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Pfizer is a US drug maker who has released late-stage human trails data of the Covid-19 vaccine that has been developed with German biotech Firm BioNTech. Pfizer and BioNtech has announced their mRNA-based vaccine candidate, BNT162B2, against SARS-CoV-2 has shown evidence of efficacy against COVID-19 in participants without prior evidence of SARS-CoV-2 infection.

According to the study based on the trials found split between vaccinated individuals and those who received the placebo indicates a vaccine efficacy which is above 90%. The efficacy rate 90% is after the second dose. This consist 2-dose schedule and its given within the duration of 28 days.

“Today is a great day for science and humanity. The first set of results from our Phase3 COVID=19 vaccine trial provides the initial evidence of our vaccine’s ability to prevent COVID-19,” Said Dr.Albert Bourla, Pfizer Chairman and CEO in a statement released upon the results

“The first interim analysis of our global Phase 3 study provides evidence that a vaccine may effectively prevent COVID-19. This is a global collaborative effort,” Prof Ugur Sahin ,BioNTech ,Co-Founder and CEO in a statement released upon the results

To review the COVID-19 situation in India Union Health Minister Dr.Harsh Vardhan holds virtual meeting with all the States Health Ministers Andhra Pradesh, Assam, Haryana, Himachal Pradesh, Kerala, Punjab, Rajasthan, Telangana, and West Bengal.

By Dr. Aishwarya Krishnamurthy

Diabetes is like a roller coaster – it has its ups and downs but it is up to you to scream and suffer or enjoy the ride! ~ Unknown

According to International Diabetes Federation, India has 77 million persons living with diabetes mellitus (DM) and has the second highest number of children with type 1 diabetes mellitus(T1DM). Additionally, the Nation is also burdened with a large number of those with pre-diabetes (14% of the population).

This means that not only the individuals but also their families are facing the effects of this lifestyle disease on their physical, mental, emotional and financial well-being.  Whether the person affected is a child, adolescent or adult, other family members perceive it as a more serious condition than those affected by it so they experience more fears and worries.

The effects of a diagnosis of DM in a family member varies according to the age of the patient at the diagnosis of the disease. When DM is diagnosed in a child, the major brunt of the familial responsibility is borne by the parents. This could mean several things for a parent, like giving up a job or other personal activities in order to divert more time to child care, some may on the converse be forced to take up extra jobs to meet the financial burdens of the disease management. Managing complications like hypoglycemia (i.e low sugars), particularly when the child is at school or at night as well as sick-day management of children with DM poses great strain on the caregivers. Parents of children with DM, often experience various degrees of guilt both at the diagnosis as well as the deviation from “normalcy” for the child. In the Indian settings, this is often worsened by extended family pitching in with unsolicited advice and opinions. Siblings of the child with DM are also affected by guilt, inattention and restrictions imposed by the disease on the family.

When diabetes is diagnosed in an adult, the spouse or partners are the ones who face significant changes. This could mean dealing with financial burdens posed by the disease management as well as loss of employment of the patient for health reasons. There may be problems related to having a child in both men and women with diabetes which could directly affect the partner or spouse. Many think of it as a burdensome disease that one cannot control and frequently, there is some amount of blame game due to the myths and fallacies that surround diabetes e.g. eating sugar causes diabetes, poor self-control or laziness. In an older couple, it may pose significant stress on an older spouse who might themselves be suffering from diseases and unable to support them adequately.

On the flip side, it is well documented that the family plays a crucial role in managing many chronic diseases. A supportive family helps accepting the diagnosis and treatment that much easier for the patient at any age. It not only keeps the patient motivated to adhere better to medications and medical advice but also maintain a positive frame of mind while doing so. Studies have also documented that unsupportive families can harm the patient by furthering feelings of inadequacy, guilt and helplessness.

So, the family is affected by and affects DM management universally. Here are a few tips to help families to face the battle against diabetes, together with their loved ones.

Knowledge: Arm yourself with facts about diabetes. Myths about the condition lead to greater stigma, hurt and most importantly, misunderstanding and misdiagnosis. Teach yourself and some extended family members about blood sugar monitoring, lifestyle changes required and remember that each person with DM has different needs. Keep in touch with your doctor to know more about how you can help.

Encourage healthy eating: Diabetes management needs keen attention to healthy eating so check and make appropriate changes in the family meal plans. Eating healthy is beneficial to all irrespective of the presence of DM. It is more encouraging for the person with DM to stick to the diet when the entire family is trying. Limiting highly processed foods, sweets and fried foods and increasing healthy food choices like whole grains, vegetables, fruits, low fat milk products, lean protein sources and healthy fat in the family diet will go a long way in improving overall health of the family while helping persons with diabetes to adjust their eating.

Exercise together:  Regular physical activity will help the patients to lose weight and lower blood sugar while contributing to their general mental health due to production of endorphins. A realistic goal to achieve this is a half-an-hour of activity per day, which can also be broken up into 10-minute segments. Provide companionship during this activity be it walking, biking, yoga, exercises or enrolling in a gym so that both benefits.

Rest: Make sure that the patient gets enough sleep since it will make it easier to control blood sugars, be more alert during day time, possess extra energy, experience less stress and have a more positive approach to the condition. Remember both high and low sugars can disrupt sleep.

Be observant to drops in blood sugar: Sometimes blood sugars may drop in persons with diabetes causing them to be shaky, nervous, irritable, impatient, sad, angry without reason, experience sweating or clamminess, weakness, hunger and may feel dizzy and find it difficult to concentrate. Learn to be observant of these symptoms and take necessary steps to test and take appropriate action to rectify the situation.

Don’t nag! Be Positive! The key to diabetesmanagement is a behavior change – Never to overeat, miss daily exercise or forget to take medications – supported by a realistic goal setting.  Family members should try to avoid using guilt as a method to increase compliance in patients. Instead try and encourage a positive attitude for the same. Being kind and appreciating the efforts of each other will go a long way in beating the disease.

In the words of Victor E Frankel- “When we are no longer able to change a situation, we are challenged to change ourselves.”

The family should remember that life is not over because someone in the family has diabetes – look at it as a challenge to be faced together!

By Prof (Dr.) Sundeep Mishra
Department of Cardiology, AIIMS, New Delhi

Over the last several decades, there have been rapid advances in human information, knowledge, skills, and wisdom. The advances have encompassed all fields; science, commerce, communication, aesthetics, and philosophy. In pre-modern times, irrespective of the profession one pursued, the focus was on the all-round development of personality, encompassing all the fields simultaneously. Thus many famous medical professionals of the past were also famous philosophers (Charaka, Hippocrates, Descartes, Galen, Avicenna, Carl Jung), poet / writers (Avicenna, Keats, Chekov), business (Kellogg, Pepsi Cola), communication (Osler, Benjamin Spock, Kubler-Ross). However, with advent of specialization the emphasis has shifted towards greater information / details about the area of interest but with narrowing of perspective. Translated into the medical field this has led to doctors to relatively keeping pace with scientific inventions / skills, advances in business models but slacking in fields of communication, philosophy and aesthetics. Thus we are now encountering a new breed of doctors who are smart, know their subject but lack in the social element; may lack empathy, communication skills, and are unable to gather the broader perspective of patient & their disease but rather are concerned with superficial and trivialities. This creates a huge mis-match between the expectations and actual health-care delivery in the eyes of lay public, a certain recipe of disaster at societal level. Medicine is not pure science like engineering, physics or chemistry but a social science, which is practiced in a social context where issues of empathy, ethics are foremost and far exceed mere physical cure.  
So can we do something about it?
While the solution is tackling each of these problems at an individual level, best results may be obtained when these strategies can be employed at the earliest level or at the initiation of the medical school, in other words when incorporated in the medical curriculum itself. Medical curriculum has been an evolving process and the scientific part is frequently updated to bring it abreast with the latest scientific advances. Over the past several new topics have been included in medical curriculum which was not previously present; genetics and immunology are just some examples. However, in most places, especially developing world it has failed to keep pace with advances in other areas like communication, management theory, personality development, ethics, aesthetics etc. Thus there is a need to revisit medical curriculum to attune it to current social context otherwise gap between the expectations and actual delivery will keep widening.
Here are some of the suggestions towards improving medical curriculum:
Newer Ideas in Curriculum of Medical Students
1. PROFESSIONAL DEVELOPMENT
A) Empathy Development
Understanding emotional intelligence and learning the art and skill of empathic listening and action
B) Medical Communication
Understanding modern Doctor-Patient relation and developing Doctor-Patient communication particularly “therapeutic communication” with special emphasis on lost art of “bedside manners.”
C) Personality Development
Understanding the requisite personality attributes to becoming a good doctor, training the budding doctors to incorporate these attributes in their personality. What is the appropriate professional conduct of the doctors with patients, their families, with colleagues, other health care staff, hospital administrators, regulators and society at large?
D) Technique of Medicine
Developing patient centered clinical methods, focusing on improving art of history taking, quickly incorporating evidence in medical practice and particularly on patient safety.
2. MANAGEMENT PROFICIENCY
In current times besides professional skills developing management skills is also absolutely mandatory. The requisite management skills pertain to:
A) Individual & Interpersonal Dynamics
These skills involve:
i) Understanding the motivators & motivation in medicine and assuming an ethical approach towards market-place
ii) Developing an approach of balanced decision making & judgment and a proper attitude towards clinical job
iii) Understanding inter-personal relationships & communication and developing skills; negotiation & conflict resolution especially in clinical settings, skills of crisis management especially when there is an impending threat of violence of property & personnel.
iv) Understanding in which situations there are chances of medical error, malpractice & negligence and how to avoid them
B) Team & Unit Dynamics
Understanding the (big)5 personality traits of a leader, team norms and practices and the network of organization. Learning how to evolve into a leader and be able to co-ordinate medical teams / organization.
C) Organizational Dynamics
There should be some discussion on organizational structure & design, organizational culture, change management and inter-organizational relationships.
3. MEDICAL HUMANITIES
A) Philosophy
There should be a basic introduction to various branches of philosophy particularly in context to medicine; epistemology, consequentialism, deontological Ethics with particular emphasis on medical ethics
 B) Arts
Aesthetics is perhaps the most neglected part in medical curriculum although there is a close historical and psychological relation of art with medicine particularly in developing empathy, the most essential skill in any doctor.
4. ART OF LIVING
Doctors have among the highest risk of burnouts and suicides among all professions especially “white-collared” ones. The reason is that since beginning they are ‘taught’ to focus on gathering knowledge as also keeping ‘patient first’ even at the expense of self and family. This excessive focus on professional skills leads to neglect of self and inter-personal relationship. Thus these budding doctors need to be tutored into the art of living from the beginning. Particularly they should be informed about the benefits of outdoor, the need to be flexible about things and be able to change habits and coached on how to increase mental stamina and increase attention span.

In lats 24 hours India has reported more than 45,903 new Coronavirus (COVID-19) infections cases. India has total 85,53,657 Covid-19 cases with 490 new deaths and total number of deaths mounts to 1,26,611.

Overall total active cases in India are 5,09,673 and total number of cured cases are 79,17,3

Delhi is one the worst affected State due to Covid-19, Delhi Health Minister Satyendar Jain has said “Delhi is witnessing the peak of the third wave.”

In Delhi due to number cases increased bad shortage has become the biggest concern for the Delhi government.”The government has increased the number of beds for Covid-19 patients in hospitals.This is worst wave so far but cases will come down soon,”Health Minster added

According to the Union Health Ministry in last 24 hours India has reported 45,674 new COVID-19 cases. India’s total cases surge to 85,07,754 with 559 new deaths that total counts to 1,26,121.

The total number of discharges are also decreased.

Total coronavirus cured cases are 78,68,968 and in 24 hours 49,082 has been discharged.

The total number of tests done are 11,77,36,791 for coronavirus (COVID-19 ) According to the Indian Council of Medical Research (ICMR) 11,94,487 samples were tested in last 24 hours

Delhi and Maharashtra are reporting the maximum number of positive cases.In last 24 hours Delhi has reported 6,953 fresh positive cases.and the maximum number of deaths. The total number of positive cases rises to 4,30,784.

The Indian Medical Association (IMA) has strongly opposed centre on mixing medical education with Ayurveda , homeopathy, Yoga and Unani.

“The medical fraternity of our country is highly perturbed by the recent policy changes regarding medical education practice, research, and administration. The radical changes that are being institutionalised will have a series of impacts on the health of our people.” IMA stated

 The reaction of IMA has come after the Niti Aayog officially formed the four committees to integrate all systems of medicine. These committees are in the area of medical education, clinical practice, public health, medical research and administration.

“The most importantly Ima opposes mixing of the system of medicine.IMA warns the people that millions of lives will be lost before any rectification can be made.IMA stands for purity of systems of modern medicine as well as Ayush. It is not in the  interest of traditional systems either to lose their identity and further development.” Further added in a statement

According to the Dr.Rajan Sharma, President IMA “IMA is concerned about the developments and has taken upon itself the campaign to sensitize the people on the dangers of shifting to an integrative system of medicine.

In an Exclusive interview with Medically Speaking Adar Poonawala, Ceo, Serum Institute says if it’s proven immunogenic and efficacious then it’s expected to get the vaccine by January 2021.

According to the reports it’s expected that India may get vaccine by January 2021 but it depends many important developments that includes trials success , immunogenic and efficacy.

“The UK trials are on the verge of completion, and our Indian trials are also running smoothly. It is too early to comment on when India can get a vaccine.Based on the trial’s success in India and the UK, and if approvals from regulatory bodies are in place in time, then we can expect the vaccine to be available in India by January 2021 (only if it’s proven immunogenic and efficacious).” Said Adar Poonawala, Ceo, Serum Institute.

The cost of Vaccine is yet to be decided and Serum Institute is also in conversation with the government “We are in conversation with the government regarding the cost of the vaccine and it is too soon to confirm. But it will certainly be affordable.” Said Adar Poonawala, Ceo , Serum Institute

The Serum Institute has done a huge investment till now in terms of production , technology and production “Currently, we have invested around $200mn for the COVID vaccine candidates in terms of optimizing our production of the facility, technology, and resources to ensure smooth production. Additionally, as part of our alliance with GAVI and Gates Foundation we have received $300mn to manufacture billions of vaccines for GAVI nations and India.”Says Adar Poonawala,Ceo, Serum Institute

However manufacturing capacity of Serum Institute is billions doses “Presently, we have an annual capacity of over 1.5 billion doses. Once the new facility is ready, our capacity will be around 1.95bn doses. Following the urgency of the situation,  we have dedicated two of our facilities in India to produce millions of doses of COVID-19 vaccine. So far, we have produced small batches for testing and trial purposes only. Under an at-risk manufacturing and stockpiling license from DCGI, we will soon be manufacturing 60-70 million doses, and aim to scale manufacturing further up to 100mn doses of the vaccine per month. However, we will progress to mass production only after it is proven efficacious and immunogenic for mass use.” Ceo , Serum Institute Adds

Presently, Serum Institute is conducting trials on 1,600 volunteers and 15 different locations.

By Dr. D.K. Jhamb, Director & HOD Cardiology

The global coronavairus pandemic has made us cautious about our health. A healthy body is the cornerstone of a healthy life. We should ensure that our body remains healthy in such unprecedented times. To do so, one should make sure that he/she is exercising well while being indoors as gyms are still closed.

You can go to safe areas outside like nearby parks when there is relatively less rush so that you can exercise enough to prevent rise in blood pressure, sugar, cholesterol and body weight. During the lockdown, it has been seen that people are trying their hands in cooking and that may result in greater weight gain. Since the coronavirus vaccine or cure is still a few months away, we have to adhere to all precautions to keep ourselves healthy for the months to come
But when you’re stepping out of your house, you should adhere to all the safety precautions like wearing the mask when you’re exercising outdoors. Since, you have put the mask on, it’s advisable to reduce the intensity of your exercise by 20 to 25 percent from your earlier schedule. These masks, which cover your mouth and nose, cut down on the amount of oxygen you take in while exercising. Using the mask when training forces your heart and lungs to work harder.
Choosing the right mask is essential. Consider one of the many athletic face masks or face shields available in the market. Although athletic face masks are relatively new technology, there is a lot of research and science behind their design and functionality. Bring an extra, clean mask to change into if your mask becomes wet from sweat or heavy breathing. Damp masks can make it much more difficult to breathe. Moreover, a wet face mask is significantly less effective than a dry face mask.

According to the Union Health Ministry in the last 24 hours, India has recorded 47,638 cases of Covid-19 infection cases. The total number of deaths reported in 24 hours is 670 and the total number of deaths since the outbreak of Covid-19 is 1,24,985. The total active cases are 5,20,773 after a decrease of 7,189 in the last 24 hrs.

The total cured cases are 77,65,966 and discharges are 54,157 after the treatment of coronavirus (COVID-19) .