[Zen2001]

Doctors in India are under pressure to prescribe drugs that are considered ineffective.

https://scroll.in/article/994115/cov...ed-ineffective

Unnecessary, unproven, prescriptions - either for psychological benefit or out of pressure to be seen "doing something" must stop. Have been saying this all along, based on the general inefficacy, potential (& most definitive side effects), not to mention the shortages caused by rampant prescription and agony to relatives who have been made to run helter skelter in the belief that these drugs are going to be miracle live savers.

https://youtu.be/7ZTga9x5fqs

[drrajasaravanan]

Originally Posted by Zen2001

Doctor Vs Doctor
We are caught in the malady of "seeing as doing something" when doing nothing would have worked equally well.

Hi,
Fortunately the whole team including the chest physicians do not repeat CT unless there is strong evidence. We all rely on USG lung as much as possible for progress and CXray has been reduced to the minimal.

Originally Posted by Thad E Ginathom

Have gone back to isolation. So glad to have got two vaccine doses before it all turned into a mess, but wondering how to safely get second dose for wife.

Hi,
Even if you have access and after seeing a few cases who tested positive in between doses I urge you to consider getting the 2nd dose for your spouse after we have seen a downward trend. Private hospitals are flooded and distancing has gone for a toss. Unless you a're sure wait a while, no point in getting infected while trying to access vaccine when we know it takes 10 to 12 days before you seroconvert.

Originally Posted by Zen2001

Doctors in India are under pressure to prescribe drugs that are considered ineffective.
Unnecessary, unproven, prescriptions - either for psychological benefit or out of pressure to be seen "doing something" must stop. Have been saying this all along, based on the general inefficacy, potential (& most definitive side effects), not to mention the shortages caused by rampant prescription and agony to relatives who have been made to run helter skelter in the belief that these drugs are going to be miracle live savers.]

Hi,
+1 to that. The rationale of evidence and common sense has gone for a toss. I try and so do my team members to counsel appropriately and we do fail.

[msdivy]

Need advice for a couple with co-morbidities. Husband had angioplasty 5 years back. The wife had breast cancer 12 years back. They are on daily medication (Ivabrad, Ecosprin (H); Armidex (W)) and are fine for the last 4 years. They have tested positive for Covid-19. Husband has on & off mild fever with cough. The wife has no symptoms. Since they tested positive they got a standard prescription (Dolo 650, Azithral, Montek LC, Vitamin C, Zinc) and they are on these pills since yesterday. Their oxygen levels are around 97, 98 so far, and are under home isolation.

Now the question, can the symptoms get worse based on their medical history? Can they overcome the infection without hospitalization?

[AZT]

W.H.O. approves China's Sinopharm Covid vaccine for emergency use

The WHO has already given emergency use listing to the vaccines being made by Pfizer-BioNTech, Moderna, Johnson and Johnson, and the AstraZeneca jab being produced at separate sites in India and in South Korea.
Russia's Sputnik V vaccine is the next furthest ahead in the process.

https://www.livemint.com/news/world/...403533298.html

[gotoguru]

Originally Posted by drrajasaravanan

Hi,
Even if you have access and after seeing a few cases who tested positive in between doses I urge you to consider getting the 2nd dose for your spouse after we have seen a downward trend. Private hospitals are flooded and distancing has gone for a toss. Unless you a're sure wait a while, no point in getting infected while trying to access vaccine when we know it takes 10 to 12 days before you seroconvert.

Hi, What is present advised timegap after Covid19 recovery and the first dose of vaccine?

[drrajasaravanan]

Originally Posted by msdivy

Need advice for a couple with co-morbidities. Husband had angioplasty 5 years back. The wife had breast cancer 12 years back.

Hi,
Both of their medical conditions are past and not current illness impacting their quality of life. The medication for the breast cancer does not impact the immune system, ensure she is not on additional medication and if so she has to consult her oncologist for optimization and course of treatment. The possibility of them beating the virus with standard therapy and proactive measures is Good. Let them keep a track of their oxygen level and effort of breathing. It Will give them a warning if things need extra attention. The timeline to intervene with steroids and anticoagulation should not be missed.

Originally Posted by gotoguru

Hi, What is present advised timegap after Covid19 recovery and the first dose of vaccine?

Hi,
There is no change till now. If you have risk factors which increase the possibility of infection or likely to worsen the outcome get the vaccination after recovery from the illness. If it's not wait for 30 to 60 days prior to vaccination.

[Sree]

Originally Posted by msdivy

Need advice for a couple with co-morbidities. Husband had angioplasty 5 years back. The wife had breast cancer 12 years back.

Now the question, can the symptoms get worse based on their medical history? Can they overcome the infection without hospitalization?

Majority of patients will get well without any problems. Who will require hospitalisation and ICU care still cannot be predicted well.

However, as a senior medical oncologist I should say that history of breast cancer 12 years ago will pose no extra risk. Majority of our patients on active treatment with chemotherapy get well without incident. It’s only patients with severe immunosuppresion like lymphoma, myleloma patients and those on treatment with agents like rituximab that are doing poorly. Lung cancer patients with underlying COPD are also doing poorly.

[BoneCollector]

Originally Posted by Sree

However, as a senior medical oncologist .....

Good to see an Oncologist amongst us as the next news will need your inputs too.

2-DG

The Drugs Controller General of India (DCGI) has given permission for the emergency use of drug 2-deoxy-D-glucose (2-DG) as an adjunct therapy in moderate to severe Covid-19 cases, said Defence Research and Development Organisation on Saturday.

Article about 2-DG.

Excerpt from the article.

Therapeutically, 2-deoxyglucose is an investigational drug that is being studied as an anticancer and antiviral agent. Concerning the former, 2- deoxyglucose was used as an adjunct to chemotherapy and radiotherapy in the treatment of solid tumors (lung, breast, pancreas, head, neck, and gastric tumors).

[Zen2001]

The next killers : Irrational drug prescriptions (in Covid19) causing secondary infections. More antibiotic drug resistance including MDR &XDR TB will soon follow, leading to long term morbidity and mortality (long after covid is over).

Times of India: Maharashtra: ‘Mucormycosis a death sentence once it reaches the brain’.
https://timesofindia.indiatimes.com/...edium=Referral

[Nissan1180]

I want to share some feedback about Pathway Hospital Bengaluru. A close relative (below 45) was admitted here. He did not survive at Pathway.
He was healthy, but was on oxygen support due to covid. Root cause analysis was missing. I know that many would move on with a loss, but this was too personal for me to not state that perhaps something better could be done in a more ethical hospital.

The hospital seems to have started its emergency facilities just for cashing in on the covid demand. It lacks accountability. Doctors have been recently found to have been involved in a cash for bed scam

https://www.youtube.com/watch?v=97-1nDmxnpI

.

The google reviews of this hospital are mostly fake and hence might mislead people into believing that they have good facilities.
Even the ambulance drivers and locals say that the hospital is not good. Please be advised to stay away from this hospital if you can.

[400notout]

Originally Posted by ninjatalli

That coupled with officially under-reporting deaths across states seems to be the mantra across UP, Gujarat, MP and probably a few more. Thankfully local newspapers are still reporting the reality basis cremation deaths.

Quoting your post just for context. This is not aimed at you.

Just spoke to a friend of mine who lost his mother last week. His story is what we all fear. A run to get tested, another to get admitted, another to arrange medicines and finally giving up so that you could atleast cremate the body yourself.

So seemingly people are accepting reporting deaths as covid negative just to be able to perform the last rites. This could be one reason why the official numbers and the crematorium numbers are a mismatch.

If the govt starts handing over covid positive deaths to family members then the official number could change.

[drrajasaravanan]

Originally Posted by 400notout

So seemingly people are accepting reporting deaths as covid negative just to be able to perform the last rites. This could be one reason why the official numbers and the crematorium numbers are a mismatch.
If the govt starts handing over covid positive deaths to family members then the official number could change.

Hi,
You are right. Most of the centres do a repeat swab after 14 days of hospitalization and if its negative they handover the deceased person to the family. Plus some centers report the death as due to sepsis. Invariably the numbers reported due to death is wrong by a large margin. The system is not right and misrepresenting facts at the ground level. There is no way we are able to work around this.

[Sree]

http://www.healthdata.org/special-an...ovid-19-deaths



Most epidemiologists calculate total covid mortality in India to be multiple times our official figures. This report which came out this week talks about total mortality closer to 650000.

Somehow, Kerala alone seems to be doing better.

[CliffHanger]

Originally Posted by drrajasaravanan

Hi

Originally Posted by Sree

Most epidemiologists

Hello dear doctors,

- How and when to take the oximeter reading? Is the bellow article correct?
- Should we have to walk for 5 minutes before taking the readings?
- What should be the values for older people and younger people?
- Does finger size affect the readings?

https://www.gadgetsnow.com/how-to/ho...w/82407757.cms

[Sree]

Originally Posted by CliffHanger

Hello dear doctors,

]

I ask my patients to take 2-3 readings per day.

Normal should be 98-99 for both adults and children.

If someone is symptomatic, they can try repeating the reading after 4-5 minutes of walking , to see whether there’s fall in saturation with exercise.

Anything below 95, I advise my patients to get admitted to a hospital. I don’t agree to this home oxygen therapy trend. I have seen patients coming late to the hospital and crashing out. I know it’s a challenge to get hospital beds in multiple cities.

I have not heard about finger being at heart level for saturation readings. We examine our patients either while lying down or when seated in cabin. Similarly finger size variations should not have any effect.