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Editorial (Dr SS Agarwal, Dr K K Aggarwal)
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5th  October 2016
First Treat-to-Target recommendations for gout
The first treat-to-target recommendations for gout based on the available scientific evidence have been published online September 22, 2016 in the Annals of the Rheumatic Diseases.  

The main treatment goal is to reduce levels of serum uric acid to a target of lower than 6 mg/dL and to maintain that level. While the target serum uric acid level in patients with severe gout, such as tophi or frequent attacks should be below 5 mg/dL. Decrease in pain, presence/absence of attacks and the amount/reduction/absence of tophi are other three treatment targets.

The recommended outcome measures have been grouped into three:
  • Clinical: Pain, number of joints involved, number of attacks/year
  • Lab: Serum uric acid, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum creatinine
  • Patient-reported outcomes: Quality of life, short form 36, work status, productivity, work days off and absenteeism.
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Top News
Practice Updates
Factors linked with sustained RA remission identified
Treating psoriasis reduces risk of cardiovascular diseases
Study links low cortisol levels to refractory pain 
Monitoring BMD may identify women with suboptimal response to osteoporosis treatment
Prostate-rectum Hydrogel spacer minimizes rectal radiation exposure
Pharmacoinvasive strategy as good as primary PCI in STEMI patients
Serum HBcrAg may identify patients who will benefit from prophylactic antiviral treatment
Gliptins are associated with increased risk of developing pancreatitis in diabetic patients
Obese patient may switch to very-low-calorie ketogenic diet- as it reduces the risk of developing type-2 diabetes
The Cx43 protein-assisted-beiging of white fat tissue demonstrate an anti-diabetic effect on blood sugar metabolism
Extra sleep relatively increases the risks of developing diabetes in men than women
Flu vaccination is highly recommended for diabetic patients
eMedi Humor
Medicolegal Corner
eMedi Quiz
1. Is an emotional reaction to the anticipated pain.
2. Is in anticipation of future pain.
3. Is more indicative of the need for pain medication than the pain rating. 
4. May be in conflict with the pain rating, and accepts the report of pain.
Lifestyle Updates
Inspirational Story 1: God Created The Teacher
Inspirational Story 2Shake It Off and Step Up
Press Release
Excessive alcohol consumption continues to damage the society, economy and the health of the individuals 

It is the cause of death of over 2.5 million individuals every year (almost 4% of all deaths worldwide), and the third leading risk factor for poor health globally, accounting for 5.5% of disability-adjusted life years lost
New Delhi, 04th October 2016: Excessive alcohol consumption and under-age drinking are common issues, which all countries globally continue to struggle with. The urgent need to raise awareness about the evils of alcohol consumption has been brought up by most National and International bodies during their annual meetings. However, till now, no strict action has been taken to curb the menace of alcohol. 
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IMA Updates