Diabetes: Is it dangerous to health?

Nowadays, Diabetes is a common disorder in the world. But many people may never realize, how did they get diabetes and what will happen to them and what will they go through. Diabetes is a metabolic disorder that is identified by high blood sugar levels. Increased blood sugar levels damage the vital organs of the human body causing other potential health ailments.

It is the most common endocrine disorder. It is characterised by hyperglycemia resulting from defects in insulin secretion, insulin action or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart and blood vessels. Several pathogenic processes are involved in the development of diabetes.

The basis of abnormalities in carbohydrates, fat and protein metabolism in diabetes is the deficient action of insulin on the target tissues. Deficient insulin action results from inadequate insulin secretion and/or diminished tissue response to insulin at one or more points in the complex pathways of hormone action.

Classification

1) Primary – a) type 1

b) type 2

2) Secondary – due to other pathology-

1) Gestational diabetes

2) Generic syndrome associated with Diabetes

3) Uncommon immune mediated

4) Genetic defects of insulin secretion

5) Endocrinopathies

6) Drug induced

7) Toxin induced

8) Genetic effects of beta- cells

9) Secondary to infection

Type 1 diabetes, the cause is an absolute deficiency of insulin secretion.

Type 2 diabetes, the cause is a combination of resistance to insulin action and an inadequate compensatory insulin secretory response.

Testing for Diabetes in presumably healthy individuals

Type 1 diabetes is usually an autoimmune disease, characterized by the presence of a variety of autoantibodies to protein episodes on the surface of or within the beta cells of the pancreas. The presence of such markers before the development of the overt disease can identify patients at risk.

It is epidemiological evidence that retinopathy begins to develop at least 7 years before the clinical diagnosis of type 2 diabetes. Because hyperglycemia in type 2 diabetes causes microvascular disease and may cause contribute to macrovascular disease, the undiagnosed disease is a serious condition.

Screening for Diabetes

Urine examination – urine testing for glucose 2 hours after a meal is used in medical practice for detecting cases of diabetes.

Blood sugar testing – Blood sugar testing remains the cornerstone of the diagnosis of diabetes. Mass screening programs have used glucose measurement for fasting, postprandial or random samples. The most reliable is the combination of fasting and 2 hours post radial blood glucose testing.

Target population – screening of high-risk groups seems more appropriate. These groups are-

a) age 40 and above

b) family history of diabetes

c) person with obesity

d) women who have had a baby of more than 4.5 kg

e) women showing excessive weight gain during pregnancy

f) patients with premature atherosclerosis

Symptoms

1) extreme thirst

2) excessive urination

3) weight loss

4) stomach problem

5) foot problem

6) high blood pressure

7) low concentrations

8) sweat smell breath

9) cracked skin

10) loss of consciousness

Prevention

Primary prevention

a) population strategy – the development of prevention programs for Diabetes based on the elimination of environmental risk factors is possible. The measures comprise normal body weight through the adoption of healthy nutritional habits and regular physical exercise. The nutritional habits include an adequate protein intake, a high intake of dietary fibre and avoidance of sweet foods.

b) High-risk strategy – Nutritional education, nutritional rehabilitation and management of obesity are the hallmarks of reducing the incidence and prevalence of diabetes.

Secondary prevention

The aim of the treatment is-a) to maintain the blood glucose levels as close to normal limits as possible

b) to maintain body weight in the ideal range for the desirable BMI level

The treatment is based on

a) diet modification alone

b) dist change along with oral hypoglycemic drugs

c) diet change and insulin

Good control of diabetes prevents complications that would otherwise have taken place

Routine checks are a must for

Blood Pressure, blood sugar, urine for protein and ketones, visual acuity and weight, defective circulation in the feet, loss of sensation of the skin, estimation of Glycated Haemoglobin levels yearly etc.

Tertiary prevention

Diabetes is a major cause of deformity and disability through its communication like blindness, kidney failure, coronary thrombosis, and gangrene of the feet.

Long term complications

1) peripheral atherosclerosis – it may cause intermittent claudication, gangrene, coronary artery disease and stroke.

2) cardiomyopathy – it can cause heart failure.

3) Diabetic retinopathy

4) Renal disease – it is a major cause of death and disability.

5) peripheral sensory neuropathy causes numbness, paraesthesia, severe hypothesis, and pain that may be deep-seated and severe and it often works at night.

Dr S.k.jha

Insomnia

Insomnia is a sleep disorder in which it is difficult to get or maintain sleep. In this problem, people get the inability to obtain an adequate amount of sleep. Sleeping is the most important point in physically and mentally restoring the energy for the tasks ahead.

Most people say that about 6-7 hours of sleep is an adequate amount, however, it differs from person to person depending on their sex, age, and health conditions.

Everyone has encountered some type of insomnia, usually acute insomnia, but when acute becomes diagnosed as a sleep disorder. It is a serious sleeping disorder affecting millions of people per year.

Types

1) Acute insomnia– some causes of acute insomnia are stress, illness, physical or emotional discomfort and when the sleep schedule is interfered. Insomnia makes life very hard for those who are inflicted by it.

2) Chronic insomnia– it can be caused by chronic stress, depression and anxiety.

Causes

1) stress

2) anxiety

3) depression

4) excessive caffeine or alcohol

5) changes in work shift

6) environmental factors like noise, light or temperature

Symptoms

1) difficulty getting sleep at night

2) waking up often during the night

3) not feeling refreshed after waking up

4) feeling irritable during the day

5) poor concentration

Treatment

1) counselling can help in finding out the cause responsible for insomnia and curing the cause

2) lifestyle changes may include decreasing the intake of stimulants like caffeine, nicotine, alcohol etc.

3) behavioural therapy may be used for creating behaviour and an atmosphere conducive to getting good sleep.

4) medication to induce sleep can be used as a temporary measure

Prevention

1) avoiding stress

2) avoiding caffeine

3) avoiding alcohol

4) increasing physical activities

5) relaxing the body and mind before sleeping

6) creating a comfortable sleeping environment

So, get sound sleep and make life easier and more cheerful.

Dr S.k.jha

Migraine: How to deal with this bad headache?

Headache

Now a days , headache is a common problem often chronic or recurring signifying either vascular( migraine) or tension ( muscular contraction) origin in most patients.Migraine is commonly stereotyped in presentation.

Actually, migraine is a painful headache which can be excruciating and may incapacitate in hours or even days.

Migraine is a neurological disease affecting more than 45 million people in the U.S. and around one billion worldwide.

More than 90โ„… of sufferers are unable to work or function normally during their migraine.So, migraine is also called a “bad headache “.

Migraine are pulsating or throbbing in one area of the body.

Classification

1) Classic– the onset is usually in childhood, adolescence or early adulthood. There is a often positive family history and migraine is more common in women. The classical triad is visual scotomata or scintillation , unilateral throbbing headache( occurring either left or right) accompanied by nausea and vomiting.An attract lasting 2-6 hours with relief after sleep.

2) Common– unilateral or bilateral headache with nausea .It is more common in women. The pain becomes generalised and may persists for hours or days.

3) Tension headache – pain runs from the neck to the top of the skull.

4) Cluster– It is characterised by recurrent, unilateral , nocturnal retro orbital scaring pain. It is typically a young male 90โ„… awareness 2to 4 hours after sleep.Onset with severe pain accompanied by unilateral, lacrimation , nasal and conjunctival congestion.Pain lasts 20-60 minutes and subsides quickly but tends to recur at the same time at night or several times each 24 hours over several weeks.

5) Anxiety headache – in this case , pain crosses the headache.

6) Headache Caused by the digestive system- as stomach, intestinal, kidney or gall bladder ailments.

Causes

It may be caused by functional changes in the trigeminal nerve system, a major pain pathway in the nervous system and by imbalance in the brain chemical including serotonin which regulates pain message going through this pathway.

Common migraine triggers include:

1) Hormonal

2) certain foods

3) stress

4) unusual smell

5) bright light

6) intense physical exertion

7) changes in sleeping time

8) certain medications

9) changes of weather, season etc

Symptoms

1) Moderate to severe pain- mainly feel pain on one side of their head, while some experience of pain on both sides

2) headache win a throbbing or pulsating quality

3) pain that worsens with physical activity

4) nausea with or without vomiting

5) sensitivity to light or sounds

6) tingling sensation in one arm or leg

7) thirst

8) drowsiness

9) irritability or depression

Signs

1) Disability and recurring headache

2) pain worsens when one is around light, loud music, noise and/or smell

3) nausea and or vomiting

4) intense throbbing sensation often on one side of head

5) neck pain

6) sinus symptoms( stuffy nose and watery eyes)

Treatment

Principle of treatment of headache

1) Establish a clinical diagnosis

2) after diagnosis, initiate therapy based on the frequency, severity and incapacitation caused by headache.

3) pain-relieving medicine – Take pain-relieving medicine as soon as experience signs or symptoms of a migraine headache. It may help if we rest or sleep in a dark room after taking drugs.

4) Ergots

5) Non-steroid anti-inflammatory drugs(NSAID) – Ibuprofen or aspirin may help relieve mild migraine. Others are a combination of acetaminophen, aspirin and caffeine also may ease moderate migraine.

6) Triptans:- Sumatriptan was the first drug specifically developed to treat migraine. It works faster than any other migraine-specific medication- in as little as 15 minutes and it is effective in most cases.

7) Medication for nausea- Metaclopromide is useful for relieving nausea and vomiting associated with migraine, not the migraine pain itself.

Preventive medication

Preventive medication can reduce the frequency, severity and length of migraines and may increase the effectiveness of pain-relieving medicine used during migraine attacks. Generally, in most cases, preventive medication does not eliminate the headache completely.

1) cardiovascular drugs – Beta-blocker

Which are commonly used to treat high blood pressure and coronary artery disease – can reduce the frequency and severity of migraine. These drugs are considered among the first-line treatment agent.

2) Antidepressant-certain antidepressants are good at helping prevent all types of headaches including migraine. This medication is considered among the first-line treatment agent and may reduce migraine by affecting the level of serotonin and other brain chemicals.

3) Non-steroid anti-inflammatory drugs– Ibuprofen, aspirin etc

Prevention

Whether or not taking preventive medication, we might benefit from lifestyle changes that can help reduce the number and severity of migraine. One or more of these helpful for them.

1) avoid trigger

2) exercise regularly

3) reduce the effect of estrogen

4) quit smoking and drinking habits

So, with this type of prevention, we can surpass the headache and live life happily.

Dr S.k.jha

Esophageal cancer

Esophageal cancer is the world’s 6th leading cause of cancer death across the world.

It is more commonly seen in men than women. The oesophagus is the long, hollow tube connecting the back of the mouth to the stomach. After taking the food that becomes a soft pulp and other liquids pass through the esophagus. Thus, foods and drinks reach the stomach for further digestion and absorption of nutrients.

Generally, Esophageal cancer occurs within the inner lining of the esophagus where the cells grow with no control. When cancerous cells spread to other parts of the body, it is known as metastasis.

Smoking and tobacco use along with alcohol impose a great risk in the development of this cancer.

Types of esophageal cancer

1) Adenocarcinoma

2) Squamous cell carcinoma

Causes

Some factors increase the risk of esophageal cancer.

1) Barrett’s Esophagus

2) Tobacco

3) Alcohol

4) High fat, low protein diet

5) Esophgeal irritation

6) Exposure to nitrosamines

Signs and symptoms

Very few cases are diagnosed at early stages. Most patients present with later stages of this cancer, at which point they complain of difficulty in swallowing solid foods.

1) weight loss

2) loss of appetite

3) cough

4) bone pain

5) hoarseness

6) shortness of breath

Diagnosis

When there is suspicion of this condition, a physical examination followed by Endoscopy to visualise the esophagus. CT scan and MRI is a vital procedures in the workup of patients with esophageal cancer. If an abnormal area is seen in Endoscopy or detected in physical examination, then a biopsy is performed and the tissue sample is sent to the pathologist.

Treatment

Most patients are treated with a combination of surgery, chemotherapy and Radiation therapy.

Even for the most advanced disease, a combination of chemotherapy and radiation therapy may control disease in a high percentage of patients.

The majority of patients are treated with a combination of 5-FU and cisplatinum and radiation.

Radiation therapy

Radiation to the esophagus is a treatment offered over six to eight weeks.

Prognosis

The prognosis depends on the extent of the disease at diagnosis, as well as response to the treatment. Most patients with early-stage cancers can be cured.

Special situations

Patients with advanced esophagal cancer may develop any of the following complications.

1) Pleural effusion

2) Brain metastasis

3) Bone metastasis

4) Spinal cord compression

5) Superior vena cava obstruction

6) pain

7) High calcium levels

Follow up

After completion of treatment in any combination, patients need to remain under surveillance. The frequency of follow up will depend on the condition of the patient and his\her disease. A CT scan of the chest, bone scan and Endoscopy are performed once a year.

Prevention

preventions are the best precautionary measures that reduce the chances of getting esophageal cancer.

1) lifestyle

2) quit smoking

3) drinking moderately

4) diet

5) maintain a healthy weight

6) treat Gerd

Dr S.k.jha

Brain damaging habits: why should we know?

There are a lot of factors that affect brain functioning.

1) No breakfast.. people who don’t take breakfast are going to have lower blood sugar levels. This leads to an insufficient supply of nutrients to the brain causing brain degeneration.

2) Overeating..It causes hardening of the brain arteries leading to a decrease in mental power.

Overeating

3) Smoking.. It causes multiple brain shrinkage and may lead to Alzheimer’s disease.

Smoking

4) High sugar consumption..Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development.

High sugars
The damaging effects of high sugar consumption on skin

5) Air Pollution...As we know the brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

Air Pollution

6) Sleep deprivation..sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.

7) Head covered while sleeping..sleeping with the head covered increases the concentration of carbon dioxide and decrease the concentration of oxygen that may lead to the brain-damaging effect.

8)working hard during illness..working hard or studying with sickness may lead to a decrease in the effectiveness of the brain as well as damage the brain.

9) Lacking in stimulating thoughts…Thinking is the best way to train our brain, lacking brain stimulation thoughts may cause brain shrinkage.

10) Talking rarely..Intellectual conversations will promote the efficiency of the brain.

Now, we should alert and avoid these factors.

Dr S.k.jha

Fearless: The world is in your hands

Fear is only our excuse to not do something. Of course, there is not one human being that does not have fears, but the difference is how people handle these fears.

More often than not our fears dictate our actions and determine what we bear the imprint of fear. What we should do and what we should not do, where we should go and where we should not, how we feel about ourselves and others – all these are tied directly to our fears. We can not do many things for fear of failure. we can not invest money for fear of losing. we can not speak well before an interview board or in a meeting for fear of rejection. This we continue to remain deprived of many things we could easily get had we not be fearful, there is thus a need to overcome fear as our attitude of success is proportionate to our ability to overcome fear.

Learn a lesson from the birds. They feed those who can not fly far… they help and serve each other no thoughts of reward.

All of us have fear in life and it is carried forward by our thought processes. It is not possible to get rid of fear as it is a part of our survival instinct. Hence, we need to be masters over fear and not let fear take over our lives. Fear can be a deep, driving force, the greatest motivator behind success as it helps to elicit extra potential from within to face challenges.

The fears we don’t face become our limits.

The source of fear is always within us irrespective of any external things as it is intensely personal and subjective in nature. Fear is our own creation, our own emotion and could sometimes be totally baseless.

To overcome fear, we must face fear.

Be fearless: have the courage to take risks. Go where there are no guarantees. Get out of your comfort zone even if it means being uncomfortable. The road less travelled is sometimes free with barricades bumps and uncharted terrain. But it is on that road where your character is truly tested.

Therefore, action and getting started is always essential to winning over fear. The journey of a hundred miles begins with the first step. Instead of looking at how far we have to go, we should focus on taking small steps.

When we are filled with a burning desire to do something, fear instantly disappears. So, the result or achievement is never in our hands. It is shaped by circumstances, destiny and other factors.But making effort is in our hands.We must not give up.

So be fearless and win the World.

Dr S.k.jha

Check out your brain

During our hectic Lifestyle, we need to increase our brain function. As with body fitness and emotional fitness, the brain also needs nurturing and nourishment. We often neglect to look after our brains. It might be due to a busy schedule or the demanding nature of our career.

Let’s discuss have how we can keep our minds sharp and healthy.

1) challenging your brain – it can be something as simple as taking a different route to work– it can protect our brain against memory loss later on. Some mental challenging activities can sharpen the brain and are much less likely to get Alzheimer’s disease.

a) start reading a book

b) go to a lecture or attend the seminar

c) listen to music

Researchers say that exercise they all “Neurobic” which challenge our brain to think in new ways.

Being obese in middle age makes twice as likely to have dementia later on. High blood pressure and high cholesterol raise the chances too.

Too much stress can hurt our grey matter, which is a part of the brain. The brain contains cells that store and process information. Because, as we get older, we might not remember things easily as we need to. That is a normal part of ageing. so, in this case, write things down, are the calendar and reminder functions in the phone, even for simple things. Focus on one task at a time.

2) Eating healthy foods – Many nutritious foods are good for the body and mind. A lot of fish, eggs, broccoli and turmeric can improve brain health and keep the memory sharp.

3) Sleep well– A sound sleep is necessary to recover from the stresses of our daily life. Because sound sleep improves memory, mood, energy levels and concentrations.

4) Physical exercise – Some exercises can lower blood cholesterol levels, high blood pressure, boost mood and increase the happy hormone levels in the brain like serotonin and endorphins.

5)Meditation – Even 10 minutes of meditation daily can help in boosting the mood and also reduce stress.

6) Stress management – if anyone becomes mastered how to manage stress then the mood becomes more stable, thoughts become clearer and the relationship improves.

Stress
Listening music

7) Brain training exercise – There are many ways to keep the mind sharp as puzzles, exercise for lifting mood, improving memory and increased concentration etc.

Games
Morning walk

8)Socialising– socialising can also feel good , lifting mood and help in improving memory and keeping the brain sharp.

Party
Fun together

9) Learning new things – learning new things like new skills, a new hobby and a new language can have significant positive effects on the brain.

10) Reading – No one can deny that reading can have a positive effect not just on life but also on the brain and body.

So, keeping the brain fit and healthy should be a top priority. Having a sharp mind will help in boosting our confidence, developing empathy, reducing the risk of dementia, improving focus and alertness.

Now, I think all of you will focus on your brain and body.

Dr S.k.jha

Blood Donation: save a life

Blood is essential to our life. Blood circulates through our body and delivers essential substances like oxygen and nutrients to the body cell. There is a substitute for blood. It can not be made or manufactured in Laboratory. Generous blood donors are the only source of blood for patients in need of a blood transfusion.

Our donation can save three lives and our country needs blood every two seconds.

Donating blood has several benefits. It reduces stress, improves emotional well-being, benefits physical health helps get rid of negative feelings.

Donating blood also lowers the risk of heart disease and prevent heart attacks. This is because it reduces the viscosity of blood. Regular blood donation can also lower the blood pressure.

Researchers note that frequent or regular blood donation significantly lower the mean total cholesterol and low-density lipoprotein. Cholesterol protects against cardiovascular disease.

But remember, before donating blood, some checkup is necessary.

1) Pulse

2) Blood Pressure

3) Body temperature

4) Hemoglobin level except it some tests are also necessary —

a) hepatitis B

b) hepatitis C

c) HIV

d) Syphilis

e) side effects of donating blood

Blood donation is safe for healthy people. There is no risk of contracting the disease. New sterile equipment is used for each donor.

Some people may feel nauseous, lightheaded or dizzy after donating blood. If this happens, lie down and take some juice and rest for a few minutes.

Blood donation is a big boon for society as donated blood is used for saving needy people. It is life-saving for many people.

Give blood, save a life

Every second of every day, people around the world — of all ages and from all walks of life — need a blood transfusion to survive.

Accidental cases, traumatic injuries requiring blood transfusion. Anaemia, cancer, women with complications of pregnancy or childbirth, a blood disorder — there are several reasons, why need to get blood from others.

So, I hope all of you agree with me to help and encourage people to donate blood.

Dr S.k.jha

Hypertension

Blood Pressure is the pressure in the arterial system, which waxes and wanes as the heartbeat. It also varies from best to beat. The major determinants of blood pressure are cardiac output i.e. the amount of blood expelled by the left ventricle in one minute of pumping and peripheral resistance, which is determined by the tone of tension of the vascular musculature and the diameter of the vessels in the periphery.

Hypertension is one of the recognised risk factors which if it remains higher than the desired value poses a grave risk to the individual as regards his cardiac and cardiovascular health.

Hypertension has become one of the most prevalent and serious risk factors in the world. When hypertension and insulin resistance are concomitant, the risk of macrovascular complications rises further.

All diabetic and pre-diabetic patients should be screened for hypertension, patients with hypertension should receive aggressively antihypertensive therapy should be carefully evaluated; and those with IR or hypertension should be carefully screened for other cardiovascular disease risk factors. Hypertension is a widely prevalent condition. Proper identification and treatment of hypertension in patients with IR, both diabetic and pre-diabetic, particularly by primary care providers, is crucially important in achieving risk reduction in the primary care setting.

Classification of Hypertension

1) primary hypertension – Essential hypertension is the most prevalent and is present in more than 90โ„…of the high blood pressure cases.

2) Secondary hypertension – it is due to another disease or disorder. Prominent among these are kidney diseases like chronic glomerulonephritis and pyelonephritis, tumours of the Adrenal glands, congenital narrowing of the Aorta and Toxemias of pregnancy etc altogether this account for about 10% of the hypertension cases.

3) Malignant hypertension – it is a condition where the blood pressure rises sharply and rapidly too causing complications like internal haemorrhage in the brain or the eye or even causing cardiovascular complications. This condition is usually fatal if not detected and managed in time.

Steps of prevention

1) primary prevention

a) population strategy

b) high risk strategy

2) secondary prevention

1) primary prevention – it has been defined as all measures to reduce the incidence of disease in a population by reducing the risk of onset.

Detection of high-risk subjects is the key to this method. Family history and tracking of blood pressure right from childhood may be used to identify high-risk individuals.

2) secondary prevention

The goal of secondary prevention is to detect and control high blood pressure in the affected individuals. Modern antihypertensive drug therapy can adequately control high blood pressure and consequently the excess risk of morbidity and mortality from coronary and cerebrovascular and kidney disease.

Some useful tips for the prevention of blood pressure

1) nutrition

2) dietary changes as reduction of salt intake

3) moderate of low fat intake

4) avoidance of alcohol

5) avoidance of smoking

6) control and monitoring of sodium lipid levels

7) regular physical exercise

8) stress management, time management, self-motivation, yoga etc.

9) health education and modification of mindset towards a positive and responsive health behaviour

Treatment

In essential hypertension, we can not detect and treat the cause and therefore we try to scale down the blood pressure to acceptable levels. The aim of treatment should be to maintain a blood pressure of below 140/90 mmHg. According to the modern concept, patients having diastolic pressure of 90- 105 mmHg should also be treated. Recently it has been shown that these mild hypertension cases whose blood pressure is brought down from 100-105 diastolic levels to about 80-90 mmHg benefit a great deal and the incidence of stroke and CAD drops drastically in them. This is a major reason for identifying and treatment of these cases.

Patient compliance

1) patient compliance is the matching of the health behaviour of the patient to the prescription of the doctor.

2) the treatment of blood pressure when warranted is generally lifelong and this present problem of patient compliance.

3) the following has been the experience of so many years of operational research regarding hypertension.

4)control of hypertension in the population is feasible.

5) control of hypertension leads to the reduction of complications of high blood pressure.

So, I hope all of you will take care of your health.

Dr S.k.jha

Lifestyle and health: How is your life?

Workplace

Everyone wants to lead a happy comfortable and luxurious life. For this, they work hard and neglect their health. Our lifestyle not only influences our health and well-being but also the personality of our life. Our lifestyle affects someway society also.

Sometimes excessive noise, too much furniture equipment, poor lightening arrangement and ventilation. Too much heat/ cold, fast food habits diet and depression look and overwork may adversely affect our workplace and family life.

Furniture can be rearranged, noise can be controlled, sufficient light can be set and the place can be cheered up with pictures, flowers and plants and keeping it nicely cleaned. Overwork, fast food and other stressed work can be controlled.

Similarly, our family life also plays a key role in keeping and maintaining good health and well-being. Keeping a good relationship with children and other members of the family, feeling of loving and getting love, spending time with the family can solve many problems in daily life and reduce the stress in life.

Except it, proper communication is the key to maintaining balance in life. Identification of the problem followed by taking initiative and discussing the problems with family members and other play a vital role.

Science and Technology have made people leisure which needs an effort of planning for proper use. Mostly, we are not aware of it and as such we don’t plan for it and fail to enjoy it fully.

Life is like a river that goes on flowing.

Health and balanced lives are based on our thinking. On goal points and so we should start to improve our health and family life as we as do for society.

Every part of our life relies on us having good health.

Everybody’s self-esteem and outlook influence our life. so, we need to develop a positive outlook and attitude towards leisure to develop more benefits from physical activities so that we may have a healthy balanced lifestyle.

Take care of your body. It is the only place you have to live in.

So, my dear friends judge yourself and have a healthy life.

Dr S.k.jha