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Quaternary prevention: Every practitioner need to know it

“I am going to prove, that you all are dead”. Juan Gervas (famous doctor and author) once put it in a presentation. He was talking about a new guideline for heart failure. It defines four stages of heart failure. Stage A is for people without structural heart disease or symptoms of heart failure, but who are “at risk” for it. At the end he came back to his statement from the beginning: “Now you can see that you are all dead – but fortunately only stage A!”


There is a lot of truth in this joking. Is it really the worry for people that drive them to doctors? Or is it the sarcastic broadening of the narrow spectrum of patients by doctors who are more and more specialized and by this rising specialization have less and less patients? Or is it the seemingly moral free activity of pharmaceutical companies in search of new consumers for their products? Probably it is neither only this, nor only that. It is a danger we are all in. This is what we should keep in mind while thinking on the risks of being ill or having any major chronic illness. While the patient experiences illness and deserves a disease label, doctors, as newly proposed, would label a majority of these illnesses as MUS (medically unexplained symptoms). 


All these symptoms and illnesses widely open up the doors for endless diagnostic procedures. Most of them will have normal results, but many will have borderline or false positive results. The consequences are endless further diagnostic tests and prescriptions of never proven therapies with well-known side-effects.

Much has been learned about the importance of risk factors being relative. Say for an example, the majority of men over 80 will have prostate cancer. Only few of them will die from it.


In fact the media, the pharmaceutical industry, politicians and the medical professions in a weird mixture of best intentions and economic profit have the potential to create doubt and worries about even the most robust health of the people. Moreover, after some age people start saying, “You know, I was always in good health but I feel I am coming to a certain age now and my wife said that I should start to do something to stay healthy”. 


The human mind seems to be more open to action, even if it turns out to be useless or even harmful, than to no action or a ‘wait and see’ approach. This can turn into absurdities such as women continuing to have Pap-smears in 69% of cases after having had a complete hysterectomy (removal of uterus) in the US.

The feeling of being ill does not necessarily meet the doctor’s judgment that there is a disease present. 


To understand the risk factors is quite essential. At the same time, it is highly recommended to evaluate its relative value in your case.


Courtesy: Thomas Kuehlein MD, General practitioner, Germany; Donatella Sghedoni, PhD, Italy; Giorgio Visentin MD,

General practitioner, Italy; Juan Gérvas MD, PhD, General practitioner, Spain; Marc Jamoulle MD, MPH, General

practitioner, Belgium


The women of the world

Trust.org recently reported about the so called “5 most dangerous places for women” based from six key risks: Sexual violence, non-sexual violence, cultural and religious beliefs, discrimination and lack of access to resources and human trafficking, and as you can see, all of the risks are part of the giving in for the self interests of some people.  See more... http://www.challengefuture.org/news/388

Be ready for the CHANGE

The best hockey player in the history, Wayne Gretzky, said that “A good hockey player plays where puck is. A great hockey player plays where the puck is going to be.” 

It is about perceiving the Change. How we make out the change is the key factor to decide outcome of our actions. Those who accept and modify themselves according to the new circumstances become more efficient and most effective. But sometime knowingly unknowingly we don’t want to change our plan, our management or our organization strategies. See More... http://www.challengefuture.org/news/346

What lies behind my suffering?

This is something very special and I want to share this to many of you as fast as possible.

Print this hard that it’s not the conclusion but the perspective which will definitely help us to live better, for after all, perspective is everything one need to perceive in order to see the wider range of reality. Knowledge always brings the responsibility within it and that is the same reason for me to share this week's Hot Topic. See more... http://www.challengefuture.org/news/374

I'M miracle

I am convinced that He (God) does not play dice." - Albert Einstein

Here is the story of one entity. It has all the following characteristics altogether.

Efficiency, Management skills, planning, organisational skills, communication, teamwork, decision making, problem solving, analysis, performance reviews, auto feedback mechanism, harmony, productivity, prophecy, effective dealing with changes, self-recovery (up to certain extent) and sustainability etc. See More... http://www.challengefuture.org/news/459 

Interview of Dr. Saunil Malwania
As part of the C:F Action Team #7, Health Saviours, I had the opportunity to conduct an Interview with Dr. Saunil Malwania, one of my mentor and inspirations. Enjoy and get the insights! See more... http://www.challengefuture.org/news/482
Self Conscious Activities 

Life is going on very unique path once we recognize and work according to our Individuality, according to our own unique Will. It’s not really easy to think and realize how much our creator has already thought for us. We can not even imagine it until we start walking on the ‘ROAD OF UNIQUENESS.’ We used to believe what other speaks to us and on us, we used to depend on guidance from someone; we crave for appreciation from outer world. There are very few who can listen the whispering of life in this today’s LOUD world.

Calm down my heart,

Take few Deep breaths.  See more... http://www.challengefuture.org/news/318

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