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Doctors reluctant to take up certain procedures if the chance of survival is 1-3% or less: President of Telangana Jr. Doctors Assn

by Medically Speaking Team August 3, 2021

Doctors throughout Telangana are hesitating to perform dangerous surgeries after a series of violent assaults on healthcare workers by patients’ families, despite knowing that a last-minute intervention may save a life.
In most state-run hospitals, the attacks have become more frequent and dangerous. At least ten similar cases have been recorded in the state in the last year, with threats and insults being flung every day, physicians added.

“In such situations, there is hesitation among doctors to take up critical procedures where lot of risk is involved. Unlike earlier, where doctors took up a step-by-step approach to reach the last line treatment, now they are not ready to take up certain procedures, especially if the chance of survival is as little as 1-3%,” said Dr Sagar Dharmula, president Telangana Junior Doctors Association (TJUDA).

“As doctors, we are bound to take the chance even if we can extend the life of a patient by a few hours, but we are now forced to not choose a procedure that can save a life,” he added.

With frequent incidents of assault, doctors working in critical care and intensive care units (ICU) are avoiding last minute CPR on critical patients, anesthesia in a seizure patient and in rural areas even snakebite patients are turned away, or a pregnant woman with cardiac disease history is asked to leave.

August 3, 2021 0 comment

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Covid reduces breast milk donation at Sion hospital by nearly half

by Medically Speaking August 3, 2021

written by Medically Speaking

One of the most serious consequences of the pandemic has been the decline in the donation of breast milk. The Human Breast Milk Bank of Sion Hospital, one of Asia’s oldest, has seen a significant drop in donors since the beginning of 2020. According to data, while 1,000 litres were donated in 2018, the figure dropped to 526 litres in 2020. So far this year, only 325 litres have been donated.

Sion Hospital’s milk bank, which opened on November 27, 1989, typically receives 800 to 1,200 litres per year (about 3 to 4 litres each day). “The dip was primarily seen at the peak of the first wave, especially because no one wanted to visit the hospital,” said Dr Swati Manerkar, neonatologist and director of the Sion Hospital milk bank.

The number of donors in 2018 and 2019 was 7,700 and 7,300, respectively. The number reduced to 6,600 in 2020 and is 3,500 till date this year.

Two categories

“Our donors are divided in two segments. In the first category, we have those mothers who deliver at the hospital. They donate before being discharged. The other category includes the mothers who visit our OPD with their newborns for follow-ups or vaccinations,” explained Dr Manerkar.

She further said, “We could not collect breast milk from Covid-positive mothers or anyone with symptoms of the infection. We still do not know whether the virus passes through breast milk. A substantial number of mothers who were delivering in our hospital were testing positive. The OPDs also suffered.”

“There was a need to prioritise because donor milk is a scarce resource. For a brief period, we provided it to the smallest, sickest and most vulnerable babies instead of being liberal. There is always a buffer stock of 35-40 litres. We could just about tide over. By the time the stock reached a single-digit figure, things started getting better donation- wise,” she added.

Shortage of manpower

Dr Manerkar said they also had to deal with shortage of manpower at the milk bank but they ensured that the available resources were optimally used.

“We had very strong counselling services. We had one counsellor visiting the Covid-19 maternity ward every day and asking mothers to breastfeed their babies. We tried to ensure that the mother provides her own milk to the baby and therefore the need for donor milk decreases. You need donor milk to tide over the period for which the mother cannot breastfeed. This was strongly advocated. And our counsellors also spoke to the family member who would be present with the mother just to transfer the milk in a container to the baby in the NICU,” said Dr Manerkar.

She added that they are slowly returning to normalcy and the number of donors is improving.

“Things have started to show up. The number of Covid-positive mothers has gone down and we are closer to what we were in the pre-Covid days. We had 30-50 mothers donating milk every day before the pandemic, and slowly we are matching up to that number,” she said.

August 3, 2021 0 comment

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Safdarjung only govt hospital in Delhi giving ECMO therapy to Covid-19 patients

by Medically Speaking Team August 3, 2021

written by Medically Speaking Team

For Covid-19 patients with badly damaged lungs, Safdarjung Hospital is the only government-run facility in Delhi that provides ECMO (extracorporeal membrane oxygenation) as a last resort treatment. The treatment entails assuming control of the lungs and heart, allowing the injured lungs to heal on their own. However, the two patients who were placed on ECMO therapy at the hospital did not survive, and the treatment is costly.

While ECMO treatment has been successful in patients with acute respiratory distress syndrome and is considered by some as the only hope for Covid-19 patients who won’t survive even with ventilator support, its success rate has been very low. Recently, a seriously-ill Covid patient was treated successfully using ECMO at the KIMS Health hospital in Kerala’s Thiruvananthapuram. Another Covid-19 patient, a doctor from a Delhi government hospital, has been on ECMO support for over 40 days at Yashoda hospital in Hyderabadad, awaiting a lung transplant.

The patients offered ECMO tratment at Safdarjung hospital were critical and died of other complications. The first one admitted last year died of a heart attack three days after being put on ECMO and the second patient, a woman under 40 years of age, admitted during the second Covid wave this year, died after 18 to 19 days of treatment due to sepsis or blood infection.

August 3, 2021 0 comment

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Initial hiccups in Bharat Biotech Bengaluru plant delayed Covaxin production: NTAGI Chief

by Medically Speaking Team August 3, 2021

written by Medically Speaking Team

India achieved the target of 47 crore COVID-19 vaccine doses till the month of July, Dr N K Arora, Chief of National Immunization Technical Advisory Group (NTAGI) said and added that some hiccups like initial difficulties in the new Bangalore plant of Bharat Biotech had delayed the production of Covaxin.

Speaking to ANI, Arora said, “The test batches of that plant weren’t satisfactory and got rejected which led to delay in ramping up production, but now the batches have been approved by the competent authority and will be available for public consumption.”

Dr NK Arora also said that Bharat Biotech will be able to ramp up almost 7-10 crore doses of its Covid vaccine in the coming weeks.

“We achieved it out of 50 crore almost 47crore doses have been administered this period, In August we think availability will increase quite significantly overall and it is expected that Bharat Biotech will be able to provide 7 – 10 crore doses per month in the coming weeks,” he said.

Further Dr Arora said, “Bharat Biotech and Serum Institute are our major vaccine suppliers and we hope that will also be our driver for completing the adult immunization in this country by the end.”

On production of Covishield and Covaxin, he said, “Serum Institute almost 8- 10 crore doses, 3-3.5 crore from Bharat Biotech and small contribution from Sputnik also. In August and coming months, there will be an exponential increase in the availability of vaccines and administration.”

August 3, 2021 0 comment

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As doctors investigate whether Delta makes patients sicker, the variant spreads like ‘Wildfire’

by Medically Speaking Team August 3, 2021

written by Medically Speaking Team

With a new wave of COVID-19 infections fueled by the Delta variant striking countries worldwide, disease experts are scrambling to learn whether the latest version of coronavirus is making people – mainly the unvaccinated – sicker than before.

According to an internal assessment made public on Friday, the US Centers for Disease Control and Prevention warned that Delta, which was initially found in India and is now prevalent worldwide, is “likely more severe” than earlier versions of the virus.

People infected with the Delta variant were more likely to be hospitalised than patients earlier in the pandemic, according to data from Canada, Singapore, and Scotland.

In interviews with Reuters, disease experts said the three papers suggest a greater risk from the variant, but the study populations are limited and the findings have not yet been reviewed by outside experts. Doctors treating patients infected with Delta described a more rapid onset of COVID-19 symptoms, and in many regions an overall increase serious cases.

However, experts say that further research is needed to evaluate outcomes in epidemiologic studies involving larger numbers of people to determine whether one variation causes more severe disease than another.

“It’s difficult to pin down the increase in severity and population bias,” Lawrence Young, a virologist at Warwick Medical School in the United Kingdom, said.

Furthermore, the doctors believe that the high rate of Delta transmission is contributing to an increase in the number of severe cases coming at hospitals.

According to the CDC, Delta is as contagious as chickenpox and significantly more contagious than the typical cold or flu.

August 3, 2021 0 comment

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Bharat Biotech’s Rotavirus vaccine receives ‘Prequalification’ from WHO

by Medically Speaking Team August 3, 2021

written by Medically Speaking Team

Rotavac 5D, a variation of Bharat Biotech International Limited’s Rotavac vaccine, got “Prequalification” from the World Health Organization (WHO) on Monday. Rotavac is a vaccine that prevents rotavirus, a virus that causes severe diarrhoea and vomiting in newborns and children.

“Today’s announcement is an important step to further strengthen and fulfil Bharat Biotech’s vision to address neglected diseases, and prevent infections that continue to affect millions in the developing world,” a statement from Suchitra Ella, the Hyderabad-based pharmaceutical firm’s Joint Managing Director, said.

WHO’s website describes “prequalification” as a “systematic process to determine a manufacturer’s capacity to produce a product of consistent quality in accordance with international standards and specifications laid out by WHO/United Nations Population Fund (UNFPA).” The purpose, it says, is to ensure procurement and distribution of good quality products.

Once “prequalified,” vaccines can be procured by organisations such as the United Nations Childrens’ Emergency Fund (UNICEF) and Pan-American Health Organization (PAHO).

Rotavac 5D, which was rolled out in December 2019, has a “unique” vaccine formulation that can be administered without a “buffer,” Bharat Biotech’s statement noted. With a low dosage volume of 0.5 ml, the shot is easier to be stored, and further facilitates easy cold chain management and low biomedical waste disposal after vaccination, the statement noted further.

Bharat Biotech developed Rotavac, a first-generation vaccine, in a partnership with the Government of India’s Department of Biotechnology. 16 other international partners were also involved in the project. In March 2016, India became the first country in Asia to launch an anti-rotavirus vaccine, doing so under the Universal Immunisation Program (UIP).

August 3, 2021 0 comment

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Love Nature To Lessen Covid Anxiety

by Dr Aaloc Srivastav August 3, 2021

written by Dr Aaloc Srivastav

Young but fragile Himalaya is blessed with rich Biodiversity.Its valuable resources have traditionally served as the foundation for economic and cultural life of vast & vibrant population.

A few attitudinal differences and climate change developments coupled with variation in soil conservation create striking changes in the terrain having fabulous flora and fauna.Such a unique bio diversity not only encompasses ecological, scientific or economic values,it is a capital of inheritance,passed down generations, stressing the need for Sustainable Development.

BIOTIC INTERFERENCE

2) Developments of past and present indicate ,however, extremes of biotic interference.Making wise use of bio diversity inheritance should not be tutored.It has to be felt ,imbibed and carried forward when one is confronted with the tentacles of Corona Auntie And whims & fancies of the Covid Uncle.Without entering into realm of discussion on the origin of the virus,one should believe that SARS II virus is an off shoot of the prevailing environment.An environment throttled by one and all..

Fauna Such As Elephants Need Fresh Look

3) Coming to judicious utilisation rather than exploitation of floral & faunal wealth, there may be a need for a fresh approach.Not only farming communities near forests have to be sensitized to extract forest and non forest timber products properly but they also have to be briefed to leave ENOUGH scope for growth and sustenance of grass,shrubs,water bodies etc, vital for life of animals,such as,Lions,Elephants,Tigers, Deer etc.While saying so,one is not aiming to touch upon the crucial Food Chain,
rather the purpose is to prick our mind specifically about the plight of gentle Elephants,who,being vegetarian,show full loyalty towards their masters.
Of 27,000 Asian Elephants in India,21% reside in Assam.Due to loss of forest habitat, they are increasingly coming face to face with humans.Every year,around 100 of them, unfortunately, get killed.They are also misused in the Tourism industry.The Wildlife Protection Act,1972 bans the sale of captive & unregistered elephants.
The mere fact that they live,eat and move in groups or clusters,goes on to show their strong family instincts,something reflected glaringly in:

A) Episode of 18 elephants in Nagaon,Assam in May,2021 crushed by lightening And
B) Freak,directionless walk of over 500 kms by 15 elephants in Kunming area of Yunan province of China in June,2021.

Sympathy Is Necessary

4) Despite the inherent friendly attitude of the elephants and many other animals often the reports of Entry into the human habitations, hit the head lines.There has to be some reason for such an entry.What they get in return is hectic,irrational and merciless action.The facial expression of the fauna in such a situation shows their State of helplessness. The onlookers, never the less ,get sarcastic pleasure in having an exciting glimpse.Whether it is a case of entry by the loveable Monkeys.,Leopards,Tigers or the Elephants into towns of different states, these should not be considered as an intrusion by the animals.

Assertion of Rights

5) It is felt that such a behavior has to be viewed as a valiant act of ASSERTION of rights by certain species to counter the actual intrusion into their bonafide habitat by the shrewd human beings.There should be no justification to suppress or subjugate the innocent animals either by mechanical or muscle power.
Will our Forest Service friends wake up and take requisite action especially during the current wave of Covid,when almost two dozen “positive” tigers and couple of similar infected lions have already left the world ?
.Lingering threat to pets & domestic animals who soothen our feelings when we are tired & exhausted, also fill the atmosphere,time and again.

5) Having stated so,I may humbly submit :
“When the animal instinct among the humans crosses conceivable limits,the actual and bonafide sons and daughters of mother earth are left with no alternative but to react vehemently or justifiably”.

Unhealthy Tussle

6) It is not only the competition or tussle factor for a habitat between the animals and human beings, But it is a question of displaying adequate love and care for the natural endowments,indiscriminately gifted by the Almighty.

Saviour Duty

7) It may not be out of context to remind ourselves about the basic Hindu philosophy of emphasizing reverence to the flora and fauna right from childhood.For generations, plants, such as,Peepal,Banyan,Tulsi,Banana,Mango, etc.and the animals,namely,Cow,Bull,Lion,Tiger,Elephant,Monkey,Rat,Cobra snakes etc were being worshipped. Also the morning ritual of offering water to Sun God, Tulsi plant and Peepal tree not only has given the requisite faith & confidence to the worshippers but it can also teach us again the forgotten lesson to do everything possible to Preserve Flora & Fauna.

8) To Sum Up:

If we are mandated to avoid Social Interaction due to Corona virus and more lethal Third Wave, how can we afford to undermine similar “social” instinct among the animals?
Their state of hunger and helpless facial expressios during last two rounds of Lock Downs, calls for improving our overall attitude towards them. Timely food intake and sound health of fauna not only can improve their internal social behavior but it may also ensure a refined attitude towards their human handlers, caretakers or masters.
Even if we get rid of COVIDITY clinically, the love and affection displayed by the pets may prove much more valuable if not decisive in reducing our anxiety and depression. It may Ultimately Facilitate Satisfactory Healing of the Community.

August 3, 2021 0 comment

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Johnson & Johnson still in talks with India about COVID-19 vaccine

by Medically Speaking August 2, 2021

written by Medically Speaking

Johnson & Johnson said on Monday that it was still in talks with the Indian government about its COVID-19 vaccine, despite the country’s drug regulator announcing that the company had withdrawn its proposal for accelerated approval for local trials.

India had, in May, scrapped local trials for “well-established” foreign coronavirus vaccines as it tried to hasten vaccination rollouts to fight a second wave of infections.

“We are in ongoing discussions with the Government of India and are exploring how best to accelerate our ability to deliver our COVID-19 vaccine to India,” Johnson & Johnson said in an emailed statement.

The Indian junior health minister said last week that a team had been formed to engage with vaccine makers.

“This team is in continuous dialogue with Pfizer, Moderna and Johnson & Johnson to discuss and address various issues including the issue of indemnity,” Bharati Pravin Pawar had said.

The Central Drugs Standard Control Organisation (CDSCO) did not immediately respond to Reuters’ requests for comments on Monday.

As of July 28, only 10% of India’s adult population of about 944 million people had been inoculated with both doses, with 47% receiving at least one shot.

Johnson & Johnson is yet to request a full approval for its shot with the U.S. Food and Drug Administration, while Pfizer Inc and partner BioNTech SE, and Moderna Inc have already sought full approval of their vaccines. In India, the drug regulator had in June given emergency use authorisation to Moderna’s vaccine.

August 2, 2021 0 comment

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To continue, the Delhi government has issued an order restricting Covishield for second doses

by Medically Speaking August 2, 2021

written by Medically Speaking

The administration of Covishield will be limited to only second doses at government-run vaccination centres in Delhi until the end of August.

According to a senior health department official, the first Covishield shot will not be available at these locations and that the arrangement will continue for some time.

Citing vaccine shortage, the Delhi government on July 22 had ordered that all Covishield slots at government centres be reserved for second doses till July 31. For Covaxin, only 20% doses at these centres are for the first shot and the rest reserved for the second.

For the month of July, Delhi had incidentally received more vaccines from the Centre than what was promised and allocated to it. It had been promised 15,19,590 doses in July and received 21,88,100 doses – 3,67,000 Covaxin and 18,21,100 Covishield.

On Saturday, Chief Minister Arvind Kejriwal announced that 74 lakh people have been administered at least one vaccine dose in Delhi so far, which, he said, amounts to about half of Delhi’s adult population.

He had stated that the pace of distribution of vaccines from the Centre means that Delhi has not been able to able to scale up its vaccine administration programme. Now, the focus of the Delhi government is to ensure that those who have received the first dose and are due for the second shot receive it on time.

As of Sunday afternoon, 1.01 crore vaccine doses had been administered in the city. Of these 74,31,842 are first doses, and about one-fourth are second doses at 26,70,949.

With the government’s push for second dose administration, the number of these doses administered in the city began to outnumber first doses for the first time since the Centre took over the vaccination programme for the 18-44 category on July 21.

On that day, 29,966 first doses had been administered and 33,446 second doses. This difference has now grown to 20,179 first doses and 62,870 second doses on July 31.

August 2, 2021 0 comment

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PG doctor assaulted by patient’s kin at Hyderabad’s Niloufer Hospital parking lot

by Medically Speaking Team August 2, 2021

written by Medically Speaking Team

On Saturday, a patient’s family member allegedly assaulted a doctor at Hyderabad’s Niloufer Hospital. The accused attacked the PG doctor, who works in the Paediatric Department and is in his last year, when he honked at him in the parking lot. The doctor’s nose and face were injured, according to photos obtained after the event.

The accused, Mohammed Shaffudin, had blocked the parking lot exit and refused to move even when the doctor, who was in his car, honked at him, according to a written complaint filed with the Nampally police station by the Hospital Superintendent. “At 2 p.m., the doctor was leaving the parking lot after his shift. The accused refused to allow the automobile to pass and blocked the exit. The accused began assaulting the doctor when the doctor honked at him, according to the complaint.

The accused then went over to the car, forcefully opened the door, hit the doctor on his face with his knuckle and tore his shirt, the complaint mentioned. Another female attendee of the patient also used abusive language towards the doctor.

August 2, 2021 0 comment

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