OTHERS

The National Medical Commission which regulates the Medical Education has clarified that due to COVID-19 crisis online classes for theory will be considered valid for MBBS students.

“Online classes are valid and approved for teaching during current pandemic COVID-19 only,”Dr R K Vats, Secretary, National Medical Commission, said in a letter to the heads of all the medical colleges.

“Such online theory classes are required to be supplemented by practical and clinical training as per current curriculum in all MBBS subjects in the Colleges/Institutions and affiliated hospitals as and when colleges reopen.” He adds

The confusion about the online classes was started over MCI’s response to an application.

The ICMR in collaboration with a Hyderabad -based biopharmaceutical company Biological E. Limited   has developed “antisera” prepared by injecting inactivated SARS-COV2 in horses, this “antisera” is highly purified and can be a potential treatment for COVID-19.

“ICMR and Biological E. Limited, Hyderabad has developed highly purified antisera (raised in animals) for Prophylaxis and treatment of COVID-19” ICMR tweeted.

The “antisera” is yet to undergo human clinical trials after than only safety and efficacy will be established.

According to the experts Highly purified “antisera” can also bring some effective treatment for Covid-19.“For a disease like Covid-19 for which there is no effective treatment or preventive vaccine, any development which offers hope is good news. The use of animal-derived antibodies to treat human illnesses is an age-old approach.” Say’s Dr Lalit Kant , Former HOD, Epidemiology deptt, ICMR

In the past animal-derived antibodies have been used to treat tetanus cases and snake bites. “I remember the use of diphtheria anti-toxin, a Nobel prize-winning discovery in 1901, for management of severe diphtheria cases. Horse derived antibodies have also been used to treat tetanus cases and of snake bites.  The use of human convalescent plasma for management of Covid-19 cases was not found to be effective by an ICMR led the study. One of the reasons may have been the quality and quantity of the neutralizing antibodies in the convalescent sera. This can perhaps be overcome by developing antibodies in animals. However, the safety of animal-derived antibodies have always been a concern. Cases of serum sickness have been reported in the past.  Presently there is a move to shift to non-animal approaches for the generation of antibodies like sequence-defined recombinant antibodies (rAbs) which offer greater advantages.  There has been progress towards development of non-animal antibodies against SARS CoV-2 too.” Say’s Dr Lalit Kant, Former HOD, Epidemiology Deptt,ICMR

Dr Raman Kapur

Acupuncture has been proven scientifically by many studies to improve immunity against all types of viral and bacterial infections.

Mechanism of Acupuncture in sleep disorders/stress due to fear of covid infection:-

a) insertion of Acupuncture needles activates peripheral nerves and muscles through sensory stimulation which further modulates the parasympathetic nervous system ( a major regulator of sleep)

b) Acupuncture regulates various neurotransmitter’s and hormonal factors like endorphins, serotonin, norepinephrine, ACTH and melatonin. ( All of which play a major role in sleep regulation).

ACUPUNCTURE TREATMENT:- Most common scientific studies have been conducted using acupoints DU.20, P.6, ST.36 and SP.6.  Treatment with acupuncture to promote immunity is generally given thrice a week for about 4 weeks and then a maintenance treatment of once a week is sufficient.

Other adjuvant modalities:

a) Moxibustion, in which a herb ( Artemesia vulgaris) is made into a roll and burnt over an acupuncture point ST.36 ( 10 minutes each side).  It can also be used as a self help device to improve immunity.  This point is also known in Acupuncture as a point for treating 400 diseases.

b) Ear press needles at specific ear points can also be used to promote immunity and restore normal sleep patterns.  Ear points used are shenmen, sympathetic, Lu, K and spleen points. 

c) Catgut embedding therapy at a specific point on the anterior chest wall (REN 17) has also been used to improve respiratory capacity in patients with chronic asthma and COPD.

d) Electro Acupuncture(EA)- Electrodes are applied to certain acupuncture points in order to stimulate the body’s central nervous system ( specially the hypothalamus) to produce specific neurotrasmitters and opoids.  These chemicals further enhance the patient’s immunity.

d) Cupping therapy:- Application of special cups ( Bamboo, plastic or glass) at certain target points, helps to relax the tense muscles and induce a sense of calmness in the body.  This helps induce sleep.

As patients are recovering from Covid 19, the problems which they are suffering with in the aftermath of the infection, are multifarious.

The commonest issues which are persisting even after 2 weeks of testing negative are:-

1. Cough- persistent, with sore throat

2. Extreme fatigue

3. Post-covid lung disease.

4. Anxiety, depression, insomnia

5. Cognitive issues similar to moderate traumatic brain injury.

6. Digestive problems like bloating, imitable bowel, nausea and vomiting, abdominal pain.

The problem of persistent cough after recovering from a covid attack is very common.  Acupuncture produces 90% effective rate with no side effects.  Such patients complain of dry cough, throat irritation and scanty white phlegm.   In the acupuncture group, patients were needled at Lu.10 , Lu.1, Lu.5, Lu.6, Lu.7, ST.25, ST.36 and ST.40.  Total treatment sessions were 10 and each session is of 30 minute duration.

In the medication group, patients were given Methoxyphenamine capsules thrice a day for 10 days and success rate was 70%.

Patients develop extreme fatigue following Covid illness due to depletion of their Qi due to hypoactivity of the Hypothalamic- pituitary axis.  Acupuncture was given at selected acupoints P.6, ST.36, SP.6, Liv.3, Ren.4, Du.20, Ub.23 for 5 days in a week for 2 weeks and 80% patients showed improvement in their fatigue levels.

Post covid lung disease can be effectively tackled using acupuncture and moxibustion.  The principle is to promote, regulate and stimulate the body’s self regulating function.  Most of these patients have symptoms similar to COPD, due to damage to lung parenchyma caused by Pneumonitis

Anxiety, depression and Insomnia are very common in Post covid patients and these can be effectively tackled by stimulating specific acupoints which release melatonin and the happy hormone-> SEROTONIN.

Many patients who have recovered from Covid illness complain of a lingering cognitive impact- problems with their memory and inability to stay focussed.  This is caused due to the body’s response to infection which leads to blood becoming extremely sticky.  This is particularly seen in patients who stayed in ICU care for covid illness.  Early studies on this problem have shown that acupuncture given at points LI.4, Li.11 DU.20, ST.36, ST.40, GB.34 shishencong, P.6, H.7, Du.16, Liv.3, improved cognitive ability.  Treatment ws given over a period of 4 weeks, 5 days a week, for 30 minute each session.

Post covid digestive symptoms are mainly persistent nausea and vomiting, loss of appetite, bloating, abdominal pain and irritable bowel.  Patients were given Acupuncture thrice a week for 4 weeks.  The major cause of these symptoms is the impact on spleen, stomach, and liver organs.  Acupuncture promotes gastric peristalsis in subjects with low intensity gastric motility and suppresses peristalsis in those with acute initial motility.

Almost 70-80% patients showed improvement in their symptoms with acupuncture which is a safe, efficacious treatment without any side effects.

Dr. Raman kapur,

Padmashri

Vice Chairman, Apex Committee on Acupuncture, Gov. of India

President, Indian Society of Medical Acupuncture

Director, Institute of Acupuncture and Natural Medicine

Head of Department of Acupuncture, Sir Ganga Ram Hospital

Coronavirus Cases: 34,823,216

Deaths: 1,033,174

Recovered: 25,889,974

Active cases: 7,900,068

Currently Infected Patients: 7,833,778 (99%) in Mild Condition

66,290 (1%) Serious or Critical

Closed cases – 26,923,148

Cases which had an outcome: 25,889,974 (96%) Recovered / Discharged

1,033,174 (4%) Deaths

Acccording to the Ministry of Health and Family Welfare India’s today data on COVID-19 related deaths cross 1 lakh mark with 1,069 deaths reported in the last 24 hours. With 79,476 new cases, the tally reaches 64,73,545 including 9,44,996 active cases, 54,27,707 cured/discharged/migrated cases & 1,00,842 deaths.

The safety of a vaccine must be monitored throughout its lifecycle, No vaccine is 100% safe says Dr. Gagandeep Kang, one of India’s highly regarded clinical scientists and professor at Wellcome Trust Research Laboratory, Christian Medical College, Vellore.

Q. What do you think about the safety of a vaccine? Q. Do you think no vaccine is 100 percent safe?

 A. We won’t know till we see the vaccine being used in many thousands of people, if not hundreds of thousands. Usually, when vaccine manufacturers are asked to manufacture vaccines, there are pre-clinical trials, i.e. animal testing, and then in clinical trials, they first test on tens, then on hundreds, and then on thousands of people. The safety of a vaccine candidate must be monitored throughout the entire lifecycle of the vaccine, before and after licensure. So far, from all the vaccines we have seen, there seems to be some fever, swelling, redness, while some people feel unwell, so no major safety signals yet. But so far, we also don’t have safety data from phase three trials. No vaccine has zero effects. Every injection causes pain, redness and swelling. Many vaccines have minor side effects, some vaccines have major side effects, but it’s very rare. For example, a person can get paralysis from GBS syndrome, from the viral injection, and can get it from the vaccine also, but it’s very rare; chances of it happening are one in a lakh. The oral polio vaccine causes polio in a million children but we still use it because the benefit of preventing polio is much greater than the risk of a small number of children getting polio because of the vaccine. So, no vaccine is 100 percent safe. But you have to bear the risk and benefit and then decide if the risk is lesser than the benefit, and then go ahead with it for the public health purpose of using the vaccine. 

Q. How to test the efficacy of a vaccine? 

A. The efficacy of a vaccine is tested in phase three trials, and phase three trials are done in many thousands of people. The idea here is to give the vaccine and wait for them to naturally develop the infection. If the people who are vaccinated are less infected than the people who are not vaccinated, then you know that the vaccine works. 

Q. When India will get a vaccine? 

A. Most of the vaccines are in phase two trials at the moment. The vaccine that will most likely move faster is going to be the Oxford vaccine because its clinical efficacy is already being tested outside the country. So, if the vaccine works outside the country and we get the vaccine being evaluated for immunogenicity in the country, then we can take the results from outside the country and get the vaccine licensed in India. So, that will be the fastest. For others, we will have to do phase three trials, and then we will see what the results of those are and license them. It may be early next year for the Oxford vaccine. And for other vaccines, it depends on when they start their phase three trials and what their recruitments look like. However, licensure is unlikely before the middle of next year. 

Q. A recent study says that the role of children has been underestimated. Children are very likely to transmit the virus further. How do children transmit the virus? 

A. That’s not unexpected because we know that children share a high risk of the virus. I don’t think people are looking at it in the right kind of way. But you should be expecting children to transmit the virus just like others transmit it. 

Q. How do the elderly have a surprisingly low mortality rate in India, as compared to other countries? 

A. This is something called the survival effect. It means that if you are over 70 years old in India, you probably belong to a higher socioeconomic status because if you were older and had co-morbidities, you would have died of something else before Covid. This is the survival effect, where a population itself is special because it has been able to overcome the challenges which other people have succumbed to. 

Q. As per a study, India reported people dying within a period of 6-7 days after the tests. What can be the reason behind this? 

A. People came late to the hospitals for treatment in India. If they came early, they could have had more time for treatment in the hospital. When they come late, it becomes difficult.

Dr Poonam Khetrapal Singh, Regional Director of the WHO South-East Asia Region, talks about the pandemic and whether we are witnessing a second wave of the disease worldwide.

In an exclusive interview with The Daily Guardian, Dr Poonam Khetrapal Singh spoke at length about efforts being made to develop a vaccine, and How people can protect themselves because in some countries after less cases again they are witnessing surge once again. Excerpts from the interview:

Q. How world can beat this pandemic?

A: We do not know how long it will last. Till such time there are safe and effective vaccine or medicines for Covid-19, we must continue to fight this virus using public health measures that we know work — that is test, track, isolate and treat. People should be encouraged to follow Covid-appropriate behaviour such as proper wearing of masks wherever recommended, physical distancing, hand hygiene, and cough etiquette. These are our best defenses against Covid-19, and they work as seen in countries that have curtailed virus transmission using these measures.

Q. Do you think there is a second wave of the disease in the world?

A: Nine months into the pandemic, Covid-19 cases globally are still rising. Some countries that were able to curtail transmission, are witnessing a surge once again. Clearly, we need to remain vigilant. We cannot let our guards down. We should continue our efforts to suppress Covid-19 transmission.

Q. What precautions are needed to keep ourselves and healthcare workers should take to protect themselves?

A. Practising physical distancing, hand hygiene, cough etiquette are best ways to protect against Covid-19. A healthy diet and physical activity are also a must for physical and mental wellbeing.

Q. Why so many healthcare workers are dying?

A.It is true that an alarming number of healthcare workers have been infected with Covid-19, and WHO is closely following this issue through our global networks. Some of the factors that are contributing to infections in health workers are the lack of PPE or the proper training to use it.

The WHO has been addressing this issue since the beginning. Globally, around 14% of Covid-19 cases reported to the WHO are among health workers, and in some countries it can be as much as 35%, although data are limited.

Health workers are facing tremendous challenges globally — including healthcare-associated infections, such as violence, stigma, psychological and emotional disturbances, illness and even death.

Furthermore, working in stressful environments makes health workers more prone to errors which can lead to patients’ harm.

It’s important that we prioritise safety for healthcare personnel — both physical and mental — because let’s also not forget that it’s only when they are safe that the patients they are caring for will be safe too.

Q. When do you think the world will get a vaccine?

A. So far there is no vaccine to prevent Covid-19, but work is underway across the globe to find one that is effective and safe. Of the over 200 vaccine candidates in development, over 10 are being tested in humans, and a few are entering Phase III trials soon. The WHO is working with companies and sponsors, as well as with Gavi, CEPI and others through the ACT Accelerator to expedite vaccine testing, as well as the scale-up of manufacturing so that countries will have access to sufficient doses if and when a vaccine is available. Globally, investments are being made in manufacturing of promising candidate vaccines even before the Phase III trial results are in. There are many unknowns in this process. It is hoped that if a successful vaccine is found by the end of the year, there will be enough doses available for countries by the end of 2021 so that those in priority populations, who choose to be vaccinated, have access to them. The WHO will propose solutions on a fair and equitable distribution of vaccines, for member states to consider.

The Indian Medical Association (IMA) is tweeted the list of doctors who their lives due to COVID-19. The percentage of doctors who lost their lives can be more than 515 in numbers. According to the updated list by Indian Medical Association, more than 515 doctors succumbed during COVID-19 crisis in the country and this number is increasing day by day. IMA database says the doctor-patient ratio is 1:94. A majority of doctors 201 were in the age group of 60-70yr of age.  Above 70years of age doctors are 66, 50-60years were 171who killed,59 doctors are between the age 35-50 years of age and 18 doctors are who died were less than 35years of age.

“IMA dedicates the sacrifice of 515 Indian doctors in the fight against COVID-19 pandemic to the nation. We salute these martyrs. We salute all the nurses and the healthcare workers who sacrificed their lives as well. The mortality rate in drs& health caregivers is 9 times more than the general population.” IMA tweets

“From today onward 25000 patients will not get medical care daily which was available to them daily through them
Our homage to these soldiers.”Say’s Dr. R N Tondon, Former General Secretary, IMA

“Families of healthcare workers are also at risk. Unfortunately, govt has no data on deceased doctors & healthcare workers. The number of deaths is much more than published data. India should care for its healthcare workers.” Say’s Dr Ravi Wankhedkar, Former President, IMA

There are vacancies for total 42 posts , which includes 19 vacancies in Ministry of Defence (MOD) and 23 vacancies in Ministry of Health and Family Welfare (MOFHW).The online application process will be closed on 15 October at upsc.gov.in

UPSC recruitment 2020 : Post wise vacancy details

Ministry of defence – 19

Ministry of Health and Family Welfare – 23

The candidate with an MBBS degree can apply for post specialist Grade -3 Assistant Professor (Clinical Haematology) , Immuno Haematology , Blood Transfusion and Medical Oncology. Atleast three years of experience in teaching is preferable.

Donald Trump announced early Friday about getting infected from COVID-19. Trump tweeted shortly “Tonight, @FLOTUS and I tested positive for COVID-19. We will begin our quarantine and recovery process immediately. We get through this TOGETHER!”

Later, the first lady wrote on Twitter that she and her husband were “feeling good.”