it is mandatory to wash feet as youenter the house. This is fine, but make sure that your skin does notbecome dry due to washing too often.

Those who use shoes constantly need to slip them off now andthen. This airs the socks a bit and makes them less smelly. Wear cottonsocks. Wear a clean pair everyday. Powder your feet before wearingsocks. Many people have sweaty feet, and socks and shoes can get quitesmelly. If possible do not wear the same pair of shoes every day. Keepatleast one more pair and use it alternatively. Go for a pedicure oncein three weeks.

Give importance to wearing comfort in the choice of footwear.For those who go barefoot indoors, door mats must be cleaned or changedfrequently. Extra foot care is required for diabetics.

Menstrual HygieneNo woman feels completely comfortable when she has her period. If itis not pre menstrual tension or stomach cramps it is the problem ofdealing with the menstrual flow.

Technology offers sanitary pads, tampons or menstrual cups orcaps to deal with the flow. The user has to decide what suits her best.Absorbent pads may be noticeable in form fitting clothes. They causesome soreness on the inner thighs.

Some women prefer tampon to external pads. A plug of absorbentcotton or gauze is inserted inside. But these should not be leftunchanged beyond six hours. Some brands state that tampons leftunchanged for more than 12-18 hours increases the possibility of toxicshock.

It is not clear what causes toxic shock. But there seems to be a link between tampons and Toxic Shock Syndrome(TSS). Approximately 1% of all menstruating women carry the bacteria inquestion (Staphylococcus aureus) in their vagina. Absorbent tamponsprovide the medium for them to grow and spread infection.

TSS cases were first reported in 1978. It is marked by highfever, severe vomiting and diarrhoea. The cases can be mild to fatal.

The menstrual cup (or cap), is inserted within and collects the flow and can be emptied, cleaned and re used.

Whatever the preference, washing is important. There need be notaboo about bath on these days. Some people have the problem of odourduring menstruation. Cleanliness and change of pad/tampon as often asis necessary reduces this problem. It is not advisable to use perfumedpads or tampons. In fact, using powder in the genital area is notrecommended.