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OP Kapoor

Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.

Rheumatoid arthritis is supposed to be of 3 types:

1. Self limiting

2. Easily controlled (type I)

3. Progressively increasing (type II)

Hypertension could be

1. Self limiting without any drugs

2. Easily controlled with any anti-hypertensive tablets

3. Needing progressive increasing dose of anti-hypertensive tablets (in combinations)

Osteo-arthritis of the knees could be

1. Self limiting

2. Easily controlled by any pain killer and physiotherapy

3. Can progressively increase and call for knee replacement surgery

A patient of Chronic Renal Failure (CRF)

1. Can remain at a value of blood creatinine of 1.6 or 1.8 for years (self limiting)

2. Can be easily controlled if you omit NSAID group of drugs, some antibiotics like Tetracycline, Quinolones or treat hypothyroidism.

3. It can progressively increase till the patient needs dialysis or renal transplant.
Finally even a common illness like enteric fever could be:

1. Self limiting like in olden days when there were no antibiotics.

2. Could be easily controlled by a single antibiotic

3. The patient might need progressively increasing doses of antibiotics because of multi drug resistance.

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