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Editor-in-Chief eMediNexus – Dr KK Aggarwal
16th September 2018
Add another anti-HT drug, instead of increasing dose of the initial anti-HT drug

Dr KK Aggarwal, Recipient of Padma Shri

Most patients with hypertension require combination antihypertensive therapy to control their BP. Monotherapy has been the usual practice followed by step wise titration of the dose of the first drug prescribed to its maximum, before adding another drug or switching to another drug, if the target BP is still not achieved.

A meta-analysis of 42 trials involving 11,000 participants published in Am J Med. 2009;122:290-300 which compared the effects of combining drugs with doubling dose showed that the extra BP reduction from combining drugs from two different classes is approximately 5 times greater than doubling the dose of one drug. Low dose combination therapy also has the advantage of reducing the adverse effects in comparison to maximum dose of more

Top News

SC issues directions to end stigma attached to leprosy patients

New Delhi, Sep 14 (PTI) In a bid to remove centuries old stigma attached to leprosy patients, the Supreme Court Friday directed the Centre to consider framing separate rules for issuing them disability certificates so that they can avail of reservation and various other welfare benefits. The apex court said that acceptability of leprosy patients in the society would go a long way in... read more

Second case of monkeypox in the UK

A second person has been diagnosed with the deadly monkeypox virus in England, just a few days after the first case was revealed. The patient, who had travelled to Nigeria, arrived at Blackpool Victoria Hospital with symptoms of the disease, Public Health England (PHE) said. They are now being treated at the Royal Liverpool University Hospital, a specialist centre. The... read more

Morning Medtalks

Morning MEDtalks with Dr KK Aggarwal 16th September 2018

As per the report HIV Estimations 2017, India had around 21.40 lakh people living with HIV (PLHIV) in 2017 with adult prevalence of 0.22%. Around 87.58 thousand new HIV infections and 69.11 thousand AIDS related deaths happened in 2017 while around 22,675 mothers needed Antiretroviral Therapy (ART) for prevention of mother to child transmission of HIV (NACO)... read more

Practice Updates

TAVR associated with shorter duration of hospitalization than SAVR

According to a new study published Sept. 14, 2018 in Circulation: Cardiovascular Interventions, a significantly greater reduction in the average length of hospital stay was observed in patients who underwent TAVR compared to those who underwent SAVR. They were also significantly less ... read more

Biologics increase risk of serious infections in patients with refractory atopic dermatitis

Treatment of a refractory atopic dermatitis with a biologic agent doubled the risk of hospitalization for a serious bacterial or opportunistic infection vs high-potency topical steroids or nonbiologic systemic therapy. Infection risk also varied substantially among nonbiologic systemic agents, with cyclosporine posing the lowest risk and azathioprine and mycophenolate the greatest risk. These... read more

18F-FDG PET/CT scan may detect early coronary artery disease in psoriasis patients

In this cross-sectional cohort study of patients with psoriasis assessed with 18F-FDG positron emission tomography/computed tomography and coronary computed tomography angiography, aortic vascular inflammation was directly associated with quantitative burden of coronary artery disease, luminal stenosis severity within the coronary arteries, and the prevalence of high-risk... read more

Eating more whole grain foods lowers the risk of type 2 diabetes

The study from the Danish Diet, Cancer, and Health Cohort published in the September 2018 issue of the Journal of Nutrition says that eating more whole grain foods such as rye bread, whole grain bread, or oatmeal/muesli significantly lowers the risk of developing type 2 diabetes among... read more

Pembrolizumab + pemetrexed + platinum chemotherapy approved as first-line treatment of metastatic NSCLC

Based on efficacy and safety data from the phase 3 KEYNOTE-189 trial in patients with advanced disease, the European Commission has approved the combination of pembrolizumab (Keytruda, Merck), pemetrexed (Alimta, Lilly), and platinum chemotherapy for the first-line ... read more

eMedi Humor
Medicolegal Corner
eMedi Quiz
a. HAART should be initiated at diagnosis of TB.
b. Patient with CD4+ count of 100-200 cells/μl should complete antituberculous therapy before starting HAART.
c. The development of IRIS does not seem to be associated with any particular drug class or antiretroviral regimen.
d. IRIS often occurs following completion of antituberculous therapy.
Lifestyle Updates
Inspirational Story 2: The Trouble Tree
Suicide rates alarmingly high among Indian women
Married women fall in the high-risk category
New Delhi, 15 September 2018: A study in The Lancet has found that about 37% of global suicide deaths among women and 24% among men occur in India. Married women account for the highest proportion of suicide deaths in India, across lines of religion, geography, social class and age. Awareness needs to be raised that dangerous level of ignorance and stigmatization, family pressures, career, and financial worries and an increasing influence of social media are putting many Indians at risk.

Suicide is a public health crisis. Arranged and early marriage are thought to be behind high suicide rates among women in India.

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