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Clinical trial data proves Pfizer safe for children aged 5-11 years

by Medically Speaking Team September 20, 2021

On Monday, Pfizer and BioNTech announced that their coronavirus vaccine was safe and produced a strong immune response in children aged five to eleven, and that they would seek regulatory approval soon.

The vaccine would be administered at a lower dosage than for people over 12, they said.

“In participants five to 11 years of age, the vaccine was safe, well-tolerated and showed robust neutralising antibody responses,” US giant Pfizer and its German partner said in a joint statement.

They plan to submit their data to regulatory bodies in the European Union, the United States and around the world “as soon as possible”.

The trial results are the first of their kind for children under 12, with a Moderna trial for six-11-year-olds still ongoing.

Both the Pfizer and Moderna jabs are already being administered to adolescents over 12 and adults in countries around the globe.

“We are eager to extend the protection afforded by the vaccine to this younger population,” said Pfizer CEO Albert Bourla, noting that “since July, paediatric cases of COVID-19 have risen by about 240 per cent in the US”.

Kids in the 5-11 age trial group received a two-dose regimen of 10 microgrammes in the trial, compared with 30 microgrammes for older age groups, the companies said. The shots were given 21 days apart.

September 20, 2021 0 comment

Kids OTHERS Uncategorized

In two months, Covid-19 can easily export curbs: Adar Poonawalla

by Medically Speaking September 18, 2021

written by Medically Speaking

The export restrictions for Covid vaccines are expected to be alleviated within a two-month period by Adar Poonawalla, Chief Executive Officer of the Serum Institute of India (SII), provided India has created a enough stock to cope with the third wave.

The provision of raw materials for Novavax vaccines has improved compared to March and in December, Poonawalla told the media, SII plans to announce its monthly manufacturing plan.

“No export ban was in place, but temporary restrictions were in place and rightly so. In the next month or two I think these will be slowly easy, but I don’t want to go astray. But soon,” he said, adding that India is close to a point in which more than enough stocks of vaccines exist.

The government of India, Poonawalla says, is relieving the export restrictions, and it will follow what the Center thinks is appropriate.

“The Centre has to balance the needs of the country and stockpile vaccines for India in case of the third and fourth waves. Taking lessons from the first and second waves, the government is rightly being very cautious,” he said.

SII is expanding its Covishield capacity, which now stands at around 160 million doses a month. From October, it is expected to touch 200 million doses a month.

On the other hand, the production of the Novavax vaccine is not constrained by SII’s capacities, but by raw materials, Poonawalla said. SII is working on developing alternative vendor sources for critical raw materials. “Developing new supplies takes time. The silver lining is we have got people who can make quality raw materials, but they are inundated with orders from different vaccine companies – from Korea, China, Europe, etc,” he added.

SII is trying its best to scale up the production of the Novavax vaccine, Poonawalla said, and that there have been major improvements in raw material supplies since March. “We will wait and see, and in December, for sure, we can comment on what our monthly production will be,” he said.

As for the Novavax vaccine’s clinical trials on paediatric population, Poonawalla said the company has started trials, and three to four months is the minimum timeframe for that. By January-February, there is a possibility that Covovax (SII-manufactured Novavax vaccine) could be ready for approval for use in kids.

September 18, 2021 0 comment

Kids OTHERS Uncategorized

Zydus Cadila seeks approval of its approved tri-dose COVID-19 vaccine in India for two dose regimen

by Medically Speaking September 13, 2021

written by Medically Speaking

New Delhi: Taking into consideration the burden for the healthcare system and the costs associated with three doses, Zydus Cadila intends to seek approval on 20 August of the India Emergency Drug Regulation (IER) for its needle-free COVID 19 vaccine ZyCoV-D.

Tests are in progress for the two-dose scheme.

2mg of the vaccine has been prescribed in each dose of the present-day three-dose vaccine i.e. total of 6 mg. The company is now evaluating a 2 dose regime with 3mg in each dose.

The vaccine is said to be pathbreaking as it is for the first time that a technologically advanced vaccine has been successfully developed on the Plasmid DNA platform for human use.

A plasmid DNA vaccine uses non-replicating DNA molecules. As per Zydus Cadila, the vaccine which when administered produces the spike protein of the SARS-CoV-2 virus and elicits an immune response mediated by the cellular and humoral arm of the human immune system, which plays a vital role in protection from disease as well as viral clearance.

The platform because of its rapid plug-and-play technology can be easily adapted to deal with mutations in the virus, such as those already occurring. The company plans to manufacture 10-12 crore doses of ZyCoV-D annually.

The vaccine is stored at 2-8 degrees Celsius. Unlike Pfizer and Moderna vaccines that need to be stored at a very cold temperature, ZyCoV-D can be stored at 2 to 8 degrees. This vaccine is also effective against the Delta variant of COVID-19.

ZyCoV-D is needle-free and is administered intradermally which is done using PharmaJet, a needle-free applicator that ensures painless vaccination. This will help in administering the vaccine to kids.

The vaccine is likely to be available by early October, sources told on Saturday.

Recently in an exclusive interview with ANI, Dr Sharvil Patel, Managing Director of Zydus Group said that the supply of the vaccine will start from October onwards.

“The supply of vaccine will begin by mid-September and from October onwards, the supply will be scaled up to one crore doses per month,” Patel had said.

On expected supply of vaccine till December, Patel said the company is expecting to scale up 1 crore doses per month from October and it will supply 4-5 crore doses per month till January 2022.

“We can scale up production of a vaccine up to 1 crore a month from October at the new production plant, and it is expected to supply 4-5 million doses till January 2022,” he had said,

According to the Ministry of Health and Family Welfare (MoHFW), with the administration of 72,86,883 vaccine doses in the last 24 hours, the country’s COVID-19 vaccination coverage surpassed the cumulative figure of 73.82Cr (73,82,07,378) as per provisional reports till 7 am on Sunday. This has been achieved through 75,25,766 sessions, stated the ministry.

Currently, Covishield, Covaxin, and Sputnik V vaccines are being administered to the eligible population above 18 years.

September 13, 2021 0 comment

Kids OTHERS Uncategorized

World Suicide Prevention Day: Prevent loss of your loved one through these steps recommended by Experts

by Medically Speaking September 12, 2021

written by Medically Speaking

Suicide accounts for one out of every 100 fatalities globally. It has the potential to influence each and every one of us. Every suicide is heartbreaking and has a lasting impact on those who are left behind. We can, however, reduce suicides throughout the world by raising awareness, lowering the stigma associated with suicide, and promoting well-informed action. World Suicide Prevention Day is an opportunity to increase suicide awareness and encourage action via proven methods to reduce the number of suicides and suicide attempts throughout the world.

According to WHO, more than 700 000 people die by suicide every year. Furthermore, for each suicide, there are more than 20 suicide attempts. Suicides and suicide attempts have a ripple effect that impacts on families, friends, colleagues, communities and societies.

Medically Speaking spoke with a team of experts to examine this significant, yet often overlooked subject, the mental health concerns that contribute to it, as well as the probable early indicators and its treatment.

Here are a few snippets from the interview:

Why is mental health becoming a cause of concern?

Dr Sandeep Vohra: Mental health has long been neglected, but since the pandemic, it has risen to the forefront, and everyone must pay attention to it since it is clear from all aspects that people are stressed. According to an Indian government study, we lost a person to suicide every 4 minutes in 2019, and we lost 1,40,000 individuals in total. If these are pre-pandemic statistics, you may guess what the post-pandemic figures would be. Suicide is a widely underreported issue, owing mostly to the societal taboo of revealing the suicide death of a cousin or family member. Mental health problems are growing as a silent epidemic and must be addressed once the Covid-19 pandemic is cured. We need to understand that unless there is brief emphasis on Mental Health and the fact that Suicide is preventable, these figures will continue to rise.

Would you agree that loss of near and dear ones to Covid is adding to the anxiety and depression of people, thus making them susceptible to take such steps?

Dr. Akansha Batra: I agree that Covid has cost us jobs and businesses, and there have been reports of domestic violence and parenting issues, as a result of which many individuals have begun to have health worries. A lot of the time, we’d have patients who were just talking about small symptoms that they’d observed, and they’d get all worked up in their heads, causing them a lot of anxiety. There was also a great deal of anguish at the loss of those who were close to them. As a result of all of these factors, as well as a lack of support, individuals are taking such severe measures. Suicide and depression warning signals are not being recognised.

When does the situation, their mental health started deteriorating, how significant is it to catch the early signs and to provide the support to those who are vulnerable?

Dr Harpreet Kaur Bhan: It is critical to detect the early indications of depression, which can progress to more serious actions such as suicide. Because of the taboo, many individuals in our environment avoid discussing it.

Sadness, weeping, lack of interest, and energy are early indications, and the individual will seek treatment or tell friends or family that “I don’t want to live” or “I’m worthless.” Symptoms such as hopelessness, helplessness, not eating, sleeping well, not attempting to talk to anybody, or trying to be alone might help you recognise that there is a problem and that the individual requires professional assistance. It is critical that you make time for that individual.

It is a widespread myth that depression and mental health disorders are disease for the rich and the privileged because they have nothing better to do. How would you like to debunk this myth considering it is such an important day

Dr. Jyoti Kapoor: People have so many myths and misconceptions around mental health issues that they are still questioning themselves. People have this notion that our feelings and emotions should be in our control. Like if someone is feeling sad, then people will say things like “you can’t be sad,” “get yourself out of this,” etc. There are many parents who come to us with their kids and say that they always keep thinking negatively and being sad, to which we, as doctors, have to say, “Who wants to feel sad? No one does.” We have to understand that the brain and our nervous system are a part of our body and they contribute a lot to how we feel. That is the function of it. If we are not able to feel good and think positively, it can be a neurochemical disorder because that’s what it is. This is just like when we go to the doctor for stomach problems or other problems, we need to go to the doctor for brain problems as well.

Have you noticed apprehension amid the patients that they could probably be suffering from depression?

Dr Sandeep Vohra: Some of them may be hesitant because, in a depressed state of mind, the brain is difficult to make a choice due to feelings of pessimism. Suicidal ideation, like diabetes and hypertension, is curable and preventive. Just as blood sugar and blood pressure are examined, a mental figure examination can detect depression, for which we have medicines and treatment. Many people can be prevented from taking this step if they are intervened on time. Where people are hesitant to share their issues for fear of being criticised, the element of treatability must be examined. If you have a depressed family member, it is advisable to start a polite dialogue and urge that individual to speak out. Even if suicide is spoken casually, it should be taken seriously and professional aid should be sought.

Do you face resistance when it comes to prescribing medication and following through?

Dr. Akanksha Batra: We would frequently advise patients to begin taking medication or send them to a psychiatrist during counselling sessions. So they have a lot of doubts, such as if these drugs will be addictive because they would be used for the rest of their lives. Would I be taking it for the rest of my life? Are they going to call me insane? Will I be sleeping the entire day away? What good will it do me? Resistance to medicine is common, but we’ve also seen resistance to counselling. The psychiatry department is not a place where people desire to be seen. There is also the taboo of secrecy or not visiting a psychologist or psychiatrist. So we need to do a lot of counselling for the care givers and the patient themselves regarding the medication as well as the treatment of the disorder.

Dr Sandeep Vohra: If someone says that mental health medicines are addictive, ask them if people who take diabetes or blood pressure medications are also addicted to them. Long-term medications can save lives in some situations if the disease is severe. Fortunately, the government has begun tele-consultation as a result of the Covid epidemic, which can tackle social taboo component as well as anonymity. For those who are hesitant to talk about their problems, digital mental health is the way to go, and these services are available across the country. Keep in mind that life is really valuable.

What are the early signs which one needs to watch out for? Depression and anxiety are a few symptoms, but there are many who are suffering silently because of the social stigma and taboo around mental health issues. The second is also because of the stigma and the resistance in the minds of those who are around the patient to begin with.

Dr Jyoti Kapoor: Yes, we all know that 90 percent of the people who commit suicide have mental health issues, so this is a significant thing, plus, according to statistics, most of the suicide cases are happening in the age group of 15–39 years, which is a very young age. So when young people come to us, they don’t only have depression or anxiety, but a number of issues that can cause suicidal tendencies. Coming to the signs of suicide, one is that someone is talking about suicide. Things like “life is not worth living” and “what’s the point of living?” have to be taken seriously. Second, behavioral changes, such as someone who used to be a talkative and funny extrovert who has started withdrawing and trying to be alone; another sign can be that a person starts talking about death more often, someone who starts reading literature about death and all; and the third important sign is that someone starts taking drugs, liquor, or other things more frequently and believes that we have seen the signs, then there are many suicide screening tools that are available which have very simple questions with which you can know that a person is having suicidal tendencies.

Once you have been able to detect that a person indeed has you suicidal tendencies, what would be the first immediate step which should be taken? What would be your advice to their family and friends?

Dr Harpreet Kaur Bhan: It is important to send a person with suicidal inclinations to a psychiatrist. We also recommend that they be admitted to a hospital since such patients require special attention. We can’t leave the patient alone, even if it’s in the restroom or sleeping. Sharp items, cables, and even medications should not be near them.

If someone does have suicidal tendencies, what is the diagnosis for it and how are they treated?

Dr Sandeep Vohra: Suicidal ideation, Suicidal Attempt, and Suicidal Gesture are the three elements of this. Suicidal ideation may be a temporary setback in one’s life that may be resolved with a dialogue with someone. Suicidal Gesture is when someone tries to call for aid by slashing their wrists or injuring themselves in some way, but the injury is not significant. Suicidal attempt occurs when a person attempts to hang themselves or takes an overdose. The intensity of the symptoms determines the treatment for each of them.

Suicide attempt with a suicide note is a highly serious disorder that should be treated in a psychiatric facility. There, we begin pharmacotherapy and psychotherapy, which is beneficial not only to the patient, but also to the patient’s family members. If a patient’s life has challenges, we strive to address them through counselling. Suicidal ideation or suicidal gestures can be treated on the OPD basis or with medicines and combinations, depending on the patient’s and psychiatrist’s preferences. The greatest thing is that these levels of severity can be treated, but therapy must be taken seriously.

If the doctor advises, medicines should be followed up and treatment should not be left in between because it is seen that patients tend to become non-compliant towards the treatment.

If someone is on the path to recovery, what should they do to ensure the relapse and what should be the way forward?

Dr. Akanksha Batra: Regular counselling, psychoeducation of caregivers, parents, and family members, keeping yourself occupied with things that interest you and being more optimistic about the future, talking it out and taking your life seriously, talking with your counsellor, and adhering to and complying with the treatment, as Dr. Vohra stated, should be the steps to recovery.

Looking at the statistics, we know that suicide is very common among children between the ages of 15 and 29. This is a time period when children are very vulnerable and very emotional, so what will you advise parents who have younger children and who don’t seem to behave normally the way they used to?

Dr Jyoti Kapoor: I am glad that we are talking about this today because education and awareness are the first steps. We accept this fact that suicide is a reality. It doesn’t happen to our neighbor, it doesn’t happen to people in another city, but it happens to everyone and we understand that suicide is not because of certain thoughts or ideations. According to the suicide theory, there are two ideas. First is the thought and the feeling of anxiety, sadness, depression, etc., and second is the availability of opportunities, like the availability of some accessories like blades, ropes, fire arms, etc. And talking about suicide in a very sensational tone also triggers the person who is suffering to end up committing suicide. So people should be sensitive towards each other and parents and teachers should keep a check on the kids. We should keep this in mind that this is a treatable condition rather than thinking about it as I am a weak person and I am good for nothing. Parents should understand that saying things like, “How can you think like this?” etc. So we should talk about it in a very neutral manner, in a very non-judgmental manner, so that the person who is going through this can think about it. And third, the reason behind committing suicide is not just about being depressed or anxious. There are people who have certain disorders and conditions in which people don’t want to commit suicide but they keep getting these thoughts and hallucinations about committing suicide. So awareness, education, and reaching out for help are the things that I want to convey to the people out there. The final thing that I want to convey to the people out there is that just talking to a phycologist or a psychiatrist won’t put any label on your head, so please go and talk as it can help you to a large extent and can give you relief.

How do you deal with someone who is influenced by entertainment industry or media claims? How significant do you think it is to not talk about the mental health issues frivolously?

Dr Hapreet Kaur Bhan: Some people are born with suicidal inclinations, while others develop them as a result of a traumatic incident in their lives. When it comes to younger individuals, they pick up on what other people are doing by watching them. So, depending on the situation and age of the individual, we strive to assist and treat them. The basic goal is to confront your negative ideas, since people who are depressed have a lot of bad views about themselves and the environment around them. As a result, dealing with negative ideas, returning to reality, and thinking properly is a problem. When someone has a metal health problem, they are almost always having trouble with their cognitive processes and perception.

What should a person whose mental health has not deteriorated to anxiety and depression, do to channelize their energy positively?

Dr. Akanksha Batra: Identify the sources of stress in their environment. When we work with someone who is depressed or anxious, they often have negative, illogical thoughts. Try to get them to think rationally about it, to be sensible in their thinking. In general, counselling includes not only patients, but also family members, and instructs them on how to assist the patient in dealing with bad ideas.

Theme for the World Suicide Prevention Day is “Creating Hope Through Action” this year. What action is necessary to create this hope?

Dr Sandeep Vohra: The severity of depression influences whether someone is willing to seek counselling or need medication and treatment, which should be determined by the doctor. Second, impulsive suicides are common among teenagers, as well as individuals who are drug addicts or alcoholics. I appreciate NewsX bringing this out, but sadly, media statements have a negative impact on many people’s mental health. The World Health Organization has released a recommendation on this, and just as your channel is delicately treating this topic, other media outlets should do the same and encourage people to get treatment.

September 12, 2021 0 comment

Kids OTHERS Uncategorized

Dengue the latest looming threat to the community, even as COVID 19 prevalence recedes!

by Medically Speaking September 6, 2021

written by Medically Speaking

By Dr. Kanchan S Channawar, Consultant Pediatrician and Pediatric Intensivist, Kamineni Hospitals, LB Nagar.

In the current pandemic situation one more dreaded disease Dengue is raising serious concerns, as we continue to combat COVID-19. The prevalence of dengue has grown dramatically in the recent decades. The disease is endemic in more than 100 countries all over the world. A rapid rise in urban population is bringing ever greater number of people into contact with the vector especially in areas that are favorable for mosquito breeding like household water storage is common & where solid waste disposable services are inadequate. The incidence of dengue is seen in all age groups. The classical presentation is usually seen in older children, adolescents & adults, but the severity is more seen in infantile age that is children who are less than 1 year old and adolescents where they have more serious and complicated dengue.

Dengue is a mosquito borne Viral infection which causes mild to very severe disease. It is transmitted mainly by Aedes Aegypti mosquito which also causes other infections like Chikungunya, Yellow Fever. Dengue is caused by 4 related viruses as Dengue Virus 1, 2, 3 & 4 for this reason, a person can be infected with Dengue Virus as many as 4 times.

Dengue causes spectrum of disease from mild infection to severe illness. Dengue fever consists of 3 phases. Febrile Phase usually varies from 1 to 3 days and presents with high grade fever, retro orbital pain, generalized weakness, muscle & joint pains. The virus multiplies in blood during The Critical Phase, that lasts for 4 to 6 days and presents with hypotension, shock, bleeding manifestation such as gum bleeding, vomiting of blood and passage of black, tarry stools. There may be organ impairment and even platelet count may decline during this phase. Recovery Phase which follows, is 7 to 10 days of onset of fever and will see a rising trend of platelets.

Life threading Dengue often requires hospital care. However, mild symptoms of Dengue can be confused with other viral illness that causes fever, headache, rash, body pains. Generally, symptoms of Dengue last for 2 to 7 days and most of the kids will recover after about 1 week.

Occasionally Dengue develops into a potentially lethal complication called Severe Dengue. Severe Dengue develops in 1 in 20 people who got Dengue infection. It can present as shock, bleeding in internal organ or even death. Infants and pregnant woman are at risk of severe dengue. Warning signs of severe dengue are abdominal pain or tenderness, three or more vomiting in 24 hours, blood vomiting, bleeding from nose and gums or in urine and stool, child being restless, irritable etc.

Unusual presentation of patients with severe organ involvement such as liver, kidneys, brain or heart associated with dengue infection is termed as Expanded Dengue. These unusual manifestations may be due to co-infections, co-morbidities or complications of prolonged shock. The consequences of Expanded Dengue on these organs can lead to multiple complications. Expanded Dengue in Central Nervous System can lead to encephalitis, seizure or intracranial bleed. Gastrointestinal involvement can result in inflammation of liver, gall bladder, bile duct or pancreas. Renal involvement may cause acute renal failure, damage of kidney’s small blood vessels or kidney tubule cells. It can lead to complications of the heart like irregular or abnormal heart beat, impact heart’s blood pumping ability, heart muscle inflammation or even extra fluid accumulation around the heart. Respiratory involvement presents as pulmonary edema, Acute Respiratory Distress Syndrome and accumulation of fluids in the lung etc. Sometimes Expanded Dengue can also lead to complications in the eye and rarely visual impairment may also be seen.

Dengue is severe in children and adolescents and its essential to follow some preventive measures to safeguard them. Indoors should be made safe and clean to prevent mosquito breeding. Need to keep the corners and under surfaces of furniture clean. Should avoid standing water inside house and spray mosquito repellents in the garden area. Strong immunity must be built in kids by ensuring immune boosters like curd, fruits, garlic, turmeric and dry fruits in regular diet. Need to ensure that children wear full sleeved clothes and are protected from mosquito bites, especially when they go out to play. Usage of repellents enables protection from mosquito bites.

For an ailment like Dengue, which can turn fatal, prevention will always be better than cure and its essential to know when to visit the doctor. Symptoms like fever, rashes over body, headache, vomiting or body pains are all signs of being cautious and a visit to the doctor can always be beneficial.

September 6, 2021 0 comment

Kids OTHERS Uncategorized

Right approach towards children as schools reopen

by Medically Speaking September 5, 2021

written by Medically Speaking

Experts suggest honest dialogue and recitation of rules like “I wear a mask when in class and on the grass’ alleviating parents’ anxiety regarding reopening of schools.

Are we prepared to take the on sought of the third wave as far as the children are concerned?

Dr Krishan Chugh: our hospitals are conducting drills on the strategies to control the third wave. We are preparing our action plan to treat n number of patients. We know that the hospital bed ratio to the population ratio is not in our favour even when it comes to children.

In the last wave, many children produced antibodies, and the number is pretty large. Is this the reason for the confidence?

Dr Smita Malhotra: sero positivity rate is evident in children. We should emphasize that all children take influenza vaccine before going to school which will provide an additional protection till we are able to vaccinate them against Covid. Any child who are immunocompromised should take online classes which would be a prudent option for everyone.

As a career counselor, what would you tell the patents of high school students to alleviate their anxiety?

Dr Amrita Dass: There is a digital divide even in urban areas. It is important for parents to make informed decisions and discussions where they hear medical point of view also is very useful. Places where SOP’s and Covid protocols have been followed are the safest places today. Sending kids to school on alternate days with parents’ permission is very essential. I attended webinars with schools from Maharashtra, Uttar Pradesh, Himachal Pradesh and Uttarakhand where they have been reopened and initially the attendance was at 50% attendance which later went up to 60% and for the senior students it was 80% because the board exams will not be held online this time unless there is something unforeseen.

Would you say that the parents joined with your association would be convinced with these points?

Sumit Vohra: we agree as parents that we go to public places but there the children are under parents’ supervision. When in school, kids are the responsibility of the school faculty. It is a doubt among the parents whether the schools will follow SOP’s properly or not. Had this hype of third wave not been created, parents would have been much assured about sending the kids to school. We are aware that we need to send our children for practical exams and offline board exams but then we would prefer waiting for 10 to 15 days and then allow our kids to go to school.

Dr Prakamya: we do want to protect our children and that comes out from a very legitimate point of parenting but at some point of time we need to let out children venture out. At some point we need to use this as an opportunity to develop resilience among our child. Even in the urban strata, there are a lot of children with special needs, with learning disabilities, ADHD. These children need special educators and counselors for their all-round development. Adolescent is a stage where the brain is undergoing synaptic transformation and this is an important time to intervene and provide them an environment for social and mental development. Instead of being problem-oriented, we should be more solution-oriented, which brings me to having an honest conversation between the parent and the ward, and the school administration and children.

It is difficult to teach the concept of wearing mask to a 2 or 3 year old but can students in class 9 and 10 be taught with the help of a constructive dialogue in the school and at home?

Dr Shweta Sharma: we can trust our own children to follow SOP if not school authority and if you have that bond and trust with your children, they are going to follow up this thing. Schools are second parent to the kids and they are more responsible for the overall development of the children. Therefore, trust is all the more essential.

Dr Amrita Dass: there is a policy intervention I would state here. I believe authorities should prioritize vaccinating children atleast above 12 years of age as soon as possible. Government of UP has already started this and I would urge all state governments start doing this early as possible.

Is basic vaccination more important than the so called Covid vaccination?

Dr Krishan Chugh: No vaccine other than the Covid vaccine can provide significant protection against the Covid virus. Only proper vaccine with proper dosage at proper interval can ensure that children are reasonably safe. Fortunately some vaccines like Covaxin and Zydus Cadila will be approved by the regulatory authorities to be used for children soon. But once these vaccines are approved for children, they should not be used for adults except for those who have received the first dose of the same vaccine. This will ensure that we have enough vials for kids.

We have seen more number of critical cases among adults. Would you not agree with the government for prioritizing the elderly first, then 18 above and children at last?

the last wave we have seen many mortalities among the 30’s and 40’s and fortunately children have been spared of that fatality till now. Adults have been prioritized all over the world, not just India. Even the scientific evidence suggest that this is the correct protocol to be followed.

What is your advice for policy makers, parents and students?

Dr Smita Malhotra: I think it is in the individual’s hands. Children are smarter and wiser now and they can be taught how to be responsible. If each individual in the society learns to be responsible, it is not a difficult pandemic to control.

What would you like to suggest parents like Mr Vohra?

Dr Prakamya Singal: we need to be more solution-oriented and I think the best precaution against Covid is to wear mask. But how do they wear mask for a 4-5 hour stretch? Children will behave casual and it is natural so I believe we should first ask our children if they are comfortable wearing the mask that they have. They can be engaged in mask making activities, they can use their favorite colour, have their favorite cartoons on it.

We can use the initial days before the schools open up to ease them and help them get used to the sensation of wearing a mask. We need to give out clear rules and revise them on the daily basis before they leave for school to ensure that they follow the precautions. We can recite something like, ‘I wear a mask in the class and on the grass’.

Would you agree the same method would work for 6 or 7 standard students?

Dr Shweta Sharma: Yes the same method would work because if we see children as individuals, they are efficient. Thus, please trust your ward, they will take care of their hygiene and you do not need to repeat the instruction again and again because since the last two years we have been repeated the same message.

What would you say about this Dr Dass?

Dr Amrita Dass: where schools are open, students being responsible and parents being engaged has made a difference. So let us be more pragmatic about it and look ahead and bring in all the stakeholders. Schools do care about the kids as much as the parents and want to ensure that they do not have to be kept at home again. Let us trust the stakeholders.

Dr Chugh, what would you about the increasing numbers in Kerala which might probably be adding to the anxiety of the parents?

Dr Krishan Chugh: it is not just the schools that led to increase in Kerala, I believe Delta Variant was the major cause. It is the virus that is going to decide. Science is predicting that the change in the virus is not going to be a major one.

Would you suggest parents to have a healthy dialogue with the kids or maybe engage with the schools directly?

Dr Shuchin Bajaj: prediction is not our work but we have a graded action plan. Currently the positivity rate is less than 0.04% and our action plan will start when it arrives at 0.5%. Our mistake during the last wave was that we started after it crossed 5% and then it was too late. The government will be more cautious this time and lockdown will be imposed at 0.5% positivity and schools will be shut down first. Let us trust the government on this.

What do you think is a right approach as we eventually have to send our children to schools?

Sumit Vohra: the parent should take the initiative and the schools should build trust among the children ensuring that there are no mishappenings and children do not catch virus. Let us see for 10-15 days if the SOP’s are being followed properly. If the schools build up the confidence, parents would easily send their kids to school.

September 5, 2021 0 comment

Kids OTHERS Uncategorized

Alleviating Parents’ Anxiety with Reopening of Schools

by Medically Speaking September 4, 2021

written by Medically Speaking

Parents are becoming increasingly concerned about the prospect of a third wave, as numerous states mandate school reopenings. Parents’ fears and anxieties about their children’s safety are palpable, and many argue that authorities should wait until the vaccine is ready for youngsters. Learning to control anxiety and accept uncertainty are vital skills for anybody, but they’re especially critical for parents in this circumstance. Medically Speaking spoke with a few specialists about how to deal with this anxiety and what the best course of action is in this circumstance.

Shweta Sharma, Clinical Psychologist and Founder of Mansa Foundation says, “The children are utterly stranded and dissatisfied. Anxiety disorders are far more prevalent among youngsters, and parents are experiencing mixed emotions as they are both frightened and happy that their children will soon be able to return to the real world.”

She further said, “In such instances, we recommend that they communicate with the youngster in a nice manner so that they understand and do not feel compelled to wear the mask all the time. Hugs and physical touch are widespread among teenagers. Only a pleasant interaction with the parents would assist in this instance.”

Dr Prakamya Singal, Psychiatrist from Safdarjung Hospital observed, “It is very legitimate and natural for parents, children, teachers, and school people as well to have all these anxieties because these are unprecedented times, and no one can really ever be sure as to what is going to happen next. I think one of the most important things that needs to be at the center of all of this is an open and honest dialogue between all of the stakeholders.”

“I think we can also have a shift in the way that we are perceiving the situation. Having a unimodal view where we’re only looking at the harms of reopening schools is going to lead us to make probably not so wise decisions. Opening up schools right now might be a risky venture, but then there are also a lot of disadvantages to having our children locked up in their houses. Teenage is a critical stage where the mind needs to develop emotional quotient. Children need to learn how to be able to read others’ faces. This is what schooling and education is about,” she added.

Dr Sharma said, “We’re concentrating on different activities where public spaces are available, and we’re really going with the kids just to change the setting. So, what exactly is the problem with schools? There is an option. You are not required to send them on a regular basis. You don’t have to send them on alternate days. You should send them at least two or three times a week, if not more.

However, those adjustments are necessary for their psychological well-being. Because anxiety and depression in youngsters are already at an all-time high. They’re irritable. They are coming with the issues. The problem is also affecting parents. Especially with that age bracket, that interpersonal bond is already strained. So, in my judgement, if we are going to explore it, and with all the safeguards in place, I believe the government should applaud this initiative.”

Analysing the move of the government and the impact of online classes on children, Dr. Amrita Dass, Founder of ICS Institute for career studies says, “It has a significant negative impact on students because, while epidemic classes and, to some extent, virtual co-curricular activities are possible, they are insufficient for a student’s all-round development, and it is through all-round development that they develop employability skills, as well as opportunities for leadership, creativity, and teamwork. There are also many students who do not have access to online classes because many schools do not offer them, and some schools that do offer them have students with poor internet access. As a result, there are students who have completely missed out, and they are looking forward to returning to school and getting back into the excitement of teaching and co-curricular activities. There has been a great deal of worry and tension about the future, particularly since the board examinations were cancelled. They were unconcerned about the cancellation, but they were concerned about the future of higher education.”

Dr Dass added, “There’s another essential point to consider. Nobody is talking about the impact on preschool and kindergarten children. Younger children require experiences that cannot be duplicated online for their social and mental development. We should help them in small groups, with parents volunteering. In terms of emotional, social, and linguistic development, these children have suffered the most. Parents are not adequately prepared to provide the type of education that nursery and KG children require.”

September 4, 2021 0 comment

Kids OTHERS Uncategorized

Next 6 to 8 weeks is a period to assess the impact of reopening schools, it’s a dynamic situation: Experts

by Medically Speaking Team September 3, 2021

written by Medically Speaking Team

In several areas, schools have reopened with rigorous coronavirus precautions in place. Students will now physically attend classes in states such as Delhi, Uttar Pradesh, Madhya Pradesh, Rajasthan, and Tamil Nadu. In light of the pandemic, precautionary measures such as physical separation, staggered lunch breaks, obligatory masks for instructors and children, and the use of sanitizers have been implemented. Still, parents are apprehensive about sending their children to school.

In a conversation with Medically Speaking, a parent put forth his concern regarding the reopening of schools saying, “Experts foresee a third wave, but how can parents expect their children, who are most likely in elementary school or even high school, to send their children to such a situation? When it comes to third wave, the school faculties are also a little sceptical.”

He said, “What assurance do you have that the SOPs will be followed in the schools? How can I expect a nursery child to maintain social distance or a KG child to ensure that his or her tiffin is not shared with anyone? There is no transportation provided by any of the schools, which causes a great deal of hardship for parents. What about that?”

Dr Smita Malhotra, Senior Consultant, Pediatrics from Apollo Hospital, answers, “Let us also keep in mind that everything must be viewed in context. We can’t pick and choose which of our fears to deal with. You’ve all seen the images from when we first launched tourist destinations like Manali, when restaurants were completely booked. We are up and about when we have to enjoy it, but we are anxious when it comes to school. Everyone is attending meetings, parties, and get-togethers to celebrate festivals. In life, there is always a risk-benefit ratio that must be considered. Currently, the statistics are constantly low. So if not now, then when? This is the moment when we must go outside; it is an opportunity for us to witness what occurs. It’s always a dynamic scenario, where we can always close back down if there’s a surge.”

“As we all know, children are susceptible to a variety of anxiety disorders, it is quite tough to persuade them to follow the procedures, and they must attend school for 6-7 hours, which is an extremely long period of time. We need to come up with some ways that are both practical and offer a reasonable level of safety. For example, if we have to instruct them to wear a mask at least when they are in class with each other and not on the playground, where they may be separated, they must wear a mask that covers their nose and mouth,” said Dr Krishnan Chugh, Principal Director, HOD, Pediatrics from Fortis, Gurgaon.

He added, “After each period, we need to give them a 10-minute break so they may remove their mask, take a big breath, put it back on, and return to class. The other is that there should not be as many children in the class as there were previously, which implies that if a class previously had 40 desks, we should now limit it to 20 or even less.”

According to Dr Chugh, “India is a massive nation. What is true in Delhi may not be true in Kerala, where the second wave is still ongoing. We will have a solid notion of what needs be done till Diwali when we open schools while keeping our children secure. The schools should thereafter be shut for at least 3 to 4 weeks to assess the impact of the Diwali celebrations, and then reopened if no spike is seen.”

While talking about whether the schools should start offline classes for 6^th standard onwards, Dr Malhotra explained, “I believe we should reopen because we are seeing a lot of youngsters with a variety of health problems as a result of being locked indoors for over a year and a half. We’ve seen a lot of kids with psychiatric difficulties, weight issues, and stomach concerns that aren’t caused by anything organic. They have a lot of problems, so they need to go on with their life, and I believe that youngsters, as we all know, have the lesser sickness and that the people around them are fully vaccinated.”

In contrast to this, Dr Shuchin Bajaj, Founder of Ujala Cygnus Group of Hospitals mentions, “Since everything else has reopened, we’ve already passed the deadline for reopening. We’ve already seen that children in Delhi have a nearly 60% sero positivity rate, so we’re confident that they’ll have a mild disease. However, as you pointed out, everyone around these children, whether teachers, sports staff, or parents, needs to be vaccinated as soon as possible, because the pre- and post-covid eras will be very different. We need to educate kids how to follow covid protocols once they enter school.”

In assurance to the parents’ anxiety, Dr Bajaj said, “Unfortunately, we are overlooking the fact that the great majority of Indians do not have access to all of these resources, resulting in a significant digital gap. We are overlooking all of the students who do not have access to phones or other digital gadgets in order to attend class. We’re overlooking those who only have one smartphone at home and their father to take it to work. I simply want to comfort parents who are worried that if their children can carry the virus home, so can you.”

“If you don’t go out, if you don’t work, if you stay at home all the time, it’s reasonable to expect your children to do the same, but if you go to the office, to parties, and then expect your children to stay at home because there’s a risk of them contracting the virus, that’s completely unreasonable. Even if you are concerned, rest assured that all schools will make it voluntary for you. It is not mandatory for you to send your children to offline lessons, but please enable children who require a physical environment, are developing psychological difficulties, are obese, or are losing confidence to do so,” he added.

September 3, 2021 0 comment

Kids OTHERS Uncategorized

Immunity of Children sufficient to fight third wave?

by Medically Speaking Team September 1, 2021

written by Medically Speaking Team

As the number of Delta variant cases rises, health officials throughout the world are concerned, and are pushing health organizations to release revised COVID guidelines. The variant affects not just adults, but also children, according to reports. Because the majority of children have not yet had their COVID vaccinations, they are more likely to catch the virus, develop symptoms, and transmit it to others.

To talk about the same, we had a panel of experts on our special segment: Dr Smita Malhotra, Senior Consultant, Pediatrics and Gastroenterology, Apollo Hospital; Dr Shyam Kukreja, HOD, Pediatrics, Max Hospital; Dr Amit Gupta, Neonatologist and Pediatrician, Motherhood Hospital; Dr Rajeev Seth, Senior Pediatrician, Chairman, IPSCAN; Dr Naveen Bajaj, Senior Consultant, Neonatologist, Deep Hospital.

Below are a few excerpts from the interview:

Recent reports suggest that Covid in a child could be as worrying as in an adult. How worrying is this situation?

Dr. Rajeev Seth: We’ve witnessed two waves so far. The children were less affected in both rounds. As you can see from wave one, the majority of the youngsters were asymptomatic, and only a few cases were reported. More children were afflicted during this period because the disease’s effect was proportionately larger in the overall population, and children were also seen with a wide range of mild, moderate, and severe illnesses caused by covid. Mild infections may have gone unnoticed, while moderate infections may have caused breathing difficulties and decreased oxygen saturation, and severe infections may have resulted in multisystem inflammatory illness, requiring hospitalisation. Those extreme cases are now insignificant in comparison. In general, it is assumed that children who have a strong immune system and do not suffer from any serious illnesses have a robust immune system. Right now, it is critical that we take excellent care of our children. Except for one that we knew about from Zydus Cadila, none of the vaccinations have been authorised for children. For 12-18 it will take about another few months before it is available for children above 12 years.

In terms of diet, nutrition, and general well-being, adults must look after the child. Because the majority of the children have been confined indoors, they are at risk for behavioural and emotional problems. When the time comes, vaccination will be the most important component in achieving complete immunity. However, most studies suggest that approximately 60-67 percent of youngsters have antibodies, indicating that they had either a mild or moderate illness. Most professional organisations were keeping an eye on the disease’s varied patterns as it progressed. It’s becoming increasingly obvious that we don’t need to be so afraid. However, we must be prepared in the event of a significant third wave. Both secondary and tertiary care establishments have resources accessible for referrals. As a result, we must modernise the healthcare sector to provide secondary and tertiary treatment for children with covid.

There was a report by MHA which came out saying that our infrastructure is not enough to take care of children in case they get severe Covid infection. What is your overall assessment and how are pediatrician planning to deal with the upcoming third wave of Covid?

Dr. Shyam Kukreja: There are three questions that we have here,

Is third wave really imminent?
If it comes how children are going to be affected? Are they going to be affected in a different way as compare to what was happened in first and second wave?
If the third wave comes, are we prepared for it?

If you take a big group of children, for example, there are 100 cases of covid infection in adults, which means 15 of them are in trouble. They require oxygen, hospitalisation, and specialized treatment. In a group of 100 children infected with Covid, less than 1% will experience difficulties, but our denominator is so large that even 1% will be a significant amount. Therefore, I think we have to be prepared for lot of counseling of parents because 99% are going to be ordinary mild cases.

Are we prepared? What about severe cases? Are our ICU’s prepared as far as the infrastructure is concerned ?

Dr. Shyam Kukreja : Due to the large number of people, any infrastructure might fail. But I believe that now everyone is ready. It should, in my opinion, be much better controlled.

Do you think infrastructure wise India is where it should be?

Dr. Smrita Malhotra : Yes we have children who are severly affected who need tertiary care like Pediatric ICU including the elite specialty that they are under. Obviously we lack such facilities as of now. But rising up to the challenge, one may say that there will be a coordinated effort with the tertiary care centres, nursing homes, coordinating efforts between the referring pediatricians and the tertiary care center doctors.

Maternity hospitals have refused to take in Covid patients at all. What do the people who want to continue consulting the doctor in these hospitals do?

Dr. Amit Gupta: Majority of these hospitals are preparing for the next wave. Like in the second wave they were not taking covid patients initially, but have started taking them in now. Our infrastructure is getting ready for it. We are not anticipating any major thing as sir previously said most likely its not going to happen but these small hospitals are taking in mothers who are covid positive, separating them, taking all universal precautions just to keep them.

Depending on the immunity of the children, many of them already have antibody. Do you think that’s enough to fight covid third wave?

Dr. Naveen Bajaj: Talking about new born specially and said that new born are much more protected than the older children because of the factor that receptor for this virus to enter into a cell are relative the less in those kids, specially in new born and they have an immunity which is better for there particular spike protein so that particular immunity is better. Infants gain immunity from breastmilk itself which is known to transfer antibodies from mother to the baby. So it is very important that all the newborns should be breastfed exclusively and must continue till 2-3 years of age.

Talking about the immunity in children, is there anything parents can do?

Dr Shyam Kukreja: Children generally have good immunity. That’s why pediatricians have been out of work in the last two phases. Children have good innate immunity as they keep on having common colds and getting cross immunity. Because of that, children don’t smoke and they have immature lungs, so they already have so much immunity. Apart from that, breast milk is the best for babies till the age of 2 yrs.

Should we be prepared for the mutation in the virus affecting children or should we be so much dependent on the immunity of children?

Dr Smita Malhotra: It is a fact that children have good immunity, but there is one more fact which I have seen is that they come with a lot of weight gain, lack of sleep, as they are spending more time on their phones and TV screens. They are not going out to play, which is causing an epidemic of obesity along with this covid pandemic. So children don’t need some immunity building food, but normal food, which includes a wide range of different coloured foods and vegetables. Avoiding junk food is really important for good health. And as far as the preparation for mutation is concerned, it might cause problems in critical cases, like we had seen in the second wave, where we had MISC. When they had MISC, they needed more care as they have cardiac issues and they get affected, for which we needed pediatric Echoes. Unfortunately, we lack, but apart from that, we can take care of ourselves as we have an adequate amount of oxygen, medication, and ventilators.

What about emergency cases Dr. Gupta? Fortunately the numbers are low but there are cases unfortunately, which require further care.

Dr Amit Gupta: All the district hospitals and PMO recently had a meeting where they are trying to coordinate and trying to come up with solutions. We are trying to build ICU’s. If God forbid this third wave to happen, then we are most probably really for it.

Talking about jabs for healthy children, as the vaccination for children is being said to come by 2022, don’t you think it’s too late considering the third wave?

Dr Naveen Bajaj: Yes, we have to wait as it is a scientific approach to make sure that the vaccine doesn’t have any side-effects on growing children. We have other things as an alternative to this, like everyone in the family should get vaccinated and children should get other vaccinations, such as vaccinations for flue, etc, so that they don’t catch other infections which will affect their immunity and make them more prone to covid infection.

Why is it like children have good immunity but they are at risk of being carriers?

Dr Rajeev Seth: Children are prone to being carriers, as this was also seen in the first wave and second wave. For this, children need to take the proper vaccines at the proper time. They need to be in touch with their pediatricians because it is not like that all other diseases have gone because of covid. So proper care and vaccination are very important till the time we have the covid vaccine in place.

What would you say to the worried parents at this time?

Dr Shyam Kukreja: The Covid vaccine will come in due course, as we are seeing data in adults so that we will be more sure with children, but there is one thing that parents should get their kids vaccinated for other diseases as they are more deadly in children than covid.

Is like that the children below the age of 13 have even better immunity that they don’t need vaccine at all?

Dr Amit Gupta: Yes, they have very very good immunity, but parents need to create a cocoon effect around them by getting vaccinated. Especially mothers who are feeding their kids need to take extra care.

We talked about importance of vaccine, breast feeding, but what would you give for a final advice to the viewers ?

Dr Naveen Bajaj: Those who are breast feeding should continue that, skin to skin contact is very helpful for kids so don’t isolate them for a bit. Make them wear mask. That’s all.

September 1, 2021 0 comment

Kids OTHERS Uncategorized

In Amritsar, a pneumococcal vaccine was launched

by Medically Speaking August 26, 2021

written by Medically Speaking

On Wednesday, the Health Department began administering the pneumococcal conjugate vaccination (PCV) to children at the Satellite Hospital on Ranjit Avenue. Previously, the department included PCV in the vaccination regimen to protect children against pneumococcal illness. “The vaccination is marketed for Rs 5,000 in the market, but the government is providing it free of charge,” Civil Surgeon Dr Charanjit Singh said. He claims that pneumococcal bacterium infects a large number of individuals, with the majority of instances resulting in death. “The first dosage of the vaccine is given at one month, the second at three-and-a-half months, and a booster dose at nine months,” said District Immunization Officer Dr Renu Bhatia.

Deworming drive initiated

Amritsar: The Health Department on Wednesday distributed albendazole tablets in schools and anganwadi centres as a part of its deworming drive. Civil Surgeon Dr Charanjit Singh gave tablets to students at Government School, Karampura. The medicine would be made available to around 2.10 lakh students at 1,313 government schools and anganwadi centres and three lakh children at 830 private schools in the district. Children aged between 1 and 19 years would be provided the medicine. The health officials said those kids who were unable to get the medicine today would be given the medicine on September 1. The Civil Surgeon said, “Deworming of children is necessary to ensure their better physical growth.” He said schools had asked to educate kids about personal hygiene.

Dr Dhawan is new deputy director

Tarn Taran: Dr Sandeep Dhawan assumed the charge as a Deputy Director (Animal Husbandry) on Wednesday. Earlier, Dr Dhawan was working as the Senior Veterinary Officer, at the Patti Veterinary Hospital. Dr Dhawan was greeted by employees and officials of the department. Dr Dhawan held a meeting with his colleagues and instructed them to provide better services to residents of the district.

Freedom Run flagged off

Amritsar: On the second day of photo exhibition organised at the Town Hall by under the Ministry of Information and Broadcasting, as a part of the ‘Azadi Ka Amrit Mahotsav’, painting and song competitions were held on Wednesday in which school children participated in a large number. Commissioner Municipal Corporation Malwinder Singh Jaggi was the chief guest. In his address, he said that in freedom struggle Punjabis have made sacrifices for which we have to be proud. The NCC cadets from 1st Battalion performed their routine at the event. Earlier in the morning a “Fit India Freedom Run” was also organised. Sandeep Rishi, Assistant Commissioner, Municipal Corporation, flagged off this run from GNDU.

August 26, 2021 0 comment

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