IJCP Oct ober 2012

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IJCP Oct ober 2012

Text of IJCP Oct ober 2012

  • Volume 23, Number 5, October 2012

    Online Submission

    Advisory Bodies

    IJCP Group of PublicationsDr Sanjiv Chopra

    Prof. of Medicine & Faculty Dean Harvard Medical SchoolGroup Consultant Editor

    Dr Deepak ChopraChief Editorial Advisor

    Dr KK AggarwalCMD, Publisher, Group Editor-in-Chief

    Dr Veena AggarwalMD, Group Executive Editor

    Heart Care Foundation of India

    Non-Resident Indians Chamber of Commerce & IndustryWorld Fellowship of Religions

    IJCP Editorial BoardObstetrics and Gynaecology Dr Alka Kriplani Dr Thankam Verma, Dr Kamala SelvarajCardiology Dr Praveen Chandra, Dr SK ParasharPaediatrics Dr Swati Y Bhave Dr Balraj Singh Yadav Dr Vishesh KumarDiabetology Dr Vijay Viswanathan Dr CR Anand Moses, Dr Sidhartha Das Dr A Ramachandran, Dr Samith A ShettyENT Dr Jasveer SinghDentistry Dr KMK Masthan Dr Rajesh ChandnaGastroenterology Dr Ajay KumarDermatology Dr Hasmukh J ShroffNephrology Dr Georgi AbrahamNeurology Dr V NagarajanJournal of Applied Medicine & Surgery Dr SM Rajendran

    FROM THE DESK OF GROuP EDITOR-IN-CHIEF

    245 Endocrine Society issues Guidelines for Hypertriglyceridemia

    KK Aggarwal

    REVIEw ARTIClE

    246 A Critical Insight into the Present and upcoming Pharmacological Therapies for Treatment of GERD

    Vivek A, Garima Bhutani

    254 Is Essential Medicine Concept for Voluntary Organizations Only?

    Dixon Thomas, G Seetharam, Y Padmanabha Reddy, Gerardo Alvarez-Uria

    ORIGINAl STuDy

    261 Keracnyl in the Management of Acne P Khandeparkar, R Chavda, V Durosier, Q Mukaddam,

    R Kharkar

    269 Modulating Postoperative Pain Relief in Cesarean Section with use of Transdermal Diclofenac Patch

    N Gupta, R Gupta, S Agarwal, A Agarwal, SN Gupta, V Thawani

    ClINICAl STuDy

    272 Study of the Prevalence and Clinical Profile of Diabetes in the urban Population of Dibrugarh

    RK Kotokey, Abul Kalam Azad PK, Himanab Jyoti Das, Aneesh Ashok, Kamal Rajkhowa, Vishu Kumar, Tridip Kumar Das

    Anand Gopal BhatnagarEditorial Anchor

    This journal is indexed in IndMED (http://indmed.nic.in) and full-text of articles are included in medIND databases (http://mednic.in) hosted by National

    Informatics Centre, New Delhi.

  • Editorial Policies

    The purpose of IJCP Academy of CME is to serve the medical profession and provide print continuing medical education as a part of their social commitment. The information and opinions presented in IJCP group publications reflect the views of the authors, not those of the journal, unless so stated. Advertising is accepted only if judged to be in harmony with the purpose of the journal; however, IJCP group reserves the right to reject any advertising at its sole discretion. Neither acceptance nor rejection constitutes an endorsement by IJCP group of a particular policy, product or procedure. We believe that readers need to be aware of any affiliation or financial relationship (employment, consultancies, stock ownership, honoraria, etc.) between an author and any organization or entity that has a direct financial interest in the subject matter or materials the author is writing about. We inform the reader of any pertinent relationships disclosed. A disclosure statement, where appropriate, is published at the end of the relevant article.

    Note: Indian Journal of Clinical Practice does not guarantee, directly or indirectly, the quality or efficacy of any product or service described in the advertisements or other material which is commercial in nature in this issue.

    Published, Printed and Edited byDr KK Aggarwal, on behalf of

    IJCP Publications Ltd. and Published at

    E - 219, Greater Kailash, Part - 1 New Delhi - 110 048

    E-mail: editorial@ijcp.com

    Printed at IG Printers Pvt. Ltd., New Delhi

    Copyright 2012 IJCP Publications ltd. All rights reserved.

    The copyright for all the editorial material contained in this journal, in the form of layout, content

    including images and design, is held by IJCP Publications Ltd. No part of this publication may be published in any form whatsoever without the prior

    written permission of the publisher.

    IJCPs EDITORIAl & BuSINESS OFFICESDelhi Mumbai Kolkata Bangalore Chennai Hyderabad

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    ORIGINAl ARTIClE

    279 Clinico-etiological and EEG Profile of Neonatal Seizures

    Shwetal Bhatt, Nita Raju, Supriya Phanse, Sangita V Patel, Geetika Madan, Sanjeev Mehta, Chetan Trivedi

    CASE REPORT

    286 Evaluation of a Case of Penetrating Ocular Injury Jitender Phogat, Vivek Gagneja, Sumit Sachdeva, Mukesh Rathi

    PRACTICE GuIDElINES

    289 PHS updates Smoking Cessation Guideline

    PHOTO quIz

    291 linear lesions in a Neonate

    MEDIlAw

    293 Illegal Pathlabs MC Gupta

    lIGHTER READING

    294 lighter Side of Medicine

  • 245IndianJournalofClinicalPractice, Vol. 23, No. 5, October 2012

    Dr KK AggarwalPadma Shri and Dr BC Roy National AwardeeSr. Physician and Cardiologist, Moolchand Medcity, New DelhiPresident, Heart Care Foundation of IndiaGroup Editor-in-Chief, IJCP Group and eMedinewSChairman Ethical Committee, Delhi Medical CouncilDirector, IMA AKN Sinha Institute (08-09)Hony. Finance Secretary, IMA (07-08)Chairman, IMA AMS (06-07)President, Delhi Medical Association (05-06)emedinews@gmail.comhttp://twitter.com/DrKKAggarwalKrishan Kumar Aggarwal (Facebook)

    fromthedeskofgrouPedItor-In-ChIef

    Endocrine Society issues Guidelines for Hypertriglyceridemia

    The Endocrine Society Guideline for the evaluation of patients with hypertriglyceridemia recommends that the diagnosis be based on fasting triglyceride levels.At least every five years, adults should be screened for hypertriglyceridemia as part of a lipid panel.

    To facilitate assessment of cardiovascular risk, mild and moderate hypertriglyceridemia, defined as triglyceride levels of 150-999 mg/dl, should be diagnosed, as this condition may be a risk factor for cardiovascular disease.Patients with severe and very severe hypertriglyceridemia, defined as triglyceride levels of >1,000 mg/dl, should be considered to be at risk for pancreatitis.Patients with hypertriglyceridemia should undergo evaluation for secondary causes of hyperlipidemia, such as endocrine conditions and medications, and treatment should be focused on such secondary causes.Patients with primary hypertriglyceridemia should be assessed for a family history of dyslipidemia and cardiovascular disease, as well as for other cardiovascular risk factors including central obesity, hypertension, abnormalities of glucose metabolism and liver dysfunction.For patients with moderate hypertriglyceridemia, the treatment goal should be a non-high-density lipoprotein cholesterol level in agreement with NCEP-ATP guidelines.For patients with mild-to-moderate hypertriglyceridemia, first-line therapy should be lifestyle interventions including physical activity. A combination of diet modification and pharmacotherapy may also be considered.

    For patients with moderate-to-severe hypertriglyceridemia, treatment with fibrates niacin and/or omega-3 fatty acids alone or in combination with statins should be considered.A fibrate should be used as a first-line agent in patients with severe or very severe hypertriglyceridemia, in addition to reduction of dietary fat and simple carbohydrate intake.Statins should not be used as monotherapy for severe or very severe hypertriglyceridemia, but they may be useful for the treatment of moderate hypertriglyceridemia when indicated to modify cardiovascular risk.

    The guideline is published in the September 2012 issue of Journal of Clinical Endocrinology and Metabolism.

  • 246 IndianJournalofClinicalPractice, Vol. 23, No. 5, October 2012

    *Assistant Professor, Dept. of Gastroenterology **Assistant Professor, Dept. of PharmacologyPt. BD Sharma, Postgraduate Institute of Medical Sciences, Rohtak, HaryanaAddressforcorrespondenceDr Garima BhutaniH. no. 517, Sector 15-A, Hisar, HaryanaE-mail: garimahuja2010@yahoo.com

    A Critical Insight into the Present and Upcoming Pharmacological Therapies for Treatment of GERDVIVekA*,gArImABhutAnI**

    Gastroesophageal reflux disease (GERD) is defined as a condition which develops when the reflux of gastric contents into the esophagus causes troublesome symptoms (at least two heartburn episodes/week) and/or complications.1 It has a prevalence rate of 10-30% and an annual incidence of 0.38-0.45% in the western world.2 The typical symptoms include heartburn, acid eructation and water brash. Other atypi