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Progress in Medicine 2016 (Medicine Update 2016) Brothers Jaypee For Private Circulation Only Progress in Medicine and Medicine Update 2016 The publication of this book has been made possible by Unconditional educational grant from: USV Limited The scientific committee is also thankful for the unconditionalBrothers grants from: India Medtronic Abbott Healthcare Mankind Pharma MICRO Labs Cipla Limited Dr Reddy’s Lab Eris Lifesciences, Intas Pharma, Macleods Pharma, Abbott Vasc., Zydus Cadila, IPCA, Sanofi Aventis, Novo Nordisk, and Emcure Pharma Volume 26–2016 ISBN: 978-93-5250-199-1 © All rights reserved. No part of this book may be reproduced by Xerox, microfilm or any other means without written permission from the editors and publisher. The editors have checked the validity of information provided in the book, and to the best of their knowledge, it is as per the standards accepted at the time of publication. The views and opinions of the authors do not represent the policies of The AssociationJaypee of Physicians of India or the editors. Published by Gurpreet S Wander, KK Pareek Design, Typeset, Print and Distributed by Jaypee Brothers Medical Publishers (P) Ltd Progress in Medicine 2016 (Medicine Update 2016) 1st VOLUME Chief Editors KK Pareek MD Senior Consultant in MedicineBrothers and Director SN Pareek Memorial Hospital and Research Center Kota, Rajasthan, India Gurpreet S Wander MD DM Professor and Head Department of Cardiology Hero DMC Heart Institute Dayanand Medical College and Hospital Ludhiana, Punjab, India Foreword Siddharth N Shah Jaypee The Health Sciences Publisher New Delhi | London | Philadelphia | Panama Progress in Medicine 2016 Medicine Update 2016 (Volume 1 and 2) EDITORIAL BOARD MENTORS Siddharth N Shah YP Munjal Amal K Banerjee Mumbai New Delhi Kolkata CHIEF EDITORS Brothers KK Pareek Gurpreet S Wander EDITORS Jaypee Rajinder K Bansal Girish Mathur Sandeep Puri Dinesh Gupta Ludhiana Kota Ludhiana Ludhiana ADVISORS Navin C Nanda SK Sharma Jyotirmoy Pal USA New Delhi Kolkata SUB EDITORS Narender Pal Jain Vitull Gupta HS Pannu GD Ramchandani Ludhiana Bhatinda Ludhiana Kota Brothers Mohanjeet Kaur SK Goyal Gursaran Sidhu RK Goyal Ludhiana Kota Doraha Ajmer ASSISTANT EDITORS Abhishek Goyal LA Gauri S Maheshwari LudhianaJaypee Bikaner Ajmer Praneet Wander Uday Bansal Akriti Gupta New York Pune Ludhiana SECTION EDITORS EDITORIAL BOARD Endocrinology: Banshi Saboo, Ahmed. Inder S Anand, USA Soft Skills: S Shankar, Bengaluru Tejas Patel, New York Gastroenterology: Rajoo S Chhina, Lud HK Chopra, New Delhi Neurology: Gagandeep Singh, Lud Shashank Joshi, Mumbai Infectious Diseases: Rajesh Mahajan, Lud A Muruganathan, Tirupur Critical Care: Vivek Gupta, Lud Sandhya Kamath, Mumbai Toxicology: Dinesh Jain, Lud Rajesh Upadhyay, New Delhi Hypertension: HS Dhooria, Lud Milind Nadkar, Mumbai HIV: Simran Kaur, Ludhiana, Lud BR Bansode, Mumbai Pulmonology: Akashdeep Singh, Lud Mangesh Tiwaskar, Mumbai Hepatology: Omesh Goyal, Lud BrothersPrakash Punjabi, UK Diagnostics: Rohit Tandon, Lud Sanjay Jain, Chd Rheumatology: Amit Kansal, Lud JL Punglia, C. Garh Diabetes: Naveen Mittal, Lud Girish Verma, Kota Nephrology: Vikas Makkar, Lud Deepti Sharma, Kota Women disorders: Gurleen Wander, UK Yashasvi Gautam, Kota Investigations:Jaypee Meenaxi Sharda, Kota Harbir K Rao, Patiala SECRETARIAT Raja Gupta Muskan Sharma Rajbir Singh Hirdejit Singh Harmandeep Singh Naveen Bhatia Dedicated to Our Parents Mrs Mani Pareek Mrs Amarjit Kaur Mr Shiv Narayan Pareek Dr Harjit Singh for all the values they taught us Our Spouse Shashi Pareek Simran Kaur for being so tolerant and supportive all the life Our Children Kosehndu and Veena Gurleen and Manpreet Shipra and Prashant BrothersPraneet for making us so proud of them And above all to our Revered Teachers and our Beloved Patients from SMS, Jaipur GOMCO, Patiala SN Pareek Memorial PGIMER, Chandigarh Hospital, Kota DMCH, Ludhiana Jaypeewho taught us Medicine KK Pareek Gurpreet S Wander Brothers Jaypee Contributors A Amutha Abhenil Mittal MBBS Ajay Bahl MD DM Research Associate in Epidemiology Junior Resident Associate Professor Madras Diabetes Research Foundation Department of Internal Medicine Department of Cardiology, PGIMER Chennai, Tamil Nadu, India AIIMS, New Delhi, India Chandigarh, India A Bhagwati MD (MED) Abhijeet K Kohat MD DM Ajay Handa MD DM FCCP Honorary Physician and Intensivist Assistant Professor Senior Advisor and Professor Bhatia Hospital, Wockhardt Hospital Department of Neurology Medicine and Pulmonary Medicine Smt Motiben Dalvi Hospital Nizam’s Institute of Medical Sciences Command Hospital (Air Force) Mumbai, Maharashtra, India Hyderabad, Telangana, India Bengaluru, Karnataka, India MD A Muruganathan MD FRCP (Glasg) FRCP (London) Abhijit Swami Ajay K Baranawal FACP (USA) FPCP (Philippines) FICP Associate Professor Department of Transplant, Immunology and Adjunct Professor Department of Medicine Immunogenetics The Tamil Nadu Dr MGR Medical University Silchar Medical College All India Institute of Medical Sciences President, Hypertension Society of India (HSI) Assam, India New Delhi, India Dean Elect Indian College of Physicians (ICP): 2015-2016 Abhinav Anand MD Ajay Kumar MD DM MAMS FRCP Past President Senior Resident Chief and Executive Director Association of Physicians of India (API): 2013-2014 Department of Medicine Fortis Escorts Liver and Digestive Diseases Tirupur, Tamil Nadu, India Seth GS Medical College and KEM Hospital Institute (FELDI) Mumbai, Maharashtra, India New Delhi, India A Pandey MD Abhishek Goyal MD DM Ajay Kumar MD FRCP Assistant Professor Assistant Professor Consultant Physician and Diabetologist Department of Medicine Department of Cardiology Diabetes Care and Research Center SN Medical College and Hospital Hero DMC Heart Institute Patna, Bihar, India Agra, Uttar Pradesh, India Dayanand Medical College and Hospital Ludhiana, Panjab, India Ajinkya Borhade PG DNB (Medicine) A Sankaranarayanan MBBS Chief Physician and Head Division of Cardiovascular Disease Abhishek Sharma MBBS Acute Medicine University of Alabama at Birmingham Department of Dermatology Physician and Diabetologist Alabama, USA Teerthankar Mahaveer Medical College Sundaram Arulrhaj Hospitals Moradabad, Uttar Pradesh, India Thoothukudi, Tamil Nadu, India AA Mahashur MD Chief Coordinator Abhitej Sidhu BrothersAjit Mullasari S DM DNB FRCP Department of Respiratory Medicine Sidhu Hospital Director of Cardiology PD Hinduja National Hospital Ludhiana, Punjab, India Madras Medical Mission Mumbai, Maharashtra, India Chennai, Tamil Nadu, India Adhar Kulkarni MD Aakanksha Chawla MD Department of Medicine Ajit Sood MD DM Department of Respiratory Medicine Mahatma Gandhi Mission Institute of Health Professor and Head Critical Care and Sleep Disorders Sciences (MGMIHS) Department of Gastroenterology Indraprastha Apollo Hospitals Mumbai, Maharashtra, India Dayanand Medical College and Hospital New Delhi, India Ludhiana, Punjab, India Aditya S Kulkarni MD Aarathy Kannan MD Department of Medicine AK Agarwal MD Physician and Diabetologist Mahatma Gandhi Mission Institute of Health Professor and Head Sundaram Arulrhaj Hospitals Sciences (MGMIHS) Department of Medicine Thoothukudi, Tamil Nadu, India Mumbai, Maharashtra, India SMS and R, Sharda Hospital Greater Noida, Uttar Pradesh, India Aftab Khan MD DM DNB Aastha Chawla Fellow, North Delhi Diabetes Center Interventionist and Electrophysiologist AK Das MD New Delhi, India Apollo Gleneagles Hospitals Ex-Resident Physician Kolkata, West Bengal, India SK Medical College Abdul Muniem MD Muzaffarpur, Bihar, India Agam Vora MD Associate Consultant In Charge AK Janmeja MD Institute of Neuroscience Department of Chest and Tuberculosis Professor and Head Medanta—The Medicity Dr RN Cooper Municipal General Hospital Department of Pulmonary Medicine Gurgaon, Haryana,Jaypee India Professor of Chest, KJ Somaiya Medical College Government Medical College and Hospital Mumbai, Maharashtra, India Chandigarh, India Abhay N Rai MD MRCP FRCP Former Professor and Head Ajai K Garg MD Akash Batta Department of Medicine and Assistant Professor Department of Medicine Principal, ANMCH Department of Medicine Postgraduate Institute of Medical Education Chairman of AIMS SMS and R, Sharda Hospital and Research (PGIMER) Gaya, Bihar, India Greater Noida, Uttar Pradesh, India Chandigarh, India Akashdeep Singh MD DM (Pulmonary Med) FCCP Amit Bery MD Anil Chaturvedi MBBS MD FICP (USA) Associate Professor Senior Consultant Associate Professor Department of Medicine Life Style Disease and Preventive Health Department of Pulmonary Medicine Dayanand Medical College and Hospital Pushpawati Singhania Research Institute Dayanand Medical College and Hospital Ludhiana, Punjab, India New Delhi, India Ludhiana, Punjab, India Amit Dhiman MD DNB Anil Kashyap MD Akriti Gupta MBBS Assistant Professor Associate Professor Intern, Department of Medicine Department of Oncology Department of Pulmonary Medicine Dayanand Medical College and Hospital Dayanand Medical College and Hospital Dayanand Medical College and Hospital Ludhiana, Punjab, India Ludhiana, Punjab, India Ludhiana, Punjab, India Akruti Desai Amit K Ghosh MD DM MBA FACP Anil Vij MD Fellow, Oculoplasty Sankara Nethralaya Professor Professor of Medicine Consultant, Dr Agarwal’s Eye Hospital Department of Medicine Punjab Institute of Medical Sciences (PIMS) Chennai, Tamil Nadu, India Director of International Practice Jalandhar, Punjab, India Akshat Taneja MBBS Mayo Clinic, Rochester, New York, USA 30 Intern, Civil Hospital Anindya Sarkar Gurgaon,