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It has been reported from various hospitals about Covid-19 patients who are getting fungal infection.The Sir Gangaram hospital in Delhi has reported many cases of fungal infection which is leading to patients losing eyesight.On asking about such cases from Dr V K Paul , Member (Health), NITI Aayog , during press briefing said “This is a devastating disease. We need to be cautious. This could be a mild disease but can take a serious turn.”

The Sir Gangaram hospital has reported such 12 cases in just 15 days of time.

The U.S. Food and Drug Administration staff said a two-dose regimen of Moderna’s vaccine has proved highly effective in preventing COVID-19 confirmed cases. The FDA reviewers did not raise any safety related issues for using Moderna’s COVID-19 vaccine in adults over the age18. They clearly said that no serious side effects has been seen in the general population in the study.

The United States has planned to deliver 40 million vaccine doses for 20 million people this month.

The Union Ministry of Health and Family Welfare has sent a warning to the states and union territories regarding preparations for adverse events during vaccinations.

“Adverse events following immunisation is a critical issue. When we undertake a universal immunisation program, which has been done for decades, then some adverse effects are seen in children & pregnant women after vaccination,” said Rajesh Bhushan, Secretary, Union Ministry of Health and Family Welfare

He highlighted about the adverse event already begun in countries like UK during immunisation of COVID-19.

“We can’t deny chances of an adverse event when COVID-19vaccination begins. In the countries where immunisation has already begun, especially in the UK, adverse events took place on the very first day. So, it is essential that states and UTs prepare for this too.” he added

In India, there are many states who are still reporting COVID-19 higher number of cases like Uttarakhand, Nagaland, and Himachal Pradesh.According to Dr. VK Paul, who is Member (Health) . Nitiyog said “There are states where we still have concerns. We request the govt and citizens of Uttarakhand, Nagaland, and Himachal Pradesh that every effort be made to bring the situation under control.”

During the press briefing of Ministry of Health on COVID-19 Dr VK Paul , Member (Health), NITI Aayog congratulated the Government of Delhi for a significant control on COVID-19 cases, “We are happy to note that Delhi has made progress, we congratulate the Govt of Delhi as well as the other governments who have done so well in contributing towards such a significant control in the recent times.”

COVID-19 Pandemic has raised many psychosocial issues in its wake and the world is grappling at the consequences of its effect at various levels. Due to social restrictions, most of the world’s population has to rely on the internet and online communication, for work as well as pleasure. While earlier, the issue of mobile phone overuse, internet overuse and addiction were discussed in the context of unreasonable and unnecessary use that caused avoidance of necessary physical and social activity, the pandemic has forced many unwilling people into the quagmire of the virtual world of online communication.

The research in this field has been going on for few decades now, the adverse effects of excessive mobile phone use has been studied across various age groups. Studies indicate the following effects –

1. Effect of radio frequency emission on human tissues-

In 2011, the International Agency for Research on Cancer (IARC) classified mobile phone radiation as possibly carcinogenic, which means that there “could be some risk” of carcinogenicity, so additional research into the long-term, heavy use of mobile phones needs to be conducted.

With younger people, especially children using mobile phones for several hours in a day, the life time exposure  to such radiation increases exponentially with potential biological impact on cell physiology.

• Impact on neural physiology-

Scientists have reported adverse health effects of using mobile phones including changes in brain activity, reaction times, and sleep patterns. While the research is underway, children are more susceptible to such changes because they are vulnerable to emotional and behavioural disturbances due to their immature coping skills.

• Addiction-

Excessive indulgence in mobile phone activity has addictive potential due to the ease of availability of devices and immense stimulation at finger tips. Children and young adults are driven by pleasure principal, which means they are excited easily and are drawn towards activities that give immediate gratification. Internet surfing on mobile devices exposes one to a vast world and with little self control, most young people are vulnerable to indulge in virtual reality and spend less time in real world interactions. Behavioural disturbances like spending long time on mobile while neglecting routine activities like eating, self care, social interaction and academics and showing withdrawal effects like irritability, aggression, mood instability, anxiety and depression when mobile device are taken away are reasons why harmful and uncontrollable use of mobile and internet is being considered as a form of behavioural addiction.

• Impact on social health-

Real world social interactions with family, friends, neighbours and other members of society is necessary component of overall health and COVID has highlighted its importance. Excessive use of internet devices reduces the time as well as inclination to indulge in real physical interactions. Especially young adults who are learning social skills and behaviours are at risk of developing maladaptive personality.

• Impact on musculoskeletal system-

Sitting and working on mobile devices for prolonged periods can cause effect on musculoskeletal system due to bad posture and strain on muscles of neck, shoulder and back. Excessive use of mobile has also been linked to pain and swelling in joints of thumb, fingers and wrists leading to various deformities.

• Eye strain and refractory errors-

 The continuous watching of small screen results in dry eyes, irritation of eyes, watering and eye strain which can also culminate into higher incidence of ophthalmological and refractory errors. The impact of blue light rays entering the retina is a matter of concern and many experts believe that it can result in macular degeneration, even though the investigations do not conclusively prove anything.

• Impact on physical activity-

Many of us have seen the reduction of physical activity among people with the spread of technology and gadgets. Internet gaming has reduced interest in sports and less and less children are seen playing in parks.

Psychological impact of excessive mobile phone use in children-

Children have an immature biological and functional system which is why they are quite vulnerable to environmental changes. The jury is still out regarding the biological and physiological impact of electromagnetic radiation emissions but the psycho social impact is very much apparent.

Due to online education, children are at the receiving end of yet unknown effect of technology. Several hours of exposure to electronic screen has reduced necessary physical activity which is not only important for physical growth but has significant effect on mental growth as well. Many bad habits like eating too much junk food and sugar cravings are associated with electronic screen over use.

The neural activity associated with reading and writing has many subtle benefits in terms of development of Neuro motor, cognitive and emotional components of intelligence which are hampered due to effortless feeding of facts via electronic medium.The audio visual content does not allow much for imagination and can reduce creativity.

The reduction in social interaction hampers social skills development and emotional and behavioral regulation learnt during socializing. This can have far reaching impact on a developing personality with risk of development of low stress tolerance and maladaptive reactions. With the advent of compliant AI that responds to voice command, children are unfortunately losing the virtues of humility and knack of respectfully asking instead they are learning to order around what they want and even getting it.

Last but not the least, technology and nature needs to be in balance because too much of one harms the other. While children are being made aware of need to save earth through approaches focused at reducing pollution, the implications of over use of technology also needs to be highlighted. Parents and society need to be made aware of the potential damage caused by mobile phone use and alternative modes of communication and knowledge dispersion need to be worked on.

The writer is Dr. Jyoti Kapoor , Senior Consultant ,Psychiatry and Psychotherapy, Paras Hospital

In an order directed by the Rajesh Bhushan ,Secretary, Ministry of Health that non-compliance will be treated as offense under the Disaster Management Act.

“It’s hereby directed that AlIMS Delhi should ensure that directions of Delhi High Court are strictly complied with without fail & there should be no cessation or disruption of Nursing functions in AllMS nor such an action aided or abetted.”

“Non-compliance will be treated as an offense under the Disaster Management Act read with the Indian Penal Code and action will be taken accordingly against defaulting authorities/employees.” the copy of order states

The nurses union of All India Institute of Medical Sciences (AIIMS) has announced an indefinite strike over redressal of their demands.

The nurses mainly has 23 demands, which have been accepted by the government and AIIMS administration. There one of the major demand is implantation of the sixth pay commission.

AIIMS director Randeep Guleria said it is sad that the nurses union has gone on strike during the COVID-19 pandemic times.

“It’s unfortunate the union has gone on a strike now, only a few months from when a vaccine will provide the solution. I appeal to all nurses & nursing officers to not go on strike & come back & work and help us get through the pandemic.” Said Dr. Randeep Guleria, Director, AIIMS Delhi

The nurses union of All India Institute of Medical Sciences (AIIMS) has announced an indefinite strike over redressal of their demands.

The nurses mainly has 23 demands , which have been accepted by the government and AIIMS administration  admnstration. There one of the major demand is implantation of the sixth pay commission.

AIIMS director Randeep Guleria said it is sad that the nurses union has gone on strike during the COVID-19 pandemic times.

The first batch of COVID-19 doses reaches Canada, it’s expected to start the first shot of the vaccine today. Canada and the Unites States are set to start the vaccination from the Pfizer & BioNTech vaccine. The UK has already started inoculations in the last week.

“The first batch of doses of Pfizer-BioNtech’s COVID-19 vaccine have arrived in Canada,” Tweeted PM of Canada Justin Trudeau

The initial 30,000 doses will go to 14 sites across Canada and will be given to the elderly and healthcare workers.

According to the union health ministry and family welfare the total number Of COVID-19 cases reported in last 24 hours is 27,071 . The total number of cases from India are 98,84,100 and total deaths reported in 24 hours are 336 that toll mounts to 1,43,355.

The total discharged cases from the time of outbreak are 93,88,159 with 30,695 new discharges in the last 24 hours.

By Dr M D Ray

Cancer is the second most common cause of death after heart disease worldwide. It is a hard fact that in India Cancer death is 1400-1500 per day. Every year 10-12 lakhs cases being registered. At a point of time 25 lakhs cases estimated in this country. Cancer namely oral, esophageal and lungs, Prostate, Stomach in the male and breast, cervix and ovary, Oral and Colorectal cancers in the female are most common in India.
Institutions like AIIMS are over burden always during Covid too.
Due to lack of data in past, we are also not in a proper shape to find out the ideal way to handle cancer patients. But on the basis of our own knowledge and experience and constantly generating data worldwide we frame out a protocol in our center. Still it is not fixed and varies as per the need of the patient and safety of health personnel as well as the patients
No doubt any emergency related to cancer like bowel obstruction, bleeding, inability to intake of food. Elective cases should undergo the appropriate treatment proper way. Now a days almost all the cancer center in India started doing cancer surgery with special precaution. No standard guideline is there. So the treatment is individualized.

Suggestion for cancer patients
Strict to one place of your choice as per your budget. Government hospitals are always better for those who are financially challenged. Those who have the option of chemotherapy, they can undergo chemotherapy first followed by surgery
Before admission COVID test is mandatory and another COVID test to be done within 24 hours before the surgery
It is considered safe to delay treatment for both surgery and radiotherapy 3 months for low risk and stable disease
High-risk patients need treatment at the earliest. Metronomic therapy (maintenance oral chemotherapy) also recommended during the preparation phase of the patient’s before the major surgery.
Important study regarding surgical outcome during COVID published in The Lancet, June 20
We know how COVID 19 affected Whole World! Medical services specially Surgical, more precisely rate of cancer surgeries slowed down throughout the Globe.

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study-
Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths.
So one thing to understand that performing cancer surgery is a daily routine for an Onco-surgeon but getting infected by COVID-19 may endanger life. As cancer patients are immunocompromised thereby chance of infection is much higher than the general population. Thereby precautionary measure is always mandatory before performing major surgeries.

Recommendation to prevent COVID infection and get the cancer treatment
Social distancing two meter. Using mask in a proper way (Snugly tight) specially in public space. Hand hygiene and sanitation. Lung Exercise, Intensive spirometry or Pranayama. Avoid to expose the rumor and opportunist. Do regular exercise, meditation and your own work and talk to your friends and love one. And from my side you can have Vitamin C 500 mg and Tab Zinc 50 mg once daily, both have cell protective and help to develop cell mediated immunity.
Vaccine is on the way to come but that is not 100% effective(Effective 60-90%).Storage ,Transportation and inoculation in a proper way is important issues in a highly populated country like India and one important thing to understand that immunity may persist only few months .
So my suggestion is – make the most whatever is in your hand i.e. Prevent Covid and get your cancer treatment at the earliest.

The writer is Dr M D Ray , Additional Professor, AIIMS , New Delhi.