Volume 23, Number 5, October 2012
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
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
261 Keracnyl in the Management of Acne P Khandeparkar, R Chavda, V Durosier, Q Mukaddam,
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
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
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279 Clinico-etiological and EEG Profile of Neonatal Seizures
Shwetal Bhatt, Nita Raju, Supriya Phanse, Sangita V Patel, Geetika Madan, Sanjeev Mehta, Chetan Trivedi
286 Evaluation of a Case of Penetrating Ocular Injury Jitender Phogat, Vivek Gagneja, Sumit Sachdeva, Mukesh Rathi
289 PHS updates Smoking Cessation Guideline
291 linear lesions in a Neonate
293 Illegal Pathlabs MC Gupta
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)firstname.lastname@example.org://twitter.com/DrKKAggarwalKrishan Kumar Aggarwal (Facebook)
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: email@example.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