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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org
 
  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 
  Editorial …

5th February, 2011, Saturday                                eMedinewS Presents Audio News of the Day

View Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

"SMS please" : Talking on mobiles may be harmful

A few days back I was talking to Acharya Sadhna ji that we do not see sparrows and crows any more and today I saw the TOI report linking this to mobile phones.

Mobile phones radiations and towers poses serious health risks, including loss of memory, lack of concentration, disturbance in the digestive system and sleep disturbances.

An inter–ministerial 8 member committee formed by the ministry of communications and information technology to study the hazards posed by mobile phones attributed the disappearance of butterflies, bees, insects and sparrows vanishing from big cities to mobile phone–related radiation. The committee included representatives from the health ministry, Department of Biotechnology and Member Secretary, DoT. The recommendations of the committee are:

  1. Mobile phones not adhering to standard levels of specific absorption rate (SAR) – a measure of the amount of radiofrequency energy absorbed by the body while using a phone –– should be barred.
  2. Mobile towers should not be installed near high density residential areas, schools, playgrounds and hospitals.
  3. The localized SAR value as per the Indian guidelines standard is 2 watt per kg, averaged over a six minute period and using a 10 gram average mass.
  4. With higher SAR values of mobile handsets the public could potentially receive much higher radiofrequency exposure.
  5. SAR levels to be lowered down to 1.6 watt/kg, as prescribed by the Federal Communication Commission of US.
  6. In the case of a person using a cellphone, most of the heating occurs on the surface of the head, causing its temperature to increase by a fraction of a degree. The brain blood flow is capable of disposing this excess by increasing the local blood flow and increasing body temperature.
  7. Non–thermal effects of cellphone use – attributed to the induced electromagnetic effects inside the body’s biological cells – are more harmful.
  8. People who are chronically exposed to low-level wireless antenna emissions and users of mobile handsets have reported feeling several unspecific symptoms during and after its use, ranging from burning and tingling sensation in the skin of the head, fatigue, sleep disturbances, dizziness, lack of concentration, ringing in the ears, reaction time, loss of memory, headache, disturbance in digestive system and heart palpitation.
  9. Compared to Europeans, Indian cellphone users are more at risk for adverse affect of radiation due the country’s hot tropical climate, low body mass index, and low fat content.
  10. Children, adolescents and pregnant women should avoid excessive use of cellphones.
  11. People in general should use hands-free technologies to minimize the contact of the head with cell phone.
  12. People having active medical implants should keep their cellphone at least 30 cm away from the implant.
  13. There is a 400% increase in the risk of brain cancer among teenagers using cell phones for long periods.
  14. The younger the child, the deeper is the penetration of electromagnetic radiation as children`s skulls are thinner.
  15. Exposure to radiation from mobile towers and mobile phones could have an adverse impact on male fertility and pose health hazards by depleting the defence mechanism of cells. (Source TOI)

Dr KK Aggarwal
Editor in Chief
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  eMedinewS Audio PostCard

 2nd eMedinewS revisiting 2010

Revisiting the Year 2010 with Dr KK Aggarwal
New CPR Guideliness

 

Audio PostCard
 
  Quote of the Day

(By Dr GM Singh)

Friends are kisses blown to us by angels.

 
    Photo Feature (from the HCFI Photo Gallery)

Thickness of neck artery or leg artery wall– a new test to diagnose early heart diseases

Measurement of the wall thickness of the neck artery or the leg artery is a new way to diagnose early heart diseases. A special campaign on awareness of neck and keg artery thickness in the month of February was launched at a press conference. In the photo: Ms Shovana Narayan, noted Kathak exponent and Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India

 
Dr K K Aggarwal
 
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Paediatric meet focuses on handling emergencies

Training on handling emergencies would bring down mortality in children was the message that speakers conveyed at the inauguration of the third National Assembly on Paediatric Emergency Medicine held here on Saturday. Paediatricians who addressed medical students and practitioners emphasised the need to be equipped to handle emergencies instead of merely shifting a very sick child to a hospital. When confronted with an emergency, a patient should not be expected to travel, said N. Janakiraman, who is credited with starting the Paediatric Advanced Life Support course in India. Instead, doctors should be equipped to stabilise the patient by organising an emergency response system within a radius of 500 m, and then arrange for transport. The course was introduced in Indian hospitals in 1991. Lauding the progress made in reducing the mortality rate, he urged universities to train medical students in basic emergency care.
(Source: http://www.thehindu.com/news/cities/Chennai/article1137341.ece)

 
    International News

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC http://www.isfdistribution.com)

Resveratrol boosts levels of fat–control hormone

If shoring up heart and cell health isn’t reason enough to try resveratrol, then perhaps help trimming down the midsection will add some extra motivation. A new study from University of Texas Health Center suggests that supplementing daily with the anti–aging compound found in grapes may increase production of a hormone produced by fat cells called adiponectin. Adiponectin has a wide range of benefits and increased amounts of the hormone are associated with greater insulin sensitivity and reduced bodyweight. The study should interest anyone who is growing older or wants to lose weight, according to the study’s senior author Feng Liu, professor of pharmacology and member of the Barshop Institute of Longevity and Aging Studies at the Health Science Center. The study, published in the Journal of Biological Chemistry, may help unravel a novel mechanism by which resveratrol acts to deliver health benefits, apart from its well–reported activation of Sirtuin 1, the "longevity gene."

(Dr GM Singh)

New guidelines on testing for gonorrhoea

A number of factors have driven a change towards molecular detection of Neisseria gonorrhoeae in recent years. Nucleic acid amplification tests (NAATs) have a number of advantages over older, culture methods including; the use of non–invasive specimens and a greater tolerance of NAATs to inadequacies in specimen collection or storage. This makes testing easier in both GUM and non–GUM settings. The National Chlamydia Screening Programme rollout also means that STIs in non–GUM settings – particularly in young people aged under 25 – could be feasible with NAATs. This led the Health Protection Agency and BASHH to draw up new guidance on testing for gonorrhoea. Although much of the guidance is aimed at laboratories, it does make a number of recommendations of interest to primary care, including:

  • There is no evidence base to support widespread unselected testing for gonorrhoea in the community.
  • Care pathways must be in place to ensure prompt and effective treatment of gonorrhoea and contact tracing in all settings.
  • In non–GUM settings, referral into specialist STI clinics is recommended for appropriate treatment and partner notification, and to complete a full STIL screen, including HIV testing.

BASHH has also produced supplemental advice on the use of spectinomycin – an antibiotic still used occasionally in the UK for the treatment of gonorrhoea in cases of penicillin allergy.

(Dr Monica and Brahm Vasudev)

New administration guidelines urge lower salt consumption

Two out of three Americans are overweight or obese. People need to make big changes in their eating habits to fight the obesity epidemic and a host of ailments caused by poor diets, including consuming less sugar, fat and salt and more fish, fruits and vegetables, the Obama administration recommended Monday. The new guidelines urge people to avoid oversized portions, choose products that are lower in sodium, opt for water instead of sugary drinks and eat more fruits and vegetables –– half a plateful.

Gestational diabetes may portend full–fledged type 2 diabetes later

Despite the fact that "roughly half of women who’ve had gestational diabetes…go on to develop full–fledged type 2 diabetes in the months to years after their child’s birth," a new study involving some 900,000 pregnant women and published in the journal Obstetrics and Gynecology reveals that "fewer than one in five of those women returns for a crucial diabetes test within six months of delivery

 
    Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

Are there any symptoms a woman/couple may notice that might indicate an inability to conceive?

Women who have extreme pain associated with ovulation or menstruation may be at risk for endometriosis and should seek expert care. Women who are annovulatory (don’t ovulate) or who have very irregular cycles may be at risk for polycystic ovarian disease and should seek expert care. Unmanaged, these diseases can cause serious barriers to fertility. However, early treatment and expert management can preserve a woman’s fertility.

For queries contact: banerjee.kaberi@gmail.com

 
    Pediatrics Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity

What is the etiopathogenesis of CMV infection?

Cytomegalovirus (CMV), a ß–group herpesvirus latently infects monocytes and their bone marrow progenitors. It can be reactivated when cellular immunity is depressed.
CMV can infect dendritic cells and impair their maturation and ability to stimulate T cells. CMV can elude immune responses by downmodulating MHC class I and II molecules

 
    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

What should be experience of training of doctor for MTP?

For the purpose of Clause (d) of Section 2, a registered medical practitioner shall have one or more of the following experience or training in gynaecology and obstetrics, namely:

  • In the case of a medical practitioner who was registered in a state Medical Register immediately before the commencement of the act, experience in the practice of gynecology and obstetrics for a period of not less than three years;
  • In the case of a medical practitioner who was registered in a state Medical Register on or after the date of the commencement:
    • if he has completed six months of house surgency in gynaecology and obstetrics;
    • where he has not done any house surgency, if he had experience at a hospital for a period of not less than one year in the practice of in the case of a medical practitioner who was registered in a state Medical Register; or
  • If he has assisted a registered medical practitioner in the performance of twenty five cases of medical termination of pregnancy in a hospital established or maintained, or a training institute provided for this purpose, by the government.
  • In the case of a medical practitioner who was registered in a state Medical Register and who holds a post–graduate degree or diploma in gynaecology and obstetrics, the experience or training gained during the course of such degree or diploma.
 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum osteocalcin

Alternative name: Bone g1a protein measurement

Osteocalcin is a major protein found in bone. Small amounts of this protein are found in the bloodstream.This analysis is normally used to help evaluate bone formation disorders. Also it is used when a secondary malignant neoplasm of the bone is suspected. Finally it may also be used to monitor postmenopausal women who are at risk for osteoporosis.

High Osteocalcin levels in blood are found with:

  • Adolescent growth spurts (40–80 mcg/L in boys)
  • Chronic renal failure
  • Hyperthyroidism

Low Osteocalcin levels in blood are found with:

  • Pregnancy
  • Cirrhosis
 
    Medi Finance Update

Current Budget

  • Tax rebate under Section 88 on Tuition Fee to the extent of Rs.12,000 per child for two children.
  • Direct crediting of all refunds to the bank account of the tax payer through electronic clearance system (ECS). Electronic filing of return
 
    Drug Update

LIST OF APPROVED DRUG FROM 01.01.2010 TO 31.8.2010

Drug Name

Indication

DCI Approval Date

Cefixime 100mg/200mg + Cloxacillin 500mg/500mg tablets

For the treatment of adult patients with upper and lower respiratory tract infections, skin and soft tissue infections

12/02/2010

 
    IMSA Update

International Medical Science Academy (IMSA) Update

Atrial fibrillation: Lenient versus strict rate control

A randomized trial in patients with atrial fibrillation compared a lenient rate control strategy (resting heart rate <110 beats per minute) with a strict rate–control strategy (resting heart rate <80 beats per minute and heart rate during moderate exercise <110 beats per minute). There was no significant difference in the primary composite outcome at three years, but nearly nine times as many visits were required to achieve the strict rate control targets.

(Ref: Van Gelder IC, et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med 2010;362:1363).

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient wanted to know if a gel was available for use along with a condom for a high–risk sex.
Dr Bad: There is no such gel.
Dr Good: There is one such gel.
Lesson: In July 2010, the Centre for the AIDS Programme of Research in South Africa (CAPRISA) reported that a vaginal gel containing the antiretroviral drug tenofovir reduced the risk of male–to–female sexual transmission of HIV by approximately 40%. NIH funding provided the training and research infrastructure for this study.

Make Sure

Situation: A 7–month–old infant presented with grunting respiration, fever, anorexia and irritability. On chest x–ray, pneumatoceles were present.
Reaction: Oh my God! Why did you not start erythromycin immediately?
Lesson: Make sure to remember that erythromycin is an effective drug for Staphylococcal acquired pneumonia.

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Our Contributors
  Docconnect Dr Veena Aggarwal
  Docconnect Dr Arpan Gandhi
  Docconnect Dr Aru Handa
  Docconnect Dr Ashish Verma
  Docconnect Dr A K Gupta
  Docconnect Dr Brahm Vasudev
  Docconnect Dr GM Singh
  Docconnect Dr Jitendra Ingole
  Docconnect Dr. Kaberi Banerjee
  Docconnect Dr Monica Vasudev
  Docconnect Dr MC Gupta
  Docconnect Dr. Neelam Mohan
  Docconnect Dr. Naveen Dang
  Docconnect Dr Prabha Sanghi
  Docconnect Dr Prachi Garg
  Docconnect Rajat Bhatnagar
  Docconnect Dr Sudhir Gupta
 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Prachi Garg)

Why it is so hard to let go

The cheerful girl with bouncy golden curls was almost five. Waiting with her mother at the checkout stand, she saw them: a circle of glistening white pearls in a pink foil box.

"Oh please, Mommy. Can I have them? Please, Mommy, please?" Quickly the mother checked the back of the little foil box and then looked back into the pleading blue eyes of her little girl’s upturned face. "A dollar ninety–five. That’s almost $2.00. If you really want them, I’ll think of some extra chores for you and in no time you can save enough money to buy them for yourself. Your birthday’s only a week away and you might get another crisp dollar bill from Grandma." As soon as Jenny got home, she emptied her penny bank and counted out 17 pennies. After dinner, she did more than her share of chores and she went to the neighbor and asked Mrs. McJames if she could pick dandelions for ten cents.

On her birthday, Grandma did give her another new dollar bill and at last she had enough money to buy the necklace. Jenny had a very loving daddy and every night when she was ready for bed, he would stop whatever he was doing and come upstairs to read her a story. One night when he finished the story, he asked Jenny, "Do you love me?" "Oh yes, Daddy. You know that I love you." "Then give me your pearls." "Oh, Daddy, not my pearls. But you can have Princess – the white horse from my collection. The one with the pink tail. Remember, Daddy? The one you gave me. She’s my favorite." "That’s okay, Honey. Daddy loves you. Good night." And he brushed her cheek with a kiss.

About a week later, after the story time, Jenny’s daddy asked again, "Do you love me?" "Daddy, you know I love you." "Then give me your pearls." "Oh Daddy, not my pearls. But you can have my baby doll. The brand new one I got for my birthday. She is so beautiful and you can have the yellow blanket that matches her sleeper." "That’s okay. Sleep well. God bless you, little one. Daddy loves you" And as always, he brushed her cheek with a gentle kiss.

With tears gathering in his own eyes, Jenny’s kind daddy reached out with one hand to take the dime–store necklace, and with the other hand he reached into his pocket and pulled out a blue velvet case with a strand of genuine pearls and gave them to Jenny. He had them all the time. He was just waiting for her to give up the dime–store stuff so he could give her genuine treasure.

So it is with our Heavenly Father. He is waiting for us to give up the cheap things in our lives so that he can give us beautiful treasure. Isn’t God good?

Are you holding onto things which God wants you to let go of. Are you holding on to harmful or unnecessary partners, relationships, habits and activities which you have come so attached to that it seems impossible to let go? Sometimes it is so hard to see what is in the other hand but do believe this one thing……………

God will never take away something without giving you something better in…

— — — — — — — — — —

Mind Teaser

Read this…………………

k
c
u
t
s

Yesterday’s Mind Teaser: CirKEEPcle
Answer for Yesterday’s Mind Teaser: Keep in shape

Correct answers received from: Dr Rakesh Bhasin, Dr KP Rajalakshmi, Dr (Maj. Gen.) Anil Bairaria, Dr Riyazul Qamar Khan, Dr K.Raju, Dr Asim Kumar Sen, Dr H.L. Kapoor, Dr Maneesh Gupta, Dr Chandresh Jardosh, Dr Muthumperumal Thirumalpillai, Dr Sanket Kumar Gupta, Dr Prabha Sanghi, Dr Jainendra Upadhyay, Dr Anupam Sethi Malhotra, Dr Satyoban Ghosh

Answer for 3rd February Mind Teaser: Hole in one
Correct answers received from: Dr Muthumperumal Thirumalpillai, Dr Neelam Nath, Dr Vijay Kansal, Dr Shashi Chhabra, Dr Sudipto Samaddar, Dr Maneesh Gupta, Dr Raju Kuppusamy, Dr Rashmi Chhibber, Dr K.P.Rajalakshmi

Send your answer to ijcp12@gmail.com

— — — — — — — — — —

Laugh a While
(Contributed by Dr G M Singh)

The border

Juan comes up to the Mexican border on his bicycle. He’s got two large bags over his shoulders. The guard stops him and says, "What’s in the bags?" "Sand," answers Juan.
The guard says,"We’ll just see about that. Get off the bike." The guard takes the bags and rips them apart; he empties them out and finds nothing in them but sand. He detains Juan overnight and has the sand analyzed, only to discover that there is nothing in the bags. The guard releases Juan,puts the sand into new bags, hefts them onto the man's shoulders, and lets him cross the border.

A week later, the same thing happens. The guard asks, "What have you got?" "Sand," says Juan. The guard does his thorough examination and discovers that the bags contain nothing but sand. He gives the sand back to Juan, who crosses the border on his bicycle. This sequence of events is repeated every week for three years. Finally, Juan doesn’t show up one day and the guard meets him in a cantina in Mexico. "Hey, Buddy," says the guard, "I know you are smuggling something. It’s driving me crazy. It’s all I think about. I can’t sleep. Just between you and me, what are you smuggling?"

Juan sips his beer and says, "Bicycles."

— — — — — — — — — —

Knowledge is amusing

NEWS refers to information from Four directions N, E, W, and S.

 
    Readers Responses
  1. eMedinewS is the only excellant news bulletin we are receiving sofar, kindly continue to send the same as before. All of you deserve high appreciation and thanks for the wonderful service rendered by the team. Regards. Dr N. Sarmah.
 
    Public Forum

(Press Release for use by the newspapers)

Neck Artery Wall Thickness and Plaque Area – a new test to diagnose early heart diseases

Treadmill, stress echocardiography, Thallium and Angiography do not detect early blockages. Treadmill can miss blockages up to 70%; stress echocardiography up to 60%, angiography upto 40%.

Most heart attacks occur because of a plaque rupture in patients with blockages of less than 50%. If the blockage is more than 70% the patient usually presents with heart pain and not massive heart attack.

Addressing a press conference here, Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal, who is also a Senior Consultant in Moolchand Medcity and President Heart Care Foundation of India, said that the only way to detect heart blockages before they cause symptoms or are detected in conventional tests is to measure the wall thickness of the neck artery or the leg artery. Normally, the wall thickness is less than 0.5mm. If the wall thickness is more than 0.75mm, it is suggestive of underlying heart blockages and if it is more than 1mm, it is suggestive of blockages in all three arteries of the heart.

Any thickness of more than 1mm is called as a plaque and a plaque area calculated by high resolution ultrasound is a new marker for heart blockages, progression as well as regression.

If the artery wall is thick in both the neck artery and the leg artery, it is very likely that the patient will also have blockages in the arteries of the heart.

All high risk individuals, therefore, should have their neck and leg artery wall thickness checkup done. Only 2% of patients with blockages in all three arteries of the heart have a neck artery wall thickness of less than 1mm and 94% of patients with a neck artery wall thickness of more than 1.15mm will have multiple blockages in the heart.

Launching the campaign, Ms Shovana Narayan, noted Kathak exponent, said that most Indians were immune to heart diseases in the past as they used to follow conventional rituals and participated in classical yoga or dances. Today, the faulty western lifestyle adopted by Indians is responsible for the new epidemic leading to diabetes, high blood pressure, heart blockages etc.

Most heart blockages are inflicted in adolescence and early adult age. There is enough data to suggest that thickening of the neck artery starts in high risk children and very young people. Plaque formation usually occurs after the age of 35. Therefore, before the age of 35, a leg artery wall thickness is the only test to know future chances of heart attack and paralysis.

With the availability of advanced softwares, most advanced cardiac centres in Delhi with high resolution echocardiography machine can do this test.

Women with chest pain and normal neck artery morphology may not need angiography and a neck artery wall thickness test of less than 0.55mm is also a predictor of patient’s significant blockages in the heart. A plaque thickness of more than 1.5mm is associated with family history of premature cardiac deaths.

Dr. Aggarwal said that Vasant Panchami falling on 8th February is the official Valentine’s Day in the Hindu calendar and one can celebrate this day by gifting a neck artery measurement to one’s beloved.

4th February is also a World Cancer day and most cancers today are life style related. The examples are prostate, breast, lungs. The risk factors are same as that of heart blockages. Neck artery thickness is also a marker of future cancers in these patients.

Moolchand Medcity is organizing a special campaign on awareness of neck and keg artery thickness in the month of February. On the 13th of this month, there will be a family physician training program on this subject.

 
    Forthcoming Events

Maulana Azad Medical College SPIC-MACAY chapter is organizing a festival of music & dance

Date: 2nd to 5th February, 2011. 
All are invited

"MAMC SPIC MACAY VIRASAT 2011"

2nd February, Wednesday   3:00 pm– 4:00 pm    Panchavadyam by Vidwans – Auditorium Inauguration – Dr Sonal Mansingh (Odissi Dance) Pandit Hariprasad Chaurasia (Flute)
3rd February, Thursday, 10:00 am – Madhubani Painting Workshop – by Smt. Shanti Devi – Old Girl’s Hostel
4th February, Friday, 4:00 pm –Qawwalli by Qadir Niazi and troupe– Auditorium
5th February, Saturday, 9:00 am – Heritage walk by Dr. Ramji Narayan  –(Ferozshah Kotla)
Meeting point college fountain

We look forward to having you with us during this festival.

*Please be seated 15 minutes before the event,
*We request you to switch off your cellphones during the programmes.
*No flash photography and videography allowed during the programme.

Maulana Azad Medical College has been organizing such programmes for students, staff, faculty and doctors. The aim being to experience the beauty of our culture and enrich lives with beautiful moments.  The programmes are extremely relaxing for all. Such programmes are important as they help decrease stress, something which all doctors experience in routine.
 

eMedinewS Events: Register at emedinews@gmail.com

Conference Column

Workshop on Fetal and Paedatric Echocardiography Pre and perinatal management of heart disease

13th February 2011, Sunday, Moolchand Medcity

  1. Fetal Echocardiography–How to get it right: Dr Vandana Chaddha
  2. Fetal Cardiac Spectrum– abnormal cases with interactive session: Dr Vandana Chaddha
  3. Neonatal Cardiac Cases– Hits and misses inetractive session: Dr Savitri Srivastava
  4. Intima Media Thickness and Plaque Volume, New Marker for Atherosclerosis Regression: Dr KK Aggarwal

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