[BLACKRiVAL]

Originally Posted by poloman

Anchor Rohit Sardana died at age of 40 due to heart attack. He was Covid positive. Many young people in 30's and 40's suddenly dying of heart attack in a similar way?

@doctors, Is this due to cytokine storm syndrome? Any link between Covid and sudden heart attacks?

Some people develop myocarditis (inflammation of the cardiac muscle) due to covid. It could be the reason of sudden cardiac arrests in some people. I remember 2 cases of cardiac MRI from the last 6 months. A young surgeon in his 30s had a positive Troponin test indicative of cardiac muscle damage while coping with covid. 2 months later we did his cardiac MRI and were surprised to find no damage in the heart muscle. Another case was of a 20 year old guy post covid developed breathlessness on exertion. Cardiac MRI revealed substantial cardiac damage and we are not hopeful of him living more than a year. But these cases are extremely rare and not everybody is affected by covid in the same way.

[anjan_c2007]

Very shocking and untimely. Rohit Sardana will be missed by viewers. Their nature of duties are too hectic and coupled with deadlines and targets, it makes the work place almost a cauldron, with all 24 X 7 action and multiple sprints by the players.

[drrajasaravanan]

Originally Posted by lapis_lazuli

The trend in NCR doctor clinics, now, is to hand out pre-printed "medicine list as per protocol for mild to moderate" cases. Even before testing positive, as testing facilities are hyper-booked.

?

Hi,
The medications required for mild and moderate cases are standard dosages of multivitamins and paracetamol. Antibiotic are not a rule but co prescribed since there is possibility of bacterial infection and most doctors choose Azithromycin or Doxycycline or Augmentin and there is not strong evidence to prescribe one above the other. There is not much evidence to support usage of Hydroxychloroquine or Ivermectin or Remdesvir. None of them may add much benefit and patients recovering will do so in their absence too. Since their is paucity of strong support to use them and there is no evidence that they cause harm and due to perceived potential benefit the doctors are pushing it.

Originally Posted by poloman

Anchor Rohit Sardana died at age of 40 due to heart attack. He was Covid positive. Many young people in 30's and 40's suddenly dying of heart attack in a similar way?
@doctors, Is this due to cytokine storm syndrome? Any link between Covid and sudden heart attacks?

Hi,
To give an approximation roughly 20 to 30% of COVID patients who are hospitalized with moderate to severe disease show evidence of heart damage due to either direct injury to heart muscle or blocking the vessels supplying heart or the demand set by the body is not met by the heart which fails. This is an oversimplification of five different mechanisms. Most of the patients recover without lasting damage to the heart. Pre-existing heart problem and old age carries risk for injury to heart. India is famous for underage heart attack and the median age for heart disease is around 45Y and COVID is pushing in this zone.
There is few data that around 20% of death due to COVID is secondary to heart ailments and in that majority of them had pre-existing conditions which did not allow their heart to cope up. Lot of hospitalized patients who had myocardial injury recovered without any lasting sequelae.
To further simplify this heart injury is not common in most, common in hospitalized patients with severe illness which has good possibility to recover, can cause death in patients whose cardiac health was poor to begin with even if the disease is only moderate to begin with.

[breezydrive]

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[Fillmore]

Originally Posted by himarg

Need advice from the doctors among us. It is a slightly convoluted situation - kindly bear with me.

I and my wife have classic Covid symptoms since last 4-5 days. We have taken the test and are waiting for results. In the meantime we have started with the treatment as prescribed by a doctor.

My father is a dialysis patient and I am the primary care giver. He is dependant on me to take him to dialysis sessions.
....

I am in a similar situation barring the Covid symptoms.
We are based out of Bangalore.

Should my father suddenly turn COVID +ve it is a very critical situation as the Dialysis centers will not do Dialysis for him.

Would appreciate it if anyone can share info on the following
- Availability of Home Dialysis in Bangalore ( Hemo dialysis )
- Dialysis centers that will take COVID patients.

Note: I tried contacting some centers who had websites for home dialysis , but they are all non functional now.

[drrajasaravanan]

Originally Posted by Fillmore

I
Should my father suddenly turn COVID +ve it is a very critical situation as the Dialysis centers will not do Dialysis for him.
.

Hi,
In my centre in Chennai we have dialysis support for both COVID and non COVID patients albeit in different zones with necessary precautions. Different set of staff and different set of equipments. Lot of at home dialysis in Chennai at least is not fully functional. I think hospitals in Bangalore too would have both sectors covered. If your father turns COVID positive I am Sure you will have support. The risk is taking your father to the centre and bringing him back. Ensure all safety precautions.

[Zen2001]

Originally Posted by lapis_lazuli

For the doctors on the thread :

The trend in NCR doctor clinics, now, is to hand out pre-printed "medicine list as per protocol for mild to moderate" cases. Even before testing positive, as testing facilities are hyper-booked.

I am slightly confused. I have seen 4/5 sets of medicine recommendations. Please read below :

Set 1 : Ivermectin 12 mg 1 daily x 3 days + Doxycycline 100mg x 2 x 5 days plus vitamins and zinc

Set 2 : Ivermectin 12 mg 1 daily x 5 days remaining same as (1)

Set 3 : Ivermectin 12 mg 1 daily x 3 days (or 5 days) + Doxycycline x 5 days + Azythromycin 500mg x 5 days plus vitamins and zinc

What really works? Or is there a bare minimum dosage as in <1> above?

@Behemoth, since you are a proponent of Ivermectin (like me ) , any pointers from you?

None of these regimens have been clinically proven (in real world trials) to have any benefit in mild/moderate/severe Covid19. Infact, recently there have been recommendations AGAINST the routine prescription of such fixed drug cocktails, as they can have potentially serious side effects. I've posted more on this a few days ago, following someone posting such a prescription given by a govt hospital.
Paracetamol for fever, eating well, plenty of fluids (you can have ORS in summer), plenty of rest, warm saline gargles, steam inhalation (nothing added), and hot liquids like soups helps upper respiratory symptoms. The only drugs to possibly show benefit (but not in mild cases) are steroids - but these should not be used without supervision (as they have immunosuppressive effects).

Over 300 Indian scientists write to PM Modi asking for transparency in COVID-19 data.

https://www.thenewsminute.com/articl...19-data-148091

This is not meant to be a political post - but if eminent scientists claim to have censored access to virological, genomic, and epidemiologic data, how can we ever hope to:

1. Know what is driving recurrent waves
2. Mutations and their likely effects on infection, transmission, severity and vaccination
3. Formulate evidence based interventions to contain the virus
4. Predict the likelihood of future outbreaks
5. Plan development of newer vaccines, effective against current prevalent virus strains (instead of wasting time & resources over the ones that don't).

It's a novel virus, so why keep secrets? Who stands to benefit from this?

PS: Mods, please shift this post to a new thread on "covid19 policies" , if required. The elephant in the room also needs to be addressed, sometime.

[AZT]

A disturbing trend I've seen recently is people avoiding covid vaccines on advice from their Homeopath. Last week one friend told me his parents are getting this advice from their Homeopath and today another friend said her mom is also being told the same thing. These are both from different parts of the country. She even sent me the photo of some Aspidosperma drops which 'increase oxygen'. A simple google search shows this product is plain snake oil.

I'm not going into whether Homeopathy works or not but are these practitioners even qualified to give an opinion on vaccines.

In the short term we need a massive ad push where we get some famous Homeopaths / other alternative therapy practitioners to make it clear vaccines are safe. Long term goal should be telling people only MBBS doctors / researchers can give an opinion on this, the word Dr. itself has been diluted with so many different practitioners using it to describe themselves.

[vivek95]

Remember only 3 things work in Covid-19 treatment of admitted hypoxic patients --

1. Oxygen
2. IV Steroids ( lovely drug )
3. Prone ventilation

Rest all are inconclusive.

--Dr. Vivek

[Akshay6988]

Originally Posted by vivek95

Remember only 3 things work in Covid-19 treatment of admitted hypoxic patients --

1. Oxygen
2. IV Steroids ( lovely drug )
3. Prone ventilation

Rest all are inconclusive.

--Dr. Vivek

You missed one most important thing doc - You and all medical staff and your efforts to go above and beyond to save lives. Hats off to you sir ! Your posts in this thread are immensely helpful and quite assuring to us common folks Stay safe, take care and please accept this small token of gratitude.
Regarding the IV steroids, is it something that doctors prescribe or the "saline". Sorry I do not know much about medical terminologies.

[drrajasaravanan]

Originally Posted by AZT

A disturbing trend I've seen recently is people avoiding covid vaccines on advice from their Homeopath.

Hi,
I had this query among few patients whether they can opt for Siddha or Ayurrvedic medicines. Handling such patients is tricky as a push in wrong direction may make them choose something which will not help. So instead I and some of colleagues tell them they can use them for long term benefit for boosting their immunity while they should take the benefit for allopathic medicines for immediate results. I am at loss at how social media could reach so deep with misinformation.

Originally Posted by Akshay6988

.
Regarding the IV steroids, is it something that doctors prescribe or the "saline". Sorry I do not know much about medical terminologies.

Hi,
Steroids are extremely potent drugs to be used in moderate to severe cases who are hospitalized to blunt the damage triggered by the corona virus. It has two sides to it and in appropriate doses it protects against damage and if used callously will work against the patient. Never to be taken lightly without a medical practitioner monitoring its effect.

[warrioraks]

People in Gurgaon who are unable to get RT PCR test done - Try Paras hospital. Went there today to get myself and family tested. Minimal crowd. Registration and tests done within 30 minutes.

They did say that the report will take 4-5 days but it is still better than trying to get it done through home sample collection. Most of the labs are taking the booking and advance payment but are a no-show when it comes to picking up the samples for testing.

[Doonite]

I had to get my dad admitted in hospital today because of covid severity, so after trying everything I have a good grasp of current Covid-19 situation in Dehradun, Uttarakhand:

1) There are no oxygen cylinders available anywhere, period. Refilling is available. If you manage to find one and get it filled, the machine/pump to compress it is not available in the market. People have hoarded all the available stuff as per multiple suppliers I talked to.

2) Maximum hospitals do not accept Antigen test (rapid test) and you have to get RT-PCR test report for any kind of hospital assistance whether you're positive or negative. RT-PCR test's are being done for minimum 1000 rupees and it can anything above that price. I had to call 24 different numbers just to get 1 proper response for booking an appointment for the test for my mom as most numbers are dead or perennially busy.

3) Very very few beds with oxygen available. This is just pure luck to find one. Everybody has very weird T&C's and you can use almost any government etc connection to get a bed, it probably will not work. If your loved ones or known ones condition is not improving at home, start scouting and looking for hospitals by visiting them and assessing them in advance. (It's risky but you have to, as any Hospital staff will not talk over the phone in any condition.)

4) Medicnes like fabiflu (FABIPIRAVIR) are not available in the market. I've personally checked 21 medical stores in the radius of 8-10 km's. Remedisivir is being made available and it's only being allowed to purchase with certain conditions: positive report + patient's AADHAR card + doctor's prescription mentioning Remedisivir. But it's still very very scarce and is available only at select medical stores.

5) Situation in hospitals is grim. People crying and begging to get their loved ones admitted only to be rejected while many people crying in the parking lot or main building over losing their loved ones against covid. Positive/Negative patients, everybody is standing together in lines, no social distancing as everybody is stressed and desperate. Doctors are overwhelmed.

6) Makeshift hospitals will only provide oxygen in case of extreme emergency + doctor visit once a day maximum in such hospitals, so the only basic covid positive beds are available. Getting an ICU bed is just luck.

To sum it up, I request everybody to not risk themselves even 0.1%. This virus is very vicious and after staring at death and misery all around me whole day for the past two days at multiple hospital's, the situation is very very critical. I can't stress this enough, do everything in your power to not get infected.

Also, if anybody needs help, Facebook/Twitter/Instagram are the best options out there to quickly spread plea for help. There are tons of good and kind people out there who are sending innumerable resources and links once you post your plea. I've got my dad admitted and mom's RT-PCR appointment as she has all symptoms + very high fever just because of such people's help and am eternally grateful to them. Please do not stop trying and do not give up hope. Do everything in your power to find help for your loved ones if they're infected. Please.

Please don't take this as gospel truth, this is just my personal experience of past 10 days finding a bed for two of my friend's father's and then my own. I just want to give everybody an idea and make sure you are prepared for it if the situation arises. Please take necessary precautions and wear double mask if necessary (I've been told this at multiple hospital's, don't know how effective this is).

[charanreddy]

To doctors in the forum.

I was infected with COVID in Nov’20 and got admitted and was on IV Steroids (Dexa), anti biotics and remedisvir.

In April 1st week, I had a bad case of eye irritation, and extreme weakness. No fever or cough or sore throat. My smell and taste faculties are ok though some times I get a bitter taste even from water.

I consulted my doctor who treated me last time and got a few tests done. RT PCR was negative and chest CT Scan did not show infection. However my HBA1C was very high, at around 9 and HS CRP is hovering between 11 and 25. I also suffer from diabetes and Ankylosing spondylitis. I have been on anti- virals ( fluvir 75 mg) and anti biotics , ivermectin from the past 3 weeks however weakness still persists. I have some feeling of chest constriction as well. My doubt is if it has to do with any heart problem. What is the best way to preemptively diagnose this ? Do I need to get an Echo done. I was on blood thinners last time I was admitted but currently doctor has not advised( I can sense that the doctor who runs two hospitals for covid is under a lot of pressure to the high COVID cases around him)

What is the best course of action here ?

[one-77]

Originally Posted by lapis_lazuli

For the doctors on the thread :

The trend in NCR doctor clinics, now, is to hand out pre-printed "medicine list as per protocol for mild to moderate" cases. Even before testing positive, as testing facilities are hyper-booked.

I am slightly confused. I have seen 4/5 sets of medicine recommendations. Please read below :

Set 1 : Ivermectin 12 mg 1 daily x 3 days + Doxycycline 100mg x 2 x 5 days plus vitamins and zinc

Set 2 : Ivermectin 12 mg 1 daily x 5 days remaining same as (1)

Set 3 : Ivermectin 12 mg 1 daily x 3 days (or 5 days) + Doxycycline x 5 days + Azythromycin 500mg x 5 days plus vitamins and zinc

What really works? Or is there a bare minimum dosage as in <1> above?

@Behemoth, since you are a proponent of Ivermectin (like me ) , any pointers from you?

To be honest, none of these have been proven to work in COVID. They aren’t backed by any significant trials.
The vast majority of infections are asymptotic or mild, and don’t require any treatment.
For severe infection (high fever, pulmonary infiltrates, drop in saturation) remdesvir and a monoclonal antibody have received “emergency use authorisation” in the US and the EU. Steroids can help ease the inflammatory response, but can lead to secondary infections. Cytokine storm can be treated with tocilizumab but with many caveats. Respiratory support may be required in the form of supplemental O2, HFNC, NIV, invasive ventilation, etc.

Perhaps it is out of desperation, or perhaps for “patient satisfaction”, that many in our medical fraternity prescribe a myriad antibiotics, ivermectin, favipiravir, HCQ, aspirin, apixaban, dexa, multivitamins etc outpatients?