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PMA Karachi condemns
murder of Dr. Amir Mehdi

KARACHI: An emergency meeting of Pakistan Medical Association (PMA) Centre and PMA Karachi, was held at PMA house Karachi on 13th August 2014, Prof. S.Tipu Sultan Immediate Past President, presided the meeting and was attended by Dr. S.M. Qaisar Sajjad, Dr. Serajuddaula Syed, Dr. M. Idrees Adhi, Dr. Naseer Baloch, Dr. Shoaib Sobani, Dr. Qazi Wasiq, Dr. Hamid Manzoor, Dr. Khalil Mukkadam, Dr. Usman Ghani, Dr. Najam Feroz Mehmoodi, Dr. Shaukat Malik, Dr. Abdul Ghafoor Shoro and many other senior members of PMA.

This meeting strongly condemned the brutal murder of Dr. Amir Mehdi, who was 56 years old. Dr. Amir Mehdi was at his Rifah-i-Aam clinic in Landhi-2 when 2 gunmen shot at him and killed. Dr. Mehdi was killed on sectarian basis.

The menace of sectarian violence is increasing day by day in our society. Up-till now so, many innocent doctors have fallen prey to this barbarism. It seems that the Government of Sindh is totally unwilling to fulfill its responsibility of providing safety and security to the doctors. The Law enforcing agencies have miserably failed to curb these crimes. Unfortunately, The Judiciary is also not taking notice of this serious situation. Despite assurances of the high-ups of the law enforcement agencies, there is no stop to the killings of innocent doctors. Killings of the doctors have become an order of the day. Due to this violence and killings, sense of insecurity and uncertainty is increasing among the medical fraternity. Doctors are leaving the country for security reasons.

PMA demands from the Federal Interior Minister, Chief Minister of Sindh, Chief Secretary, I.G Police and all other state Institutions which are responsible to maintain the Law and Order, to take an urgent notice.PMA also demanded a fair compensation to the family of Dr. Amir Mehdi. We also demand to arrest the culprits and bring them to the courts for justice.

Aggressive lowering of BP linked
to greater risk for poorer outcomes 

According to reports a study published Aug. 4 in the Journal of the American College of Cardiology, some patients may be over treated for hypertension. The study, which involved a review of EHR data on some 400,000 patients taking antihypertensives, revealed that lowering blood pressure below certain levels was associated with a greater risk for kidney failure or even death.

CardioSource reported that the study “evaluated the discrete ranges of achieved BP and subsequent risk for mortality and end-stage renal disease and found that ‘treated hypertension patients with BP in the range of 130 to 139 mm Hg systolic and 60 to 79 mm Hg diastolic experienced the lowest risk for the composite outcome of mortality and end-stage renal disease.’”Overall, the study’s results revealed “a significant J-shaped association between actual, treated BP levels and adverse outcomes.” Even though “the lowest risk of the composite outcomes was a systolic BP of 137 mm Hg and a diastolic BP of 71 mm Hg, BP that was either higher or lower than 130 to 139 mm Hg systolic and 60 to 79 mm Hg diastolic were associated with increased risk of the composite endpoint.”

Not all physicians agree with
2013 ACC/AHA guidelines on statins

According to reports not all physicians concur with 2013 guidelines released by the American College of Cardiology and the American Heart Association for the prescription of Statins. The updated guidelines are a paradigm shift calling for tailoring a Statins dose to a patient’s particular risk for cardiovascular disease, not to a target cholesterol level. This means that some patients without increased LDL cholesterol levels could be placed on Statins if they faced an elevated risk of a cardiovascular problem within a decade. A state-of-the-art review (8/5, 2K) of the guidelines and a discussion of the resulting paradigm shift appeared Aug. 4 in the Journal of the American College of Cardiology.

CardioSource points out that in addition, the guidelines provide “a new risk estimator for primary prevention decisions, including stroke outcomes and data on African Americans, which is designed to significantly increase the number of patients recommended for outcome-related benefits of any cholesterol-lowering therapy.” Even though a need still exists “for additional randomized controlled trial evidence regarding effective strategies to reduce ASCVD [atherosclerotic cardiovascular disease] risk in women, in patients older than 75, in patients younger than 40, and in additional ethnic groups such as East Asian, South Asian and Hispanic, the updated parameters are designed to help achieve optimal care and reduce ASCVD risk.”