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Editor-in-Chief eMediNexus – Dr KK Aggarwal
1st September 2018
Think before you prescribe

Dr KK Aggarwal, Recipient of Padma Shri

Monitor electrolytes in hypertensive patients on thiazide diuretics

Thiazide diuretics have been widely used for the treatment of hypertension. Their efficacy and cost-effectiveness often makes them a first-line choice in treating hypertensive patients. However, their effectiveness in patients with chronic kidney disease (CKD), especially those with a glomerular filtration rate less than 30 ml/min/1.73 m2, has been of concern. Consequently, they were thought to be ineffective in patients with advanced CKD.

There have been studies, which have documented the beneficial effects of thiazide diuretics in moderate to advanced CKD challenging this widely held belief. Chlorthalidone was found to significantly reduce BP among people with moderate to advanced CKD with poorly controlled hypertension in a small study. Albuminuria was significantly reduced by 40-45% (Am J Nephrol. 2014;39(2):171-82). But, the 2017 ACC/AHA guideline for treatment of hypertension recommend loop diuretics in patients with moderate to severe more

Top News

Cases of dengue show an increasing trend in flood-hit Kerala

A rising trend in cases of leptospirosis, acute diarrheal disease and dengue has been observed in flood-hit Kerala. The government is closely monitoring the disease surveillance data for potential outbreak of epidemic prone diseases. As of date, Union Government has supplied 73 MT of essential emergency drugs; 58 items of essential drugs/ consumables weighing about 120 MT, and 40 Ultra Low Volume (ULV) Fogging Machines are also being sent to the state.... read more

Morning Medtalks

Morning MEDTalks with Dr KK Aggarwal 1st September 2018

Health Ministry has formulated a draft policy for prevention and control of hemoglobinopathies - thalassemia, sickle cell disease and variant hemoglobins in India. The policy envisages creation of centres of excellence in states that will have advanced facilities required for comprehensive care for patients with thalassemia/sickle cell disease, including a bone marrow transplant unit and a prenatal diagnostic center. The centers of excellence will provide technical support for thalassemia in the medical colleges, tertiary care hospitals, district level health facilities and primary health centers and also impart training to the health professionals. ... read more

Practice Updates

Using laryngeal tubes to resuscitate patients associated with higher survival rate

Results of the multicenter Pragmatic Airway Resuscitation Trial show that use of the newer laryngeal tube for intubation by paramedics in prehospital settings to resuscitate patients with sudden cardiac arrest can significantly improve the chances of survival. Overall, 18.3% of patients survived three days in the hospital and 10.8% survived to reach hospital discharge. For the group... read more

Listening to yoga music at bedtime is good for the heart

Listening to yoga music at bedtime is good for the heart, according to research presented August 27, 2018 at the ESC Congress 2018. The heart rate variability increased during the yoga music, decreased during the pop music, and did not significantly change during the silence. Anxiety... read more

Impaired coronary microvascular function is highly prevalent in HFpEF

Impaired coronary microvascular function is highly prevalent in patients with heart failure with preserved ejection fraction (HFpEF) in the absence of unrevascularized macrovascular coronary artery disease (CAD) and is associated with NTproBNP (a marker of HF severity), systemic... read more

FDA warns about occurrence of serious genital infection with SGLT2 inhibitors

The US Food and Drug Administration (FDA) is warning that cases of necrotizing fasciitis of the perineum, also known as Fournier’s gangrene, a rare but serious infection of the genitals and area around the genitals have been reported with SGLT2 inhibitors. FDA has asked for a new... read more

Obstructive sleep apnea increases the risk of gout

People with obstructive sleep apnea (OSA) may have a higher risk of developing gout, according to a study published online August 30, 2018 in Arthritis and Rheumatology. The risk of incident gout among OSA patients compared to those without was highest one to two years after index... read more

eMedi Humor
Medicolegal Corner
eMedi Quiz
1. Rotavirus infection.
2. Enterotoxigenic E. coli infection
3. Staphylococcal toxin.
4. Clostridium perfringens infection.
Lifestyle Updates
Inspirational Story 1: The Touchstone
Inspirational Story 2: Do not be jealous
Exposure to environmental toxins can cause heart diseases in the longerterm
Heart disease is emerging as the number one killer in India
New Delhi, 31 August 2018: Exposure to environmental toxic metals such as arsenic, lead, copper and cadmium are linked to an increased risk of cardiovascular disease and coronary heart disease, as per recent research. Exposure to arsenic was found to be significantly associated with a 23% greater relative risk of coronary heart disease and a 30% greater relative risk of composite cardiovascular disease.

Estimates indicate that India will soon have the highest number of heart disease cases in the world. About 50% of all heart attacks in Indians occur under 50 years of age and 25% in Indians under 40 years of age. Population living in the cities is three times more prone to heart attacks than people living in villages.

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