Preventing and managing chronic diseasesBMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l459 (Published 31 January 2019) Cite this as: BMJ 2019;364:l459
All rapid responses
Having read this editorial in the BMJ, “Preventing and managing chronic diseases”, I found it quite interesting and very pertinent . My sincere compliments to the author. Non-communicable diseases (NCDs) are on the rise. In times to come, their sheer numbers along with associated multi-morbidities might overwhelm existing resources and healthcare facilities. This editorial talks of such difficulties, and they need to be addressed and tackled squarely.
Long time ago, in September 2012, upon an invitation by the Commonwealth Medical Association, the prime author had delivered his paper on non-communicable diseases (NCDs) in their international conference. He also had the privilege of chairing the very first session of that conference, which had invitees and researchers from all the Commonwealth countries, learning whatever new had been happening from them. There, his presentation had featured on moving ahead from just managing NCDs, to obtaining some degree of cure as well by simple innovative techniques which could provide better patient outcomes. There certainly is a need to start looking beyond the tunnels . It is only when we really care to take a wider perspective, we may start finding newer innovative solutions for many of the common chronic medical problems, including NCDs.
Over the last decade, much has already written by us out here in the BMJ . At the cost of reiteration, we had opined that world needs to start looking beyond the accepted text, and beyond the present “evidence based medicine”. Many innovations are accidental, and must not be ignored outright . Surely there will be people who would realize what it takes to deal with such medical problems in far flung and remote areas, where there can be no second chance, where having to think out of the box for any possible respite for their patients was so much needed. Nothing more would have mattered in those trying situations when evacuation or transfer to other hospital or medical facility would have been out of question altogether for some or the other reason. They say, necessity is the mother of all inventions.
Whichever way one may look at our innovations, a little has already been accomplished. We do not have resources or appropriate support, otherwise we may have taken all these innovative techniques of ours to their logical conclusions. Notwithstanding, in our opinion there is a need to start building from the point that has been reached by such innovations, maybe incidentally or accidentally. Surely, better results can be obtained if multi-level and multi-centric research is undertaken under patronage of governments, world medical bodies, or under the patronage of international NGOs and good Samaritans.
When we already know that continued exposure to noise is one of the underlying cause for age-related hearing loss (presbycusis), wherein damage of ‘hair cells’ is the most important factor. To us it does not appear scientifically correct when despite knowing that it has been the noise primarily which has caused the damage to hair cells, leading to hearing loss in presbycusis, we still continue to use amplification of sound as a modality of managing hearing loss. This time we place a hearing aid very close or inside the affected ear (s), unconcerned about the deleterious effect of such amplified sounds by hearing aids on the remnant population of ‘hair cells’. Long ago we had developed a technique for presbycusis wherein near normal hearing can be restored without invasive techniques or surgery and without needing any amplification modalities or hearing aids anymore [5-6].
We have done possibly all that we could. We have disclosed almost every innovative medical techniques out here in the BMJ. A presentation of 35 innovative medical techniques for the world was also given to the Ministry of Health, India, on 25 October 2017, when invited by them to Delhi. Our intention has been to lay out for the world a newer perspective for the common chronic medical conditions and NCDs. For an instance let’s consider coronary blockages. Presently we have stenting and coronary bypass surgery as available modalities. As a possible alternative, our accidental innovative technique might be of help. It is non-invasive, non-surgical, painless, and does not require any anaesthesia. We are hopeful that like all of our other techniques, this too may be improved and made absolutely safe by scientists and researchers of the world so as to make this as a first line management modality [7-8]. Should our innovative technique fail, other modalities that are in vogue can be used.
Probably we have a sort of accidental breakthrough for primary hypertension and for type 2 diabetes as well [9-11]. A news of our innovative techniques had made a headline here in India, and in most other parts of the world, once our book describing 25 innovative medical techniques was published by an international publisher in the year 2016 . Based on our experiences on our new innovative techniques, we had also mentioned about the need of surgery can be avoided for 12 different types of surgical problems [2, 13-16]. Their management could be done by non-painful and non-invasive methods, not requiring any anaesthesia. Possibly with some improvement and foolproof safety accorded to our innovations by researchers from across the world, surgeries for DNS, ‘nose job’, hypertrophied nasal turbinates, face lift, removal of flab and cellulite, arthritis of knees, frozen shoulder, plantar fasciitis, macroglossia, gynaecomastia, lumbar canal stenosis, benign prostatic hyperplasia, may not be needed in majority of cases. Looking at the rapid swell in the number of patients suffering from hypertension, we have considered compulsory iodization of salt could be the reason when it is done for even those areas where there is no iodine deficiency [17-18]. Maybe our observations could be of help, here as well.
To usher in beneficial changes, scientists and researchers around the world will need proper backup, motivation, help, guidance, encouragement, etc, that we had lacked altogether and all throughout. While we are at it, we must consider why cure has remained elusive for most of the NCDs and why we are satisfied at providing just a stable condition, rather than a cure. For this, first of all we really have to settle all those issues which really restrict us to look beyond the horizon, or at least beyond the preset mindsets, and beyond the tunnels. Or are we just happy and contended with the way the things are?
1. Nugent Rachel. Preventing and managing chronic diseases BMJ 2019; 364 : l459
2. Chauhan R, Parihar AKS, Chauhan S. Medicine : Perhaps its time to look beyond the tunnels and to remove constraining straight-jackets. BMJ 26 Nov 2014. Available at : https://www.bmj.com/content/349/bmj.g6123/rr/788689 (Accessed on 06 Feb 2019)
3. Chauhan R, Chauhan S, Singh AK. New, innovative and novel series of medical innovations almost ready for healthy aging, but no takers so far. BMJ 25 March 2018. Available at : https://www.bmj.com/content/360/bmj.k1288/rr (Accessed on 06 Feb 2019)
4. Chauhan Rajesh. Kindly don't let accidental discoveries for things like essential hypertension fade away into oblivion. What if the medical discoveries were accidental, and with no help forthcoming from any one or from governmental or global resources ? BMJ 08 July 2015. Available at : http://www.bmj.com/content/351/bmj.h3572/rr (Accessed on 06 Feb 2019)
5. Chauhan R, Parihar AKS, Chauhan S, Chauhan SPS. Re: Cost effectiveness of strategies to combat vision and hearing loss in sub-Saharan Africa and South East Asia: mathematical modelling study. BMJ 20 April 2013. Available at: https://www.bmj.com/content/344/bmj.e615/rr/641987 (Accessed on 06 Feb 2019).
6. Chauhan R, Chauhan S, Singh AK (2016) Age-related hearing loss (Presbycusis) & our “Dr. Arulrhaj Technique” for restoration of natural hearing. In: Innovative techniques for treating 25 common chronic human diseases. Lap Lambert Academic Publishing, Saarbrücken, Germany. pp. 1-120.
7. Chauhan R, Chauhan S, Parihar AKS. Innovative medical techniques showcased at international medical conferences. Chapter 14. New exploratory ‘Betaa ka naglaa technique’ for clearing the coronaries and carotids during emergency. Pp 99-106. ISBN -13 : 978-3-659-62328-8; ISBN -10: 3659623288; EAN : 9783659623288
8. Rajesh C, Shruti C, Ajay K S. About A Newer Non-Invasive Technique for Managing Coronary Compromise. OAJ Gerontol & Geriatric Med. 2017; 3(1): 555602. DOI: 10.19080/OAJGGM.2017.03.555602
9. Chauhan R, Parihar AKS, Chauhan S. Perhaps its time to consider some other perspectives as well, for managing some cardiovascular diseases and primary hypertension. BMJ 10 August 2015. Available at : https://www.bmj.com/content/351/bmj.h4333/rr (Accessed on 06 Feb 2019)
10. Type 2 Diabetes : can we think differently and improve the management and control ? Perhaps by our "BRIJ PAL TECHNIQUE". BMJ 03 June 2016. Available at : https://www.bmj.com/content/353/bmj.i2933/rr (Accessed on 06 Feb 2019)
11. Rajesh C, Shruti C, Ajay K S . Newer Ways for Managing Multi-Morbidities in Elderly Patients: Including Diabetes Hypertension, 002 and Coronary Artery Disease & Some More Problems. OAJ Gerontol & Geriatric Med. 2017; 2(5): 555596. DOI: 10.19080/OAJGGM.2017.02.555596
12. News. Healing touch : Retired Army doctor finds new ways to treat common ailments. In: Indian Express 01 August 2016. Available at : https://indianexpress.com/article/lifestyle/health/healing-touch-retired... (Accessed on 06 Feb 2019)
13. Chauhan R, Singh AK. Re: Frozen shoulder. BMJ 07 May 2013. Available at : http://www.bmj.com/content/331/7530/1453/rr/644369 (Accessed on 06 Feb 2019).
14. Chauhan R, Parihar AKS, Chauhan S. Re: Effect of caudal epidural steroid or saline injection in chronic lumbar radiculopathy: multicentre, blinded, randomised controlled trial. BMJ 04 November 2013. Available at : https://www.bmj.com/content/343/bmj.d5278/rr/670106 (Accessed on 06 Feb 2019)
15. Chauhan R, Parihar AKS, Chauhan S (2016) Perhaps its Time to Move on to Individually Tailored and Focused Treatment in the Aged Population. J Gerontol Geriatr Res S5:001. doi:10.4172/2167-7182.S5-001
16. Chauhan R, Chauhan S, Singh AK (2017) Fresh Approach for Geriatric Medical Care. J Gerontol Geriatr Res 6: 449. doi:10.4172/2167- 7182.1000449
17. Parihar AKS, Chauhan S, Chauhan R. Re: Immediate and late benefits of treating very elderly people with hypertension: results from active treatment extension to Hypertension in the Very Elderly randomised controlled trial. BMJ 22 May 2013. Available at : https://www.bmj.com/content/344/bmj.d7541/rr/646735 (Accessed on 06 Feb 2019).
18. Chauhan R, Chauhan S, Singh AK. Could universal iodization of salt be causing hypertension ? Lap Lambert Academic Publishers, Germany. 08 August 2018. ISBN 13 : 9786139897698
1. Dr (Lieutenant Colonel) Rajesh Chauhan
Honorary National Professor, IMA CGP, INDIA.
MBBS (AFMC), Master in Medicine in Family Medicine (CMC Vellore),
Diploma in Family Medicine (PGIM Colombo), Post Graduate Diploma in Geriatric Medicine, Post Graduate Diploma in Disaster Management, Associate Fellow in Industrial Health (RLI, FASLI), Diploma in Nutrition, LLB
2. Dr. Ajay Kumar Singh
Assistant Professor, Department of Medicine,
Index Medical College, Indore. INDIA.
3. Dr. Shruti Chauhan
Index College of Dental Sciences,
Competing interests: 1. These are our personal views and have no bearing to any and all the professional affiliations that we have. 2. We have written about almost every of our innovative medical techniques to your journal as rapid responses, as we truly feel that these should not go down with us to our graves without having passed them on for the posterity. For the same reason we have also penned down five medical books on some of these innovative medical techniques, before our memory fades away, and while we are still around. Our intention is to pen down our limited experiences about all these new innovations for the posterity, and hope that someday, somewhere, something more substantial about these chronic diseases can be done, by someone. Frankly our experiences have been very limited, were never designed to be “researches”, and are definitely nowhere near to being a “study” or a “research”. We have just penned down our new experiences.