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dr harshvardhan
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Union Health Minister reviews health facilities at Trauma Centre

by Medically Speaking Team
written by Medically Speaking Team

In the wake pf explosive spread of Covid-19 during the second wave, the Union Health Minister Dr. Harshvardhan visited AIIMS to review the facilities available at AIIMS  Trauma Centre , the facilities available including the oxygen supply in the trauma centre of AIIMS for the Covid patients. In the review meeting AIIMS director Dr Randeep Guleria and other doctors from AIIMS was also present.

“Covid – appropriate behavior implementation is the biggest challenge before us. People have become casual during second wave. We are doing everything to speed up vaccination and bring more vaccine in to the country. We have already given ventilators to the states and they are not demanding more because they are not able to use the current ones because of lack of space. In the last week we took many decisions to strengthen the supply of oxygen on the same dynamic pattern as we did last year,” Dr Harsh Vardhan said.

“Our biggest fight this time is to teach COVID appropriate behaviour to the people. People have adopted a casual approach which is very dangerous. COVID Appropriate behaviour is the biggest social tool we have to break the chain.”In order to encourage the public from following CAB in the quest for a COVID free environment, he put out statistics that demonstrate the diligence of the general public along with the hard-work of healthcare and frontline workers: “India has 52 districts with no fresh cases in 7 days, 34 districts with no fresh cases in 14 days, 4 districts with no fresh cases in 21 days and 44 districts with no fresh cases in 28 days.” Says the statement

On Remdesivir he said , “He also detailed steps taken by the Union government to stop black marketing of drugs like Remdesivir and Itolizumab”.

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covid
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Post February Spike Needs Patience & Tight Curbs

by Medically Speaking Team
written by Medically Speaking Team

By Dr.Aaloc Srivastava

          Keeping in view grim Covid scenario, we appealed to relatives and acquaintances  many times.

It appears, it had negligible impact. May have fallen on immune ears.
India became second on 4th April after USA to exceed one lakh positive cases in a day.Previous peak of 98,795 was on 17 September.These numbers vaulted seven times in 52 days,up from 11,364 to 78,318.It was the sharpest rise .

Maharastra Leads

Given that rise in Maharastra has been mind boggling, State declared “Lock Down 2.0”, in April beginning, ordering full weekend L.D.,night Curfew,eating ban in restaurants and shutting shops,except essentials, till April end.

But situation deteriorated further.Of 13.9 million cases nationally,Maharastra’s share is 3.52 millions, contributing 58 % national cases and 34 % deaths on 7th April.
Coming to 24 hour cases, figure of Maharastra is 60,222 as against 1,84,388 cases, pan India.Active cases nationally too have surpassed 13 lakh mark on 14 April.
To add fat to fire,national positivity rate of 25% and 16 % of Delhi can further scare.

Unpredictable Kejriwal

He relishes swimming against the tide.So 586 % rise in 24 hour cases in a fortnight as compared to 16% rise in Mumbai in a week,can’t be ignored. Also its unfortunate to see 66,300 cases in eleven days.To make matters worse, UT recorded highest ever 17,282 cases in last 24 hours. However, Kejriwal’s review of Covid & Non- Covid deserves kudos.
Apart from Virus onslaught in Chennai,
Bengaluru & Pune,
Punjab and Chattisgarh too need to be mentioned.While both blame Centre to be unfavourably disposed of towards them,situation needs better management.

Dignity In Death

After ensuring correct reporting,adequate arrangements are necessary at ‘departure grounds’,viz carriage of dead body decently,preventing theft of organs,time management,one by one disposal etc.

Augment National Vaccination

Having administered 11.44 crore vaccinations,we have covered barely 2 percent  population(1.42 Crores) as regards both the doses.While irregular supplies  closed over 100 centers recently,Govt.functionaries tried cover up. Preventive and curative vaccines were also placed in black market.

Tiny Bhutan(62%),Israel(51%) & U.K.(49%) occupy top 3 places.One can learn from Israel experience.
While speeding up,we must deal firmly with vaccine black marketting. Reported involvement of some doctors is shameful.Ruling & opposition factor has to be forgotten.Also,be it Chinese or Russian cure, its better to postpone than repent.

Is Full L.D. Solution ?

The former L.D. in contrast to present ‘Chain Breaker’ could have saved many lives.Nomenclature change hardly matters.While most of States appear having pulled up sleeves,SS Maratha warriors refrain from being decisive in public interest but they may AIM to ensure stability of their Government.
Could we blame political weakness or unknown fear for such a state of mind ?
Lock Down coming ,coming,
………. .When ? It’s becoming akin to the infamous Wolf Coming.
When do we get rid of it ?

Labour Class

When migrant workers have begun departing again, is it not easy passage this time ?
Despite creating few Covid records, we are yet to close public gathering joints,cut down vegetable & grocery hours, withdraw city & inter state buses,metros and trains.Are we learning from phase 1 to perform better?

Learn,Burn & Earn

Either in a Pandemic we LEARN or do something in a hurried way to BURN.But we need to also ensure EARN factor for service class.No motivating word from RBI or cajoling expression of IMF is expected to take us out of the mess we have created for ourselves.

Super Spreaders

Why do we need Shahi Snans
,Navratras,Ramzan,Teeka Day,AmbedkarJayanti etc when chips are down ?
Adequate Control over these Super Spreaders is necessary.

The writer is Dr.Aaloc Srivastava, Ex-Chief Secretary, Sikkim.

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coronavirus variants
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The Covid Second wave : It’s a biological war

by Medically Speaking Team
written by Medically Speaking Team

By Brig.Dr. Shashivadhanan

This is no more a pandemic. It does fall within the definition of a biological war. Whether it’s a lab grown pathogen turned rouge, or an index case of zoonosis, only time will say. The most potent and desirable bioweapons should possess four main characteristic features: low visibility, high potency, substantial accessibility, and relatively easy delivery. Whatever be its origin, the corona virus fulfills all criteria for being labeled the most potent bioweapon. It is following Darwin’s theory of survival of the fittest with élan. During the second wave, the virus has become more virulent, it’s mutating so intelligently that RTPCR is unable to effectively detect it .Vaccines too seem ineffective. The spread is like wildfire. There is no definitive treatment for this virus as on date. It does not respect the Geneva Convention. Cast creed, religion, age, gender, geographical boundaries are all passé for this virus. Evidence based medicine has taken a back seat.

Now that we know it’s a war situation, primitive instincts dictate that, each one has to protect one’s own protoplasm. Preventive measures are very easy to follow. We just need to keep our mask on, maintain social distance and sanitize our inquisitive hands.   Where death is imminent, humans need not wait for directives from government. In a war you don’t complain staying indoors, you don’t ask why you should not party or go to crowded malls or multiplexes. You don’t choose pleasure over your blessed life. Adopt safety protocols, protect your near and dear ones, and get your vaccine shots rather than insisting on class I evidence. Government need not be treating you like imbeciles requiring directives to keep you alive. Remember all activities should aim at keeping yourself and your dear ones alive. Prevention through self-restraint and self-discipline are of paramount importance. What should matter now is, come out of this war safely. It is a war and “ Corona ko Harana Hai”

The writer is Brig.Dr. Shashivadhanan, Professor(Surgeon & NeuroSurgeon)

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remdesivir
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Pharma Co owner arrested for selling fake Remdesivir

by Medically Speaking Team
written by Medically Speaking Team

A pharma company owner has been arrested by the Indore Crime Branch on Thursday for allegedly selling fake Remdesivir injections.

The accused is a resident of Indore’s Rani Bagh and a case has been registered against him under various sections including fraud, reports ANI.

“Around 400 Remdesivir vials have been recovered from the accused car’s, which were found to be fake after being investigated by the drug department. He owns a pharma company in Indore’s Pithampura. He planned to take advantage of the drug shortage and make money,” Guru Prasad Parashar, additional Superintendent of Police, Crime Branch said.

The police officer added the drugs were manufactured at a pharma unit in Himachal Pradesh, ANI reports.

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covaxin
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Centre approves Haffkin Institute to produce Covaxin on transfer of technology basis

by Medically Speaking Team
written by Medically Speaking Team

Mumbai-based Haffkin Institute has received permission from the Centre on Thursday to manufacture Bharat Biotech’s Covaxin on the basis of transfer of technology.

The owner of the institute, the Maharashtra government thanked PM Modi for the approval and tweeted, “The Dept. Of Science and Technology, Government of India, has granted approval to Haffkin Institute to produce Bharat Biotech’s CovaxinCovaxin vaccine on a transfer of technology basis.”

“CM Uddhav Balasaheb Thackeray has thanked Prime Minister for approving this request,” the tweet from the CM Office added.

Maharashtra is currently among the highest Covid case spike states.

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covid-19 virus
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India reports highest 2,17,353 COVID-19 cases

by Medically Speaking Team
written by Medically Speaking Team

India reports highest 2,17,353 COVID-19 cases and 1,185 deaths in last 24 hours .The total coronavirus cases in India reported from the time of outbreak is 1,42,91,917 .According the union health ministry Total recoveries are 1,25,47,866 and active cases is 15,69,743.

The total deaths are 1,74,308 and the total vaccination are 11,72,23,509

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Covid Tips on 9 Days of Worshipping of Goddess Durga

by Medically Speaking Team
written by Medically Speaking Team

By Dr Deepak Gupta
[Navratri Celebrations ongoing in India marks nine days worshipping of nine incarnations of Goddess Durga]

1.Steroids : Some benefit ( Dexamethasone/Hydrocortisone /MPA) : Useful only in patients on oxygen therapy/on ventilators. Don’t give in early first week, don’t give In mild cases ( More harm)

  1. Remdesvir +/- Baricitinib : Effective if given early within first 10 days of illness in patients on NIV/HFNC/ventilatory support. It speeds up time to recovery and has no effect on mortality.

3 Anticoagulants ( LMWH) followed by Oral anticoagulants ( Apixiban for 3 weeks) useful in all {if D Dimer high} but the mild disease.

  1. Plasma therapy : No Benefit …If at all then must be given within first 3 days from Plasma donor having very high antibody titres).
  2. Inhaled nebuliser interferons ( useful if available), Favipiravir ( improves time to clinical cure and cessation of viral shedding by 2-3 days) in mild to moderate disease , MoAB ( Superexpensive, can be used in mild high risk cases and helps in recovery , Tocilizumab ( IL6 antagonist) not effective for preventing death in moderate or severe covid patients and has sepsis risk. If one uses, use only one dose 400mmg only in select cases.
  3. What doesn’t work in Covid : Antibiotics ( azithromycin, doxycycline), Antivirals( Lopinavir), HCQS ( Chloroquine), Ivermectin, Vitamins
  4. Majority improve with body immunity without any treatment. Avoid steroids if you are asymptomatic and just RTPCR+ve.
  5. Oxygen therapy, HFNC/Ventilatory support if Oxygen saturation falls : Highly Recommended .

9 Vaccines : Covaxine, Covishield, Sputnik, Pfizer Moderna : 2 doses min 4 weeks recommended for all.

Remember : Covid virus is going to keep going until it infects everybody it possibly can: until it meets a vaccine or natural herd immunity … ( In India : with over 1 million cases in last 1 year and Vaccination drive at its superbest,,we are likely to achieve it soon). Just practice Covid appropriate behaviour ( Face Mask preferably N95 when outside home , Adequate hand washing, Physical distancing, Avoiding unnecessary travels outside).

The writer is dr deepak gupta, Sr Neurosurgeon, AIIMS.

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covovax
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More than 26 lakh vaccines administered today till 8 pm

by Medically Speaking Team
written by Medically Speaking Team

According to a provisional report by the Health Ministry, the total vaccination has crossed 11.70 crore today with more than 26.02 lakh vaccine doses administered till 8 pm.

Total 26,02,375 vaccine doses were administered till 8 pm today.

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IMA
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IMA writes to PM on VIP culture in govt hospitals

by Medically Speaking Team
written by Medically Speaking Team

The Federation of All India Medical Association (FAIMA) which is an association of doctors has also written to Prime Minister Narendra Modi on ‘VIP culture’ prevailing in government hospitals during the time of COVID-19 crisis .They have written in the letter to the PM that doctors of the hospitals are facing VIP culture when already there is no facilities for even doctors at the situation when they are testing positive for covid-19.

The Indian medical association is also supporting FAIMA and written letter to the Prime Minister , “IMA HQ whole heartedly support the justifiable demands of FAIMA for abolishing the VIP culture in Public health care hospital and restore accessible and affordable health care all . Junior Doctors are the back bone of health care delivery system.”says the statement by IMA

“Many govt hospitals have VIP counters for testing , allowing party workers and personal contacts of politicians and ministers to get themselves tested but in many places , doctors have no separate counter for testing. MA supports the demands of the doctors in service and request yourself kindly direct the officials to streamline this at the earliest and prevent burnt out phenomena percolating among the frontline workers and restore their morale.” states the release

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vaccination
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Union Health Ministry Issues Regulatory Pathways for foreign produced COVID-19 Vaccines

by Medically Speaking Team
written by Medically Speaking Team

The Union Government has today issued the Regulatory Pathway in India for COVID-19 vaccines approved for restricted use by US FDA, EMA, UK MHRA, PMDA Japan or which are listed in WHO Emergency Use Listing (EUL).

In a radical reform measure, the Union Government on 13th April 2021 had approved a significant streamlining and fast tracking of regulatory system for COVID-19 vaccines approved for restricted use by US FDA, EMA, UK MHRA, PMDA Japan or which are listed in WHO Emergency Use Listing (EUL). This decision will facilitate quicker access to such foreign vaccines by India and would encourage imports including import of bulk drug material, optimal utilization of domestic fill and finish capacity etc., which will in turn provide a fillip to vaccine manufacturing capacity and total vaccine availability within the country.

The Central Drugs Standards Control Organization (CDSCO) headed by DCGI has today explained that the following would be the Pathway:

  1. CDSCO shall prepare detailed guidelines specifying regulatory pathway for approval of foreign approved Covid vaccines based on NEGVAC recommendations.
  2. These guidelines have since been prepared and posted by CDSCO on its website. CDSCO will take steps to widely disseminate these guidelines to the concerned stakeholders.
  3. Applicants for grant of approval for Restricted Use in Emergency situation may be submitted to CDSCO.
  4. Application can be made by the foreign manufacturer through its Indian subsidiary or through its authorized agent in India (in case it does not have an Indian subsidiary).
  5. CDSCO will process such applications for Restricted Use in Emergency Situation and DCGI will consider and take a decision within 03 working days from date of submission of complete application by the applicant.
  6. DCGI will issue permission for Restricted Use in Emergency situation with, inter-alia, the following conditions:
  1. Vaccine shall be used as per the guidelines prescribed under National Covid-19 Vaccination Programme.
  2. First 100 beneficiaries of such vaccines shall be assessed for 7 days for safety outcomes before it is rolled out for further Vaccination program.
  3. Applicant shall initiate conduct of post approval bridging clinical trials within 30 days of such approval.
  1. Applications for Restricted Use in Emergency situation for such vaccines maybe accompanied by bridging trial protocol, application for import registration certificate and application for import license.
  2. CDSCO will process applications for Registration Certificate (registration of oversees manufacturing site and product: in this case Covid vaccine) and Import License, within 3 working days from the date of approval of Restricted Use in Emergency Situation.
  3. As per the existing protocol of CDSCO for batch release of vaccines, each batch of the vaccine will be released by Central Drugs Laboratory(CDL), Kasauli before it can be used as per the guidelines prescribed under the National Covid-19 vaccination programme.
  4. The applicant will use Covid vaccine, after receipt of CDL approval, initially only on 100 beneficiaries and submit the safety data to CDSCO.
  5. CDSCO will review the safety data submitted by the applicant, and once found satisfactory, will authorise the applicant to use the vaccine.
  6. CDSCO will approve the protocol for the bridging trial in consultation with Subject Expert Committee (SEC) within 7 days of the receipt of the proposal.
  7. Applicant will conduct the bridging trial within the time lines specified in the approved protocol, and submit data generated in the bridging trial to CDSCO.
  8. After the receipt of the bridging trial results, the DCGI will review the permission granted for Restricted Use in Emergency situation.
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