Gandhinagar, May 26 (IANS) The Gujarat government on Wednesday constituted a task force to bring uniformity in the treatment and protocols for the notified epidemic of mucormycosis in Gujarat. Also the health department released a study which said that more than 50 percent of mucormycosis patients recovered without the need for steroids to fight the fungal infection.Following the central government's advisory, the Gujarat government has notified mucormycosis or black fungus as an epidemic. More than half of the patients of mucormycosis in the country are from Gujarat.Gujarat Chief Minister Vijay Rupani on Wednesday constituted an eleven member task force to bring uniformity in the treatment and protocols for the fungus. The task force comprises of Dr Girish Parmar, the additional director and the Dean of Ahmedabad government dental college, Dr Kamlesh Upadhyay, Medicine, BJ Medical college, Ahmedabad, Dr Bela Prajapati, ENT, BJ Medical college, Dr Hansa Thakkar, opthalmologist, M&J Institute of Opthalmology, Dr Ashwin Vasava, Medicine, Surat government Medical college, Dr Anand Chaudhary, ENT, Surat government Medical college, Dr BI Goswami, Medicine, MP Shah, Jamnagar Medical college, Dr Sejal Mistri, ENT, PDU Medical college, Rajkot, Dr Neeti Sheth, opthalmologist, PDU Medical College, Rajkot, Dr Susheel Jha, ENT and Dr Neelesh V Parekh, opthalmologist, both from government medical college, Bhavnagar.Meanwhile, based on the mucormycosis patients treated in the government hospitals of the state, the health department has come out with a report on the basis of which it is claimed that more than fifty percent (50.5%) patients did not require the use of steroids. Also, 66.5 patients did not require oxygen in getting treated.It was also observed that 59 percent patients consisted of diabetes patients, 27.1 percent patients were immuno compromised and 15.2 percent were having co-morbidity.It was also observed that 67.1 percent of patients were male while only 32.9 percent were female. Less than one percent (0.5) consisted of patients below 18 years age, 28.4 percent were 18 to 45 years age, the maximum patients of mucormycosis were 45 to 60 years at 46.3 percent and 24.9 percent consisted of more than sixty year old patients.--IANS amc/bg
New Delhi, May 21 (IANS) Amid rise of mucormycosis (black fungus) infection, diabetic patients are advised to frequently monitor and control their blood sugar levels. Diabetic patients (those with uncontrolled diabetes), steroid usage and being Corona positive, a combination of these factors places one under risk of getting mucormycosis. Therefore, diabetic patients should regularly monitor and control their blood sugar levels.Mucormycosis or black fungus infection is not a new disease and it was reported even before the pandemic. Its incidence, however, was very low. Now, owing to Covid-19, this rare but fatal fungal infection is being reported in large numbers.The Coronavirus Disease Associated Mucormycosis (CAM) is being seen in patients who are either recovering or have recovered from Covid-19.Director AIIMS, Dr. Randeep Guleria, explained that earlier, mucormycosis was commonly spotted in people suffering from diabetes mellitus, a condition where one's blood sugar (glucose) levels are abnormally high."Cancer patients undergoing chemotherapy, those who have had a transplant and people taking immunosuppressants (medications that weaken the immune system) also used to get it. But now due to Covid-19 and its treatment, an increase in the number of cases is being witnessed," Dr Guleria said.He mentioned that there are more than 20 cases of the fungal infection in AIIMS itself, all of whom are Covid positive and many states have reported 400 to 500 cases, all among Covid patients.There is a higher chance of occurrence of mucormycosis in patients whose immune system is not functioning well, and since Covid-19 treatment tends to suppress the working of the immune system, it places such patients at a higher risk of contracting the black fungus infection.He advised that Covid patients with a mild form of the infection should strictly avoid taking steroids as taking steroids increases the risk of secondary infections such as mucormycosis. If a Covid-infected person's oxygen saturation level is normal, and he/she is categorised as clinically mild, steroids should be completely avoided."Those who are taking steroids should also keep checking their blood sugar levels. In most cases, one who is not diabetic finds that after taking steroids, the blood sugar level shoots up to 300 to 400. Hence, it is essential to continuously monitor one's sugar levels," Dr Guleria said. "High dosage of steroids being taken by Covid-19 patients is of no use. Mild to moderate doses are good enough. As per the data, steroids should be given only for five to 10 days (maximum). Moreover, steroids increase the blood sugar level which can then become hard to control. This can in turn increase the chance of fungal infection," Dr Guleria said.--IANSssb/ash
Hyderabad, May 17 (IANS) The Telangana High Court on Monday directed the state health authorities to ensure that there are no steroids in medicine kits being distributed among people with Covid-19 symptoms.Stating that Mucormycorsis or Black Fungus is a matter of concern, the court observed that steroids should not be given without doctor's prescription.Hearing a batch of public interest litigations on Covid-related matters, a bench of Chief Justice Hima Kohli and Justice B. Vijaysen Reddy asked the health department to be cautious in view of the reports that misuse of steroids is causing Black Fungus among Covid-19 patients.When the court wanted to know if the medicine kits being distributed contain steroids, Advocate General B. S. Prasad said he would check with the officials concerned and inform the court.The bench also asked the government to submit a detailed report as to how it plans to tackle Black Fungus.The court was also informed that Ear, Nose and Throat (ENT) Hospital at King Koti in Hyderabad has been designated to treat Black Fungus infected people.The court also wanted to know from the government about its strategy to deal with the likely third wave of Covid. The court suggested that the government should prepare in advance for third wave. It also directed the court to constitute a task force to look into complaints that private hospitals are fleecing patients. There should be a task force where an aggrieved patient could lodge the complaint.It also wanted the government to fix maximum rates for Covid-related treatment in hospitals to stop them from overcharging patients. When the government brought to the notice of the court that it has already issued a GO in this regard, the court felt that a fresh GO is required in view of the changes in treatment modalities. It wanted to know why there is no capping for various medical investigations and rates for PPE kits and other items.It asked the government to issue in 48 hours a GO fixing the maximum charges and display it on official website.The court once again pulled up the state authorities for not doing enough tests. It wanted to know why the health department is not conducting one lakh tests daily despite repeated directions.The court also expressed its unhappiness over the department not providing break up of RT-PCR and Rapid Antigen tests in the report submitted to it.When the petitioners brought to the court's notice that 15 out of 500 teachers contracted Coronavirus while attending duties for recently held elections in the state and later died, the court directed the government to treat the deceased teachers as 'Covid warriors'. It wanted the government to extend all benefits to the families of these teachers which are being given to other 'Covid warriors'.It also felt that community kitchens are the need of the hour. When the whole family is infected, someone has to reach to their door with food. It suggested that the resident welfare associations and various housing societies need to be roped in for Covid relief.Some petitioners brought to the court's notice that 390 hospitals on Telangana dashboard don't treat Covid patients. The court remarked that this is misleading and asked the authorities to update the dashboard.The Director General of Police also submitted a report on implementation of lockdown and the action taken against the violators.The police also submitted to the court videos taken at different places in Hyderabad on the occasion of Eid to monitor any violations during lockdown. The bench expressed its satisfaction over the effective implementation of lockdown during the festival and patted the police commissioners of Hyderabad, Cyberabad and Rachakonda. --IANS ms/ash
London, April 27 (IANS) If you are worried about smell loss due to Covid-19, ditch steroids and try sniffing at least four different odours twice a day, suggest an international group of smell experts.The team, including Prof Carl Philpott from the University of East Anglia in the UK, noted that steroids should not be used to treat smell loss caused by Covid-19. Instead, 'smell training' -- a process that involves sniffing at least four different odours twice a day for several months, they recommend in the paper detailed in the International Forum of Allergy and Rhinology.Smell loss is a prominent symptom of Covid-19, and the pandemic is leaving many people with long-term smell loss.Corticosteroids -- a class of drug that lowers inflammation in the body -- are often prescribed to help treat conditions such as asthma, and they have been considered as a therapeutic option for smell loss caused by Covid-19."But they have well-known potential side effects including fluid retention, high blood pressure, and problems with mood swings and behaviour," Carl Philpott, Professor and smell loss expert from UEA's Norwich Medical School."The huge rise in smell loss caused by Covid-19 has created an unprecedented worldwide demand for treatment. Around one in five people who experience smell loss as a result of Covid-19 report that their sense of smell has not returned to normal eight weeks after falling ill," Philpott added.But research shows that 90 per cent of people will have fully recovered their sense of smell after six months.The team carried out a systematic evidence-based review to see whether corticosteroids could help people regain their sense of smell.They found very little evidence that corticosteroids will help with smell loss. And because they have well known potential adverse side effects, they advise against its use as a treatment for post-viral smell loss.But smell training, on the other hand, could be helpful. "It aims to help recovery based on neuroplasticity -- the brain's ability to reorganise itself to compensate for a change or injury," Philpott said.--IANSrvt/in
New York - In a fight against novel coronavirus, researchers have now shown new evidence that suggests sex steroids may play a role in protecting against Covid-19 symptoms.
The study, published in the journal Trends in Endocrinology and Metabolism, analysed existing research to look at reasons why Covid-19 symptom severity and mortality are more frequent in men than in women and in older people.
"The paper suggests female reproductive steroids play a protective role," said study author Graziano Pinna from the University of Illinois at Chicago in the US.
Female reproductive steroids, estrogen and progesterone and its physiologically active metabolite, allopregnanolone, provide anti-inflammatory functions, reshape competence of immune cells, stimulate antibody production and promote respiratory epithelial cell repair,
It also inhibits the ACE2 receptor, the door of access for the novel coronavirus (SARS-CoV-2) to infect the organism, suggesting they may protect against Covid-19 symptoms,
Pinna became interested in the role of reproductive steroids in Covid-19 pathology in March when early case reports showed Covid positive pregnant women who had no Covid symptoms, had escalated symptoms -- severe enough to require intensive care -- immediately after giving birth.
The severity of symptoms coincided with a rapid drop of estradiol, progesterone, and allopregnanolone.
"Hormones that help sustain the pregnancy -- like progesterone -- are 100 times more concentrated in a pregnancy's third trimester," Pinna said.
Estradiol, allopregnanolone, and progesterone all have important anti-inflammatory functions and are involved in resetting the immune system.
"This suggests that pregnant women became symptomatic, and some were even admitted to the ICU, after delivering their babies because of the rapid drop in these hormones. The correlation was really striking," he added.
Pinna's paper also discusses the importance of reproductive hormones in stimulating the production of antibodies and promoting lung cell repair after virus infection and fighting against the 'cytokine storm'.
Cytokine storm is -- an immune response where the body starts to attack its own cells and tissues rather than just fighting off the virus.
"Progesterone and allopregnanolone can block the incredible overreaction of the inflammatory system, repressing it and avoiding the over-expression of pro-inflammatory cytokines," said Pinna. (IANS)
Geneva - Antenatal steroids such as dexamethasone, used to treat many conditions, including rheumatic problems and severe Covid-19, can boost the survival of premature babies when given to pregnant women at risk of preterm birth in countries like India, say researchers at World Health Organisation (WHO).
Dexamethasone and similar drugs have long shown to be effective in saving preterm babies lives in high-income countries, where high-quality newborn care is more accessible.
This is the first time a clinical trial has proven that the drugs are also effective in low-income settings, the study published in the New England Journal of Medicine, reported.
The WHO ACTION-I trial resolves an ongoing controversy about the efficacy of antenatal steroids for improving preterm newborn survival in low-income countries.
Conducted from December 2017-November 2019, the randomised trial recruited 2852 women and their 3,070 babies from 29 secondary and tertiary level hospitals in Bangladesh, India, Kenya, Nigeria, and Pakistan.
Beyond finding a significantly lower risk of neonatal death and stillbirth, the study also found there was no increase in possible maternal bacterial infections when treating pregnant women with dexamethasone in low-resource settings.
"Dexamethasone is now a proven drug to save babies born too soon in low-income settings," said study author Dr Olufemi Oladapo, head of maternal and perinatal health unit at WHO.
"But it is only effective when administered by health-care providers who can make timely and accurate decisions, and provide a minimum package of high-quality care for both pregnant women and their babies," Oladapo added.
The impact is significant: for every 25 pregnant women treated with dexamethasone, one premature baby's life was saved.
When administered to mothers at risk of preterm birth, dexamethasone crosses the placenta and accelerates lung development, making it less likely for preterm babies to have respiratory problems at birth.
The study noted that healthcare providers must have the means to select the women most likely to benefit from the drug and to correctly initiate the treatment at the right time - ideally 48 hours before giving birth to give enough time to complete steroid injections for maximal effect.
Women who are in weeks 26-34 of their pregnancy are most likely to benefit from the steroid, so healthcare providers must also have access to ultrasound to accurately date their pregnancies.
In addition, babies must receive sufficiently good-quality care when they are born, the team said.
"When a minimal package of care for newborn babies is in place in low-income countries, antenatal steroids such as dexamethasone can help to save preterm babies' lives," said study author Dr Rajiv Bahl, head of the newborn health unit at WHO. (IANS)
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