What is the treatment for Osteoarthritis

Firstly any body who is overweight and has developed Osteoarthritis should as a first thing try and lose weight. Secondly take pain killers , calcium and other vitamin supplements as advised by Spine Specialist. Further have a balanced and Calcium rich diet.
Normally these measures are enough to put people on recovery mode.But in some cases these measures fail to give relief and joint surgeries are advised.These surgeries have very good success rate and their nothing to be scared of.

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Why are obese at high risk of developing Arthritis

When we talk about obesity, it is a term which is entirely different from being overweight. Obesity is measured in terms BMI which is calculated by square of Height and Weight. When a person’s BMI is more than 30, he/she is considered as obese.

As a person gains weight, an extra amount of pressure falls on his joints. This added pressure leads to weakening of the bones and the surrounding cartilage. That’s not all; it also leads to strain on ligaments and muscles around the affected joints, which in the long run leads to Osteoarthritis. Remember, for each 4-5 kg of increased weight, a minimum of 14 kg of extra pressure is put on joints.

Losing weight is the only way out in order to protect from the dangers of developing Osteoarthritis caused by obesity. Exercising and managing diet is the best way to lose weight. But if you are already suffering from arthritis, the practice of exercising becomes difficult. Due to pain in the joints, one looses the drive to exercise and lose weight. With proper guidance from a trained physiotherapist, an arthritis patient can manage to exercise and lose those extra kilos, without worsening the existing problem.

With reduced weight, the pressure on the joints too will decrease which can help in preventing Osteoarthritis. In addition, muscle strengthening exercises can help strengthening the core muscles,which can further delay the occurrence of Osteoarthritis. But if you are already experiencing the symptoms, then also, these measures can help in coping up with the pain.

Apart from weight reduction and exercising, another important thing that a patient suffering from Osteoarthritis should keep in mind is having medicines prescribed by the doctor diligently. Your doctor may suggest you some pain killers along with calcium and other vitamin supplements in order to maintain the bone strength. Have a healthy and balanced diet. Include milk and milk products, meat, fish etc. in your diet as they are very important for the health of your bones.

In some extreme cases of Osteoarthritis, doctors suggest a joint surgery or joint replacement surgery. This is done as a last measure when all other treatment measures have failed to give relief to the patient. But even at this stage there is nothing to fear as with the advent of  advance technology, even surgeries have become extremely safe offering high rate of recovery.

But one line,I always say “Prevention is better than cure”. Osteoarthritis is completely preventable,if you keep your weight in check.

Mind Your Weight and Keep Osteoarthritis Away!

Obesity is generally on a rise among Indians and therefore becoming a health concern. We all know obese person is always at an increasing risk of developing various other health problems. Among all these problems which is always linked to obesity is Osteoarthritis.
Osteoarthritis is a joint disorder in which the cartilage or cushion between the joints becomes worn out or damaged, which leads to pain. The primary symptoms to identify Osteoarthritis are pain and stiffness in joints especially after waking up in the morning and after resting, weakness in joint muscles, mildly swollen joints, reduced joint movements and cracking sounds from the joints. If any of these symptoms are observed by you, do get yourself examined. Clinical diagnosis of Osteoarthritis involves X-ray and MRI of the affected joint.

Though, the causes behind the occurrence of this ailment may vary from aging to joint injury but in some cases, even genetic factors are involved. But, obesity is undeniably a prominent factor causing Osteoarthritis.
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Tips for healthy back

 Working for long hours in office.Pay attention to sitting posture.Remember your posture decides your back health.Here are few tips which can help you in keeping your back healthy
1 Exercise every day 
2. While bending bend you legs and not  your back.
3  Maintain a good posture – chair on which you work should be properly aligned with your seat
6.Take short breaks
7.Avoid junk food,smoking and drinking.
8.Keep your weight in check.Obesity is the mother of all health problems.
9.Learn to relax

How to identify Primary Symptoms of Spinal Disc Problem

We have number of times discussed Spinal disc problem on this platform. But how is that we at lay men's level, can catch symptoms of a Spinal problem. Its symptoms are pain, numbness, tingling pain starting from the back and going through the back leg and reaching the foot. Best diagnosis is done through MRI. Pain initially may be so severe that it may make even walking a difficult exercise for a short time. Initially a bit of rest is fine but beyond that one must start walking as that aids healing in a big way.

Knowledge of handling spinal injuries can be a boon at the time of distress

The recent Nepal Earthquake has made all of us question ourselves and our system- Are we prepared to face such calamity? Natural disasters like earthquake come unannounced. But what is needed on our part is better awareness and knowledge to tackle such situations. At the time of earthquake, a large number of people lose their lives due to lack of information on handling medical emergencies.

It is well known not the earthquake that causes deaths, but the building debris that fall on the person which causes injuries of the neck and the spine  during that period. When an earthquake strikes, people often bend down to save their lives. In such a situation, the rubble from the buildings fall directly on a person’s back, which leads to traumatic spinal injuries and the most common of them, are spinal fractures and cervical injuries. Traumatic spinal injuries often cause neurological deficits; which if not treated well in time, can in future lead to permanent neurologic injury. Untrained rescue workers are the first one to offer help but they are not aware how a person who has suffered back and neck injury needs to be immobolised before being lifted. It is pull drag method which further aggravates the condition of the affected person.

Spinal Immobilization, in-field care, proper lifting techniques and transport during rescue operations plays a very important role while coping up with a natural calamity, and especially, for the trauma patients. Certain things need to be kept in mind while handling spinal emergencies. The injured person should not be dragged. At least 5 or more people should be there to carry the patient, with one holding and supporting the head, one supporting the neck and shoulder, minimum two people standing on opposite sides of the patient holding the back and the pelvic area and one person holding the legs. Immediately shift the patient and make him lie on a hard board. Make sure that there is no abnormal twisting, turning or bending of the neck and back. Another thing to be kept in mind is that the neck should be immediately immobilized by a hard cervical collar, as failing to do so can cause cervical injury. Proper transportation and timely treatment can save many lives.

Always remember, our safety lies in our own hands. At the time of earthquake, it is important not to panic and maintain calm. The moment, you feel that an earthquake is coming move out to an open area or to the middle of the street, and stay away from electricity poles, trees and buildings, as they might fall down. Also, avoid using lifts on case of moving out of a building. But, if you can’t move out, follow the simple technique of “Drop, Cover and Hold On”. Hide under a sturdy desk or table and hold its legs firmly. You can also, sit next to a sofa or bed in a foetal position for your safety. Stay away from windows and lamps. If driving, stop your car at the side of the road and not in the middle especially, under a highway. In a crowded place like malls or restaurants, you can protect your head with your arms and hide under a seat or table. New theory has been propounded that if you lie next to triangular object, then the chances of the survival are the maximum since the debris don’t directly hit but slide down. According to this if you hide under a hard board, the heavy debris can break it and lead to more serious injuries.

Proper education regarding disaster management and how to handle any medical emergency at the time of any natural disaster, if given right at the school level can making our coming generation, a well prepared and more responsible citizen who is capable enough of helping a fellow citizen in such times of distress. It is important that general public is also trained in basic trauma care like proper lifting and carrying of injured person to prevent further aggravation of Spinal and neck injury.

Women watch out for Postmenopausal Osteoporosis

Growing age brings with it a number of health complications. And when it comes to bone health, women are usually more susceptible to developing problems, especially after menopause. One of the most common problems in post menopausal women is Osteoporosis i.e. weakening of bones.

Osteoporosis, which literally means porous bones, is a disorder in which our bones lose their density and strength. As a result, they become fragile and highly prone to fractures even in case of slight injuries. Though, osteoporosis can affect anyone, but women are generally at a greater risk. A woman acquires most of her bone mass during childhood and up till early thirties. So during that period, if enough calcium is not deposited in bones, there are high chances of developing osteoporosis later in life.

The risk and severity of osteoporosis is further high post menopause. It is a stage when there are extreme hormonal changes in a female body which affect various body functions. One of the major changes is dropping of estrogen level, which plays a vital role in maintaining bone strength in women. As a result, due to lack of estrogen, bones start losing strength and become susceptible to osteoporosis.

Osteoporosis is often referred to as ‘silent disease’ as there are generally no visible symptoms and the patient may stay unaware while suffering from it. But there are some warning signs that may be pointing towards osteoporosis like sudden severe back pain, gradual loss of height or stooping and fractures of wrist, spine or hip. In case of such symptoms, doctor must be consulted as soon as possible.

As one age, the problems associated to Osteoporosis can increase

but it can be certainly prevented by following a healthy and active lifestyle. First and foremost, for healthy and strong bones, calcium is essential. Best source of calcium are milk and other dairy products like curd, cheese etc. There are several other food items that can help your body meet its calcium needs like eggs, green vegetables, fortified orange juice, fish etc. But just taking calcium isn’t enough. Our body also requires Vitamin D for calcium absorption. So, spending at least 20 minutes a day in sunlight can be very useful for calcium absorption since, sunlight is the best source of Vitamin D.

Along with nutritious diet, regular work out is another most important factor that decides our overall health. Regular exercises make our bones and muscles stronger and prevent any further damage. Walking, jogging, dancing and involving in sports are good work out options. And always remember, that alcohol and smoking are the worst enemies of our bone strength. So, they must be avoided in order to protect ourselves from harmful effects they can have on our overall health.

Talking of the cures,it requires multidimensional approach where early and aggressive initiation can cure Osteoporosis completely.The patient needs calcium in organic form (citrate,fumarate,oxalate) as patient can easily absorb it.The patient needs to be given 500-1000 mg of elemental calcium along with activated form of dihydroxy vitamin(type of vitamin d) for a period of 1-2 years.If vitamin D levels in the body are low,then vitamin D injections need to be given on a monthly basis.

An important hormone required for boosting mineralization and deposition of essential nutrients in bones is ‘Salmon calcitonin’. Though it is already present in human body, but for purpose of treatment, is given to patients in form of nasal spray for few months. Another vital medication is ‘Zolendronic acid’ which is given once a year as intravenous infusion through drip to increase bone density and strength over time.

Apart from these conventional methods, modern DNA technology and gene therapy have brought new ways of increasing bone forming cells. In certain cases, hormone therapy is suggested to post menopausal women so that the effect of hormonal changes can be neutralized.

In some extreme cases, where back becomes so weak that it is unable to bear even the body weight, vertebral braces may be required to support the bones. Sometimes, patients may suffer from painful vertebral fractures resulting in stooping. Such condition can be treated with non invasive, non surgical technique of ‘balloon Kyphoplasty’. In this technique, the collapsed bones are raised using balloon tipped needles which provide immediate strength and stability to bones. It is a simple and safe procedure that doesn’t require any anesthesia or bed rest and patient can just get back to normal routine without any discomfort.

Other than these treatments, patients are recommended weight bearing exercises like yoga, brisk walking, dancing and lifting light bearable weights. The patient themselves need to be careful to avoid bumps and falls so as to minimise chances of injuries.

The girl child needs good care from the beginning itself. Good diet and exercises in the childhood can go long way in preventing Osteoporosis in post menopausal stage.
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Don’t let back pain ruin your pregnancy experience

News about pregnancy brings a feeling of extreme joy and excitement for a woman. But, it is also the time when the utmost care is needed by the body. People are usually aware about the importance of a healthy nutritious diet during the period of pregnancy. But, another major factor, that people often either neglect or are unaware of, is spinal health. Back pain is one of the most common problems that a woman generally suffers during pregnancy.
During a healthy pregnancy, a woman gains weight up to 25-30 pounds. The additional weight has to be supported by the bones, which puts a huge amount of pressure on them, especially the spine. This results in lower back pain, which is the most frequently reoccurring pain that a woman experiences during pregnancy. Along with this, there are many other physical changes too that happen during pregnancy as the baby grows in the uterus. All these changes put pressure on the woman’s bones and blood vessels in the pelvic region, which causes pain.
Almost 50% of women experience some sort of back pain while being pregnant, especially during the later stages. The major reason behind this back pain is poor body posture. A lot of women stay inattentive towards their posture during this sensitive phase of their life. Due to the bodily changes that occur during pregnancy, the whole body balance is altered and body’s centre of gravity also shifts towards front of the pelvis. As a result, body’s posture is also adversely affected. All this place a lot strain on organs and joints, which result in severe backache.
Also, as the baby bump increases with time, a woman’s lower back curvature also increases gradually which puts additional stress on discs in the lumber region. Maintaining appropriate posture and doing some light exercises on a daily basis can be very beneficial for expecting mother in preventing such posture related back problems.
Pregnancy is an extremely complex body process with a number of changes occurring simultaneously. Along with the visible bodily changes, there are several internal processes that keep on happening. One of these changes is muscle separation. As the baby grows, the uterus also expands, and this expansion is accompanied by separation of rectal abdominis muscle that runs from cartilage to the public bone. This separation further exaggerates the back pain.
Other major changes that occur are the hormonal and the emotional ones, which directly or indirectly affect our health. During the pregnancy months, the body keeps on preparing the body for childbirth, for which it secretes several hormones. But sometimes, these hormones also affect our joints, which may add on to existing ache. Similarly, stress, which is again very common in women, especially during the later stages of pregnancy, can cause contraction of muscles in back and lead to spasms and pain.
Being a mother is the most special feeling for a woman. But, continuous back pain can make it a miserable experience. Therefore, pregnant woman must stay careful about their health and specially the back health to make this time a joyous and memorable one.
The first and foremost tip to prevent such problems is regular exercising. Being pregnant doesn’t mean that a woman shall stop moving her body. Doing safe, simple and light exercises regularly, helps in strengthening body muscles and increases flexibility. This can help in making child birth easy. Just make sure to do exercises suggested by a specialist only and avoid any exercise that involves jerking or bouncing movements. Along with exercising, always remember to have a good nutrition rich diet and take plenty of rest also.
Be very careful about your posture and body movement. Apart from that, never lift any heavy weight, as it can put excess strain on your joints and can also be very risky for pregnant women. In case you need to pick up something, it is better to squat. Bending, in any case, must be avoided. Keep away from wearing high heels during this time. Even while sleeping, pregnant women need to be careful about their position. For pregnant women, sleeping on side is an apt position.
If you are prescribed some medicines by your doctor, take them religiously. In case of severe or persistent back pain, do not delay in consulting a doctor.
These simple care and precautionary tips can be extremely beneficial for the mother-to-be in staying healthy and having a pleasant pregnancy experience.
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Watch your back while you drive

Travel has become an intrinsic part of our routine these days. Our life style has undergone a tremendous change with driving becoming a primary means of transportation. Whether it is a daily commute or an extended road trip, we generally end up spending a lot of time behind the wheel and most of the time, unaware of our posture which ultimately leads to back and neck pains.

Long driving hours often cause stiffness in the back and neck. Also, sitting in the same position for long affects the blood circulation of our body and can cause severe back pain. People, many a times, modify their car seats on their own. For instance, removing the head rest which can be extremely risky as it makes your neck more prone to pain. Remember that our vehicles are designed in a way that they provide an ideal sitting posture to the driver. So, it is better not to modify the basic structure of seat that may lead to any spinal problem.
Don’t slouch while driving.Some people try to drive in a posture as if they are sitting comfortably in a sofa in their home and driving alongside.This posture if carried on for a long while is sure to cause back and neck pain.And if persisted it can turn into a permanent pain.
It is important to sit in a posture where both your knees and hips are at the same level. Another thing, adjust your seat at an angle of 100 to 110 degrees, in order to support the upper part of your body.
One more thing that should be kept in mind while driving is to have proper leg space between steering and the driving seat.Some people move it too closer to the steering,some too far.Before driving make sure the seat is properly adjusted and that you don’t feel any strain while driving.Also, your rear view mirror should be adjusted properly so that you can easily view it without causing any problem to your neck.
When going for a long journey, it is good to take frequent breaks in between to relax your back. If possible, doing some stretching can be a great relief.
In case you are already experiencing pain in your back, you can use cushions to support your spine. A great variety of cushions and lumber supports are available in market that can help relieve and prevent back pain by providing adequate support to your back.
Most of the time, these simple yet essential things are not given due attention. A healthy spine is crucial for a healthy body and there is only one way to maintain spinal health which is proper posture. One’s posture while driving can either contribute to or alleviate back discomfort.
Any ignorance can be damaging to our overall bone structure and specially the spine. As it is said ‘prevention is better than cure’, it is better to look after your body before it cries for attention.
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Kyphosis:It's causes and treatment

‪There is a condition in which back bends more than the normal or back appears to be hunched.Medically this condition is known as Kyphosis.Causes of Kyphosis include Osteoporosis,old age,bad posture under developed vertebrae,abnormal development of the spine in the womb.As a result it can happen in any age.Treatment involves physiotherapy,use of braces and in rare case surgery.Kyphoplasty is the non interventional technique which is used with very good results.
Good posture,good diet,proper sitting posture can prevent the incidence of Kyphosis to a very large extent.

Who all are at risk of developing Osteoarthritis?

Osteoarthritis of the spine is a breakdown of the cartilage of the joints and discs in the neck and lower back,so those who have sitting job like computer professionals ,doctors,journalists,scientists are all at high risk.Further those who speak on cell phones with phone between head and shoulder run the risk.Besides those who have uncontrolled diabetes,thyroid,uric acid,heavy smokers are vulnerable.
Prevention is possible by leading active life.However we all know about it,still people fall sick.There are several treatments like medicine,physiotherapy,non surgical injections.Only very few patients don't get relief from this,for them too there is hope in the form of surgery.
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How to have strong and healthy Spine

Seeing the increase in the number of spinal problems, often people assume that our spine is very frangible and is vulnerable to injuries. But this is a complete misconception. Our spine is a very well designed structure which is surrounded by various layers of protective shields, proving it great amount of strength and flexibility. What makes our spine vulnerable is lack of proper conditioning (exercise) and poor postures. Besides, there are several other factors like unhealthy diet, obesity, improper sleeping pattern, smoking etc. which are equally responsible for spinal injuries/problems.Stay away from these and your guaranteed to enjoy good spinal health.
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Degeneration of Disc is not a continuous process

Degeneration of disc is the leading cause of back pain.As the word connotes, degeneration means normal wear and tear.With this it is presumed that age is a factor in it.To a certain extent this is true as with aging some wear and tear of the disc does happen.But it is not entirely true.Degeneration can happen in young age also because of faulty life style.Further degeneration is not a continuous process and if corrective action is taken, it can be checked even in advancing age.
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Prevent Spinal cord injuries

Spinal cord passes between back and neck and as we all know, it has nerves which carry messages from brain to body.So as a result any injury to the Spinal cord is a serious one and can leave a person paralysed for whole life.What has been found is that most of the Spinal injuries are caused by accidents and highest among these are in car crashes.It has been observed that maximum injuries happen because victims were driving without seat belts.Already we know that accident rate in our country is among the highest with very low safety standards but in terms of cars we have the very best.So it becomes a very deadly cocktail as youngsters speed us in these and if an accident happens,they are the one's which suffer maximum injuries.The easiest way to prevent this is to drive with seat belt on.Secondly don't overspeed for your own sake as well as for others safety.
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Spinal Cord Stimulation:Revolutionary technique for treatment of Chronic back pain

We have all heard of  cardiac pacemaker  and how it can revive a critically and irreversibly damaged heart by  generating electrical impulses called cardiac impulses or action potentials required for proper pumping of heart thus acting as a true life savior in otherwise hopeless condition. Quite similar to it is, spinal cord stimulator, a device used to exert pulsed electrical signals to revive the already damaged spinal cord peripheral nerves of the patient when everything else has failed,thus giving relief from chronic pain.

Approved by the FDA in 1989, spinal cord stimulation (SCS), a form of neuro stimulation technology has over the years become a standard treatment for patients with chronic pain in their back and or limbs and those who have not found pain relief from other treatments. Spinal cord stimulation (SCS) is a pain relief technique that delivers a low-voltage electrical current continuously to the spinal cord to block the sensation of pain.

Spinal cord stimulation (SCS) in the simplest form, involves stimulating electrodes implanted in the epidural space, an electrical pulse generator implanted in the lower abdominal area or gluteal region with the conducting wires connecting the electrodes to the generator, and the generator remote control. As pain changes or improves, stimulation can be adjusted as necessary.

Most patients who qualify for neurostimulation therapy report a 70 to 90% reduction in overall pain, as well as an increased ability to participate in normal family and work activities. Many patients find that they can decrease or stop taking painkillers or other pain medications after undergoing spinal cord stimulation. Given these benefits, there has been ongoing research and advances in spinal cord stimulation technology, and many individuals suffering from chronic pain find that neurostimulation positively impacts the quality of their lives. However, it is important to note that the degree of pain relief experienced from spinal cord stimulation or peripheral nerve stimulation varies from person to person.

In general, neurostimulation works by applying an electrical current to the source of chronic pain. SCS is the most commonly used implantable neurostimulation technology for management of pain syndromes. As many as 50,000 neurostimulators are implanted worldwide every year.

Types of incurable diseases where Spinal Cord Stimulation is used for treatment

One of these is Arachnoiditis , a painful condition caused by inflammation of the arachnoid, one of three linings that surround and protect the brain and spinal cord.It impacts the nerves and causes symptoms such as numbness, tingling, and a distinctive stinging and burning pain in the lower back or legs. Other symptoms include debilitating muscle cramps, twitches, spasms, and bladder/bowel/sexual dysfunction. Some of the known causes of this are irritation from chemicals arising from Spinal procedures and epidural steroid injections;bacterial or viral infections; spinal cord injury; or complications arising from spinal surgery.There is no cure for this condition except spinal cord stimulation & neuromodulation.

One more disease where only spinal cord stimulation & neuromodulation only works is Complex regional pain syndrome (CRPS) , an uncommon nerve disorder which causes intense burning pain, usually in the arms, hands, legs or feet. Along with the pain, the patient may experience extreme skin sensitivity and changes in the color, temperature or moistness of the skin .Causes are largely unknown but it can occur after an injury, either to a nerve or to tissue in the affected area.

Besides Spinal Cord Stimulant is used in several other conditions such as Failed back surgery syndrome (FBSS) ,where surgery for back pain was done but the patient does not recover.In such cases too,SCS  works wonders. Other conditions include  Nerve damage, neuropathy, or neuritis  and motor neuron disorders(MND’s) which are classified as incurable diseases.

All in all Spinal Cord Stimulation is a measure of last resort and generally helps in reducing the chronic pain the patient might be suffering from ,thus giving him or her a chance to have better quality life.

Understand the plight of those who go through chronic back pain

When we talk of chronic back and neck pain very few normal people are able to relate to it.Just imagine you have a flu for few days and how sick you feel.And what if you continue to suffer from this flu for years and years together ,how will you feel then.This is what a person with chronic back and neck pain goes through.They may walk sometimes for about 10 minutes,but this is once in a blue moon.They may look healthy from appearance but only they know how difficult it is for them to cope up with this pain.Fortunately the medical science has advanced so much that there are almost no conditions in which medical intervention can not make a difference to the patients condition.Non invasive techniques,special injections,surgeries so many options are available.And when ever one has a pain which qualifies to be called a chronic one,such medical interventions can be quite a boon.
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Exercise to be fit

We have often written about how nutrition,sitting posture play a major role in keeping back problems at bay.These are very important things to take care of for good back health.An equally important role is played by physical workouts.People are so busy these days that they hardly have any time for physical workouts.Remember physical workouts are essential for stronger bones,first and foremost requirement for healthy back health.There is no substitute for it.Atleast on holidays,if not possible everyday,one should step out.It is so essential for good overall health.
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Age is no proof against Spinal Degeneration

Our spine is connected to our back and neck,so it is given any abnormal pressure on the either of the two or both together leads to some degenerative change.The change gets reflected either as slip disc,spinal stenosis and various other form.This change generally is not sudden but accumulation of unbearable stress over a long period of time.The stress is caused by combination of wrong posture,lack of physical workout ,junk food and high tension.Degenerative changes were something which were age related and linked to normal wear and tear associated with the process of aging.But what is surprising is that what was associated with aging is now being seen in fairly young individuals.Old theories are not working and it is now clear that age offers no full proof safety against degenerative diseases.If we are looking for something full proof,then only having the right lifestyle can work.
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Obese are at higher risk of back problems

If you are overweight,then you are at increased risk of developing back pain.Our spine is made in such a way that can carry a weight up to a certain extent.When excess weight is put there is a risk of structural change and damage.Maximum risk is to lower back.Otherwise too, obese are at high risk of different types of arthritis.

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Spinal problems getting younger

Some Disc degeneration with age does happen, so naturally the old are expected to have back problems.But what has happened is due to life style issues,(sitting on desk for long and that too in wrong posture,no exposure to sunlight,remaining all throughout in air conditioned environment ,no exercising and eating unhealthy food) the degeneration has started much earlier in the younger age itself.The result is back diseases which used to happen in old age ,nowadays is becoming younger,or are being seen in younger people.Slip disc is becoming common in mid twenty's.Spinal Stenosis is now found in mid 30's,earlier it was seen in those touching 50.So all in all scene is not good.Drastic changes are needed by the youngsters in their current lifestyle.Medical science may help them live longer but it will be a painful existence.

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