emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
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

 

Live Web Cast of 3rd eMedinewS – Revisiting 2011, on January 22, 2012

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eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

 
    Live Webcast
Docconnect
 
  Editorial …

22nd January 2012, Sunday

The 3rd eMedinewS 2011 Conference is being organized today at Maulana Azad Medical College.

The 3rd eMedinewS 2011 Conference is being organized today at Maulana Azad Medical College. Those who have not registered, kindly log on to www.emedinews.in and www.emedinews.org and watch the conference live. Not only you can watch but you can also put your questions in the chat box which the speakers will be happy to answer. Do not waste your time in taking notes of the lecture as proceedings will also be available on the website after the conference for revision.

Irisin: the hormone for obesity and diabetes control

Researchers from the Dana–Farber Cancer Institute, Massachusetts, Harvard Medical School, University of California and Denmark’s Odense University Hospital, among others, have found that some of the most widely recognised effects of exercise on muscle are mediated by irisin, a hormone secreted by muscle cells. The study has been published in the latest issue of scientific journal Nature.

“Irisin is induced with exercise in mice and humans, and mildly increased irisin levels in the blood cause an increase in energy expenditure in mice with no changes in movement or food intake. This results in improvements in obesity and glucose homeostasis.

The hormone has been found to act in two ways. It promotes the conversion of inert (white) yellow fat to the metabolically more active brown fat, and facilitates insulin action, thus decreasing blood glucose levels. While white fat is used to store energy (calories),brown fat seems to be more involved in burning it. The researchers found irisin to be present in the blood of human volunteers who had undergone 10 weeks of exercise.

When irisin was introduced in sedentary mice, the physiological effects of exercise like higher metabolism, stabilisation of blood glucose levels through better uptake of glucose from blood — one of the mechanisms by which insulin works — were mimicked in the laboratory.

In the last few years, brown fat has begun to increasingly intrigue scientists. In many ways, it physically resembles muscle more than it does typical fat. While little is known about it, it seems to play a major role in maintaining normal weight. One study found that the more brown fat a person has, the lower their BMI will be. Another study found that mice with a genetic abnormality that eliminated their brown fat became obese even without overeating.

Brown fat is common in infants but was once thought to disappear in adults. Recent studies have shown that it merely decreases. It’s found mainly in the neck and upper chest of adults. In infants, brown fat is an important regulator of body temperature, helping to keep the infant warm. Unlike white fat, when brown fat is metabolized (burned), most of its energy content is converted into heat. Adults don’t seem to need this system of keeping warm. It’s not yet known precisely what function brown fat serves in adults. So far, most studies of brown fat have been done in mice, because adult mice have more brown fat than adults humans do.

In the current study, the Dana–Farber researchers injected small amounts of irisin into the muscles of sedentary adult mice that were both obese and pre–diabetic. Within 10 days of treatment, the mice showed better control of blood sugar and insulin levels –– possibly preventing the onset of full–blown diabetes –– and also lost a small amount of weight. The researchers suspect that longer therapy would have led to greater weight loss.

Irisin was named after a Greek messenger Goddess (Iris) because it’s a chemical messenger. It’s normally present as part of a larger protein in a muscle cell’s outer membrane, where it lies dormant and inactive. Exercise (and, most likely, other unknown factors) cause this protein to be split, releasing irisin, which exits the muscle cell and carries its message to other cells of the body. Ultimately, some white fat cells are told to convert to brown fat cells and islet cells of the pancreas are told to produce more insulin. (Source Indian Express)

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Dr Narendar S Yadav on 49th Annual PEDICON

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela
Eco Fest–An Inter School Eco Club’s Health Festival

Keeping the environment clean can prevent a large number of communicable diseases

 
Dr K K Aggarwal
 
    National News

3rd eMedinewS Revisiting 2011

eMedinewS Revisiting is an annual event organized by Emedinews, the first national daily e medical newspaper of the country, in the month of January. The day–long conference provides updated information about the latest news, views, new drug launches, breakthroughs in medicine, and much more and helps physicians, medical students and other health professionals keep up with advances in medicine.

This year, the 3rd eMedinewS: Revisiting 2012 is being held on January 22, 2012, Sunday at Maulana Azad Medical College (MAMC) Auditorium. The one–day conference will revisit and discuss all the major breakthroughs and advances in medicine of the year 2011 both at home and abroad. An eminent faculty will speak at the conference. There is no registration fee.

Watch the live webcast of 3rd eMedinewS RevisitinG 2011 at
http://emedinews.24framesdigital.com/webcast/220112/, www.emedinews.in/www.emedinews.org.
People from all over the world will be able to view the conference live on the website.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology: Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    International News

FAME II trial halted

FAME II trial, which is assessing the efficacy of fractional flow reserve as a tool to improve stenting outcomes, was halted after an analysis revealed a significant benefit for patients in the FFR arm.

An interim analysis revealed a significant reduction in both hospital readmissions and urgent revascularizations among patients treated with FFR–guided percutaneous coronary interventions plus optimum medical therapy compared with optimum medical therapy alone. FFR relies on a pressure wire to determine the hemodynamic severity of stenosis.

For comments and archives

No Safe Limit of Alcohol in Pregnancy

There is no safe amount of alcohol use during pregnancy, confirms a new study based on prospectively collected data on nearly 1,000 women, said Haruna Sawada Feldman, PhD, MPH, of the Department of Pediatrics, University of California, San Diego, La Jolla.

Women who are of childbearing age and who are contemplating or at risk for becoming pregnant should be encouraged to avoid drinking, and women who are pregnant should abstain from alcohol throughout pregnancy. The study was published online January 17 in Alcoholism: Clinical & Experimental Research.

For comments and archives

MTX monotherapy still the treatment of choice in RA

Methotrexate (MTX) is currently the cornerstone in the treatment of rheumatoid arthritis (RA) and recommended as first–line therapy.

Both the treatment recommendations from the European League Against Rheumatism (EULAR) and recently published recommendations for the use of MTX in rheumatic diseases advocate MTX monotherapy as the first choice rather than combinations of MTX with other synthetic disease–modifying antirheumatic drugs (sDMARDs)

However the American College of Rheumatology recommends MTX or other DMARDs as monotherapy or MTX in combination with other DMARDs, depending on the disease duration and level of disease activity. The efficacy of adding a tumour necrosis factor a inhibitor (TNFi) to MTX in patients who are MTX inadequate responders (IR) is well established.

It is currently required that two or more sDMARDs must have failed before initiation of TNFi therapy or moderate to high disease activity level and inadequate response to MTX in patients with RA.

For comments and archives

 
    Twitter of the Day

@DrKKAggarwal: 90% of Food Allergies Are Associated With 8 Food Types

@DeepakChopra: Universal love requires one thing, that the sweet point in the heart expand until bliss and peace become the nature of our life.

 
    Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Six uses of Tila (Sesame)

  1. ShatTila Ekadashi is observed in Magh month and is based on six uses of Tila.
  2. It is also known as TilDa Ekadashi (Til means Sesame and Da means donation)
  3. Here Tila is used in six different ways

For comments and archives

 
    Infertility Update

(Dr Kaberi Banerjee, IVF expert, New Delhi)

Mention some primary risk of ART procedure?

Some of the primary risks of ART procedures:

Ovarian stimulation carries a risk of hyperstimulation, where the ovaries become swollen and painful. Fluid may accumulate in the abdominal cavity and chest, and the woman may feel bloated, nauseated, and experience vomiting or lack of appetite. According to western figures 30% of woman undergoing ovarian stimulation have a mild case of ovarian hyperstimulation syndrome (OHSS) that can be managed with over the–counter painkillers and a reduction in activity. Up to 2% of women develop severe OHSS characterized by excessive weight gain, fluid accumulation in the abdomen and chest, electrolyte abnormalities, over–concentration of the blood, and, in rare cases, the development of blood clots, kidney failure, or death. Women with severe OHSS require hospitalization until the symptoms improve. If pregnancy occurs, OHSS can worsen. initial reports suggested that women who use fertility drugs have an increased risk for ovarian cancer, numerous recent studies support the conclusion that fertility drugs are not linked to ovarian cancer.

For comments and archives

 
    An Inspirational Story

(Ms Ritu Sinha)

Working Towards What You Already Have

The American investment banker was at the pier of a small coastal Mexican village when a small boat with just one fisherman docked. Inside the small boat were several large yellow fin tuna. The American complimented the Mexican on the quality of his fish and asked how long it took to catch them. The Mexican replied, "Only a little while."

The American then asked, "Why didn’t you stay out longer and catch more fish?" The Mexican said, "With this I have more than enough to support my family’s needs." The American then asked, "But what do you do with the rest of your time?"

The Mexican fisherman said, "I sleep late, fish a little, play with my children, take siesta with my wife, Maria, stroll into the village each evening where I sip wine and play guitar with my amigos, I have a full and busy life."

The American scoffed, "I am a Harvard MBA and could help you. You should spend more time fishing; and with the proceeds, buy a bigger boat: With the proceeds from the bigger boat you could buy several boats. Eventually you would have a fleet of fishing boats. Instead of selling your catch to a middleman you would sell directly to the processor; eventually open your own cannery. You would control the product, processing and distribution. You would need to leave this small coastal fishing village and move to Mexico City, then Los Angeles and eventually New York where you will run your ever– expanding enterprise."

The Mexican fisherman asked, "But, how long will this all take?" To which the American replied, "15 to 20 years." "But what then?" asked the Mexican. The American laughed and said that’s the best part. "When the time is right you would announce an IPO and sell your company stock to the public and become very rich, you would make millions." "Millions? Then what?"

The American said, "Then you would retire. Move to a small coastal fishing village where you would sleep late, fish a little, play with your kids, take siesta with your wife, stroll to the village in the evenings where you could sip wine and play your guitar with your amigos."

For comments and archives

 
    Cardiology eMedinewS

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Marathons Pose Little Risk to Heart

Read More

Pradaxa Linked to More MIs in Certain Patients

Read More

Statins Tied to Lung Damage in Smokers

Read More

Who Can Conduct The Enquiry?

Read More

 
    Pediatric eMedinewS

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Movement Disorders In Children: Etiological Approach: PA Mohammed Kunju

Read More

P. vivax Presenting As Acute Glomerulonephritis

Read More

East Syndrome – First Report From India

Read More

"Shrikhande ke Sundae" – Tips on How To Be A Good Pediatrician: D Y Shrikhande

Read More

Polio eradication in India: Panel discussion at pedicon 2012: Prof. A. Parthasarathy

Read More

Panel Discussion: Polio Eradication: Dr A Parthasarathy

Read More

APPROACH TO A CHILD WITH ASCITES: Dr Ujjwal Poddar

Read More

 
    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Distance vision

The ability to see clearly is essential for safe driving.

Even the simplest reactions can take 0.4 seconds.

 
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emedinews revisiting 2011
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    IJCP Special

Dr Good Dr Bad

Situation: A patient came with acid peptic disease.
Dr Bad: You can eat anything.
Dr. Good: Avoid pungent, sour and salty food.
Lesson: Pungent, sour and salty foods increases acid in the stomach.

For comments and archives

Make Sure

Situation: A patient with acid peptic disease was denied any painkiller for his distressing illness.
Reaction: Oh, my God! Why did you not give him nimesulide?
Lasson: Make sure to prescribe nimesulide as it is safe in acid peptic disease.

For comments and archives

 
    Quote of the Day

(Dr GM Singh)

Success seems to be connected with action. Successful people keep moving. They make mistakes, but they don’t quit. ~ Conrad Hilton

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Stool Examination

Diarrhea is a common symptom of a gastrointestinal disturbance.
O & P (Ova and Parasite) testing: A microscopic evaluation of stool for parasites and the ova (eggs, cysts) of parasites. A basic test but very important!!

 
    Mind Teaser

Read this…………………

ababaaabbbaaaabbbb ababaabbaaabbb

Yesterday’s Mind Teaser: b
                                     bow
                                     w

Answer for Yesterday’s Mind Teaser: Crossbow

Correct answers received from: Dr Avtar Krishan, Dr Thakor Hitendrasinh G, Dr KV Sarma, Raju Kuppusamy, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai
.

Answer for 20th January Mind Teaser: d. all of the above
Correct answers received from: Dr Hiren, Dr Sharad, Dr Piyush, Dr Shubham, Dr Shipra, Dr Kshitish,
Dr KP Singh.

Send your answer to ijcp12@gmail.com

 
   Laugh a While

(Dr GM Singh)

Boss: Have you ever seen an owl?
Man (looking down) No Sir……
Boss: Don't look down. Look at me.

 
    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

Witness–doctor "selling his testimony

In United States today the liveliest intra–professional and inter–professional discussion resolved about the witness–doctor "selling his testimony" as a witness for either party on payment. The modern court has warned of this danger, said put the role of medical witness in its true perspective. Doctor as expert/forensic witness is a part of trial apparatus of court in finding the whole medical truth and facts and every possible step should be taken to channel his contribution in a direction that will serve to achieve truth and justice in the court of law if such medical witness will be paid from one party then how he/she will be towards the whole truth of medical perusal. One such step suggested by the American court is to make/treat the expert medical witness reports as non-partisan, objective and scientific as are the notable activities of his profession.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

Give your child a chewable deworming tablet

All school going children should be given a single dose of albendazole (400 mg). It is effective in almost 100 percent of cases of worm infestations including round worm and hookworms, said Padmashri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

The cure rate of round worm infection is 97.4% and egg reduction after treatment is 99.9%. The cure rate for hookworm infection is 93.1% with 96.6% egg reduction.

The drug needs to be repeated every four months as the reinfection rate at 4 months after treatment is 54.5% and 10.3% for round worm and hookworm infection, respectively.

Four-monthly targeted periodic treatments with 400 mg single–dose albendazole in highly endemic areas can have a significant impact on intensity of round worm and hookworm infection.

Although round worm infection occurs at all ages, it is most common in children 2 to 10 years old, and prevalence decreases over the age of 15 years. Infections tend to cluster in families, and worm burden correlates with the number of people living in a home.

Mass treatments with single dose albendazole or mebendazole for all school–age children every three to four months have been used in some communities. This serves the dual function of treating children and reducing the overall worm burden in the community.

In a large randomized trial of school–based deworming performed in Zanzibar, single dose mebendazole, given either twice or three times a year, decreased intensity of round worm infection by 63 and 97 percent, respectively, compared to control children who received no mebendazole.

 
    Readers Responses
  1. Thank you for useful information. Dr.T.H.Saherwala
 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS–revisiting 2011 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2011. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

See programme below.

There is no registration fee. All delegates will get Registration Kit, Attractive gifts, Certificates. Morning snacks and lunch will be provided.

3rd eMedinewS Doctor of the Year Awards

Dear Colleague, the 3rd eMedinewS "Doctor of the Year Awards" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 3 pm

More than 1100 people have registered for the conference.

View Live Webcast of 3rd eMedinewS–Revisiting 2011 at: www.emedinews.org/www.emedinews.in

Viewer Requirements

  • Windows Media Player 9.0 or above for live webcast version
  • PC: P4 (Pentium 4), 1GB RAM, good quality multimedia kit, good Internet connectivity–ideally broadband connectivity–512 kbps or 1 mbps and above dedicated bandwidth
  • Firewall etc. should allow streaming content
  • Ports 80 and 8080 should be opened to allow streaming content.

Moderator Dr K K Aggarwal

TIME

Speaker

Topic

Penalist

8.00–8.10 AM

Mahendra Kumar (LIC India)

Life Insurance Schemes

Dr Sudesh Ratan

8.10–8.25 AM

Mr Prabhakar Kabra, Sarat Upadhyaya

Doctor’s Professional Indemnity Insurance & Financial Planning

Mr Arun Kishore

8.25–8.35 AM

Dr G K Mani

Cardiac surgery in 2012

Dr Sandeep Mukherjee

8.35–8.50 AM

Himanshu Gupta (Central Bank of India)

Financial Health

Mr Anil Wadhwa

8.50–9.05 AM

Dr Dinesh Bhurani

Hemato Oncology Update

Dr Amit Bhargava

9.05–9.20 AM

Dr Kailash Singla

Gastro Update

Dr KK Aggarwal

9.20–9.35 AM

Dr Pramod Kumar

Beyond Coronaries

Dr Rakesh Arora

9.35–10.00 AM

Dr N K Bhatia

What’s new in transfusion medicine

Dr B B Rewari, Dr Bharat Singh

10.00–10.25 AM

Dr Praveen Chandra

Dual Anti Platelet Therapy in ACS

Dr H K Chopra

10.25–10.50 AM

Dr Ambrish Mithal

What’s New in Diabetes

Dr H S Luthra/Dr R K Thukral

10.50–11.15AM

Dr Ajay Kriplani

Diabetes: A curable surgical Disease

Dr K N Srivastava/Dr K Jagadeesan

11.15–11.40 AM

Dr Kaberi Banerjee

Infertility Update

Dr Veena Aggarwal

11.40–11.50 AM

Dr I M Chugh

Disorder in breathing during sleep

Dr Pavan Mangla

11.50–12.05 PM

Dr Rajneesh Kapoor

Understanding stents (a journey from bare metal to biodegradable stents)

Dr Harsh wardhan

12.05–12.20 PM

U Kaul

DES for the future–Is India ready to take the challenge

Dr Sanjay Tyagi

12.20–12.45 PM

Dr Sujeet Jha

High risk diabetes

Dr G M Singh

12.45–1.10 PM

Dr Sudhir Kumar Rawal

Robotic Surgery in Cancer Treatment in India

Dr P K Julka

1.10–1. 35 PM

Dr Amit Bhargava

Oncology

Dr P K Julka

1.35–1.50 PM

Dr Sanjay Chaudhary

Automation in Cataract Surgery with Femto–second

Dr Satish Mehta

1.50–2.05 PM

Dr Surender Kumar

Diabetes in 2012

Dr Pawan Gupta

2.05–2.20 PM

Dr S N Khanna

Valve Surgery Update

Dr O P Yadav

2.20–2.35 PM

Dr Ravi Kasliwal

Markers for cardiovascular prevention

Dr Sameer Srivastava

2.35–2.50 PM

Dr Neelam Mohan

Liver Transplantation

Dr A S Soin

2.50 – 3.00 PM

Dr Suman Gupta

Anal Fistula Treatment (VAAFT)

 

3.00–3.10 PM

Dr Vinay Sanghi

Diagnostic & Management of PVD in Modern Era

 

PEDICON 2012

Date: 18th–22nd Januray, 2011
Venue: Leisure Valley Ground, Sector 29, Gurgaon, Haryana
Website: http://pedicon2012.com/
For Latest happenings pls visit: http://pedianews.emedinews.in/

IMSOCN2012

The Annual conference of Indian Menopause Society is to be held from 17 to 19th Feb 2012 in Hotel The Claridges, Surajkund Faridabad. It is multidisciplinary approach to the problems of midlife onwards in women. This conference has participation of British Menopause Society and South Asian Federation Of Menopause Societies and opportunity to hear from international faculties.

For information Contact Dr. Maninder Ahuja (Organizing Chairperson) 9810881048 down load forms from web sit http://indianwoman35plus.com/ or Indianmenopausesociety.org or http://fogsi.org/

Contact at ahuja.maninder@gmail.com
Call for free papers and posters on theme topics of conference.

Early Registration till 30th Dec 2011

National Intervention Council Update

National Intervention Council is pleased to announce a National Interventional Fellow Competition in its forthcoming Mid–term NIC Meeting to be held in Kochi, 27–29 April 2012.

As you might know there is paucity of good interventional post–DM Fellowship programmes in the country. As such there is no consistent, dedicated teaching to the aspiring interventionists. These budding interventional cardiologists mostly learn by watching their teachers and senior colleagues. As such these students particularly lack in knowledge of basics of this sub–speciality. Therefore, NIC is focusing on alleviating this felt need by doing a "Back to Basics" session at the mid–term NIC Meeting. At the end of this session we propose to hold a National Competition.

The "Competition" will include an MCQ type written exam on basics of coronary intervention followed by a quiz. The students will be examined by judges who will award "National Interventional Fellow Award". Students enrolled in Cardiology and Intervention Cardiology teaching programme and those who have already completed within 3 years will be eligible for the competition.

Those who wish to participate for this competition can register by sending their full particulars (Name, Institution, Year of Residency, Guide/co–Guides, email address and mobile number) either on email or the following address.

Dr Sundeep Mishra

425 Mount Kailash Tower No 2, East of Kailash,
New Delhi, India 110065

drsundeepmishra@hotmail.com, Mobile 9871421390

Fellows can also register at website http://www.nickochi2012.org/ NIC will offer an all paid 3 month hands–on Interventional fellowship at an international center to winner of this award. We hope this will stimulate a desire to systemically learn the basics of coronary hardware and the techniques and will then apply this learned knowledge to clinical practice thus raising the overall standard in our country.

Please let us know what you feel about the program. Particularly, we request you encourage your students and junior colleagues to participate in this event.

 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta

 
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