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The random trial involving 52 Canadian hospitals, and with 1,282 patients, had researchers studying the effects of Remdesivir in hospitalised patients with Covid-19 between August 14, 2020, and April 1, 2021.

Medical personnel unload a patient from a Royal Canadian Air Force transport aircraft which departed from Saskatoon, after the province of Saskatchewan said it would be sending patients with Covid-19 from overloaded ICU wards to Ontario hospitals, in Kingston, Ontario, Canada

New research from a trial involving 52 Canadian hospitals indicates use of the antiviral Remdesivir could reduce the need for medical ventilation by nearly 50% in patients hospitalised with Covid-19, as against standard treatment.

The study, Canadian Treatments for Covid-19 (CATCO), is a Canadian Institutes of Health Research-funded sub-study of the global World Health Organization Solidarity trial examining the effects of various treatments and results were published on Wednesday in the Canadian Medical Association Journal (CMAJ).

The random trial involving 52 Canadian hospitals, and with 1,282 patients, had researchers studying the effects of Remdesivir in hospitalised patients with Covid-19 between August 14, 2020, and April 1, 2021.

According to a release issued by CMAJ, the researchers found that among patients not receiving mechanical ventilation at the start of the study, the need for mechanical ventilation arose for 8% of those receiving Remdesivir compared with 15% of those receiving standard care. “In addition, patients treated with Remdesivir were able to come off oxygen and ventilators sooner than those receiving standard care,” the release said.

It quoted the study’s authors, led by University of British Columbia’s Dr Srinivas Murthy, as saying, “The benefit of treatment was most apparent for preventing the need for mechanical ventilation, suggesting probable added value for patients with less severe disease to avoid progression during hospital stay.”

“This may have important implications for patients and for health systems, particularly when ICU capacity, mechanical ventilation or oxygen is in limited supply,” they added.

The trials were led by researchers at University of British Columbia and Sunnybrook Health Sciences Centre.

The research gains relevance as the number of persons infected with the Omicron variant of Covid-19 grows across the world, including in India and Canada. While infections from the variant are considered milder than those earlier, its rapid transmissibility has led to record number of cases being reported on a daily basis in Canada.

Last week, Canada also cleared the use of the antiviral pill Paxlovid, manufactured by Pfizer, which is aimed at reducing hospitalisation amid the surge in cases. Source : ht

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Prime Minister Narendra Modi announced last Saturday children aged 15-18 would start receiving Covid-19 vaccinations from January 3.

Children in the age group of 15-18 years will be able to register on the CoWIN app from January 1, two days before the vaccination programme is expanded across the country to include them, a top official said on Monday.

“We have added an additional (10th) ID card for registration, the student ID card, because some might not have Aadhaar or other identity cards,” RS Sharma, chief executive officer of the National Health Authority, which also operates the government’s CoWIN platform, was quoted as saying by news agency ANI.

Prime Minister Narendra Modi announced last Saturday children aged 15-18 would start receiving Covid-19 vaccinations from January 3 and healthcare and frontline workers will start getting the shots as a precautionary measure from January 10 as cases of the Omicron coronavirus variant rose across the country.

PM Modi also said those above 60 with comorbidities would be offered booster shots against Covid-19 after recommendations from doctors.

Bharat Biotech's Covaxin, which has been granted approval for restricted use in an emergency situation in the age group between 12 and 18 years, is likely to be the only vaccine available for children, according to reports.

Covaxin is the second vaccine after Zydus Healthcare’s ZyCoV-D that was approved for use in children aged 12 years and above.

Dr NK Arora, chairperson of Covid-19 working group of the National Technical Advisory Group on Immunisation in India (NTAGI), said on Sunday Covaxin has shown that it has a very good immune response in children in trials.

"In fact, it is slightly better than adults. Secondly, this vaccine is a safe vaccine, and even local effects like pain, swelling in the arms is much less as compared to adults. We would like to offer this protection to our adolescents," Arora said in an interview with news agency ANI.

"Our research within the country also says that almost two-thirds of the deaths below 18 years which occurred due to Covid in India are within this age group. So, this decision was mainly taken to protect the adolescents,” he said.

Arora also said adolescents produce better levels of antibodies as compared to their adults.

“Here, I would also like to say that the same Covaxin dose is given to children as an adult and the interpretation between the doses is also four weeks. So as far as implementation of the programme is concerned, there is no special effort required. And immunization of these adolescents can be started within a short period without much or a specific preparation."

The number of doses for adolescents will be the same, Dr Arora also said. Source : ht

 

 

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It could take some time for Omicron to overtake Delta in some countries, because it depends on the level of circulation of the Delta variant in those countries, Infectious Disease Epidemiologist and Covid-19 Technical Lead at the World Health Organisation (WHO) Maria Van Kerkhove said on Tuesday.

Omicron is quickly overtaking the Delta variant of Covid-19 and becoming dominant around the world, a senior WHO official has warned, with the global health agency cautioning that there is "increasing evidence" Omicron is able to evade immunity but has less disease severity as compared to other variants.

It could take some time for Omicron to overtake Delta in some countries, because it depends on the level of circulation of the Delta variant in those countries, Infectious Disease Epidemiologist and Covid-19 Technical Lead at the World Health Organisation (WHO) Maria Van Kerkhove said on Tuesday.

“Omicron has been detected in all countries where we have good sequencing and it's likely to be in all countries around the world. It is quickly, in terms of its circulation, overtaking Delta. And so Omicron is becoming the dominant variant that is being detected,” Kerkhove said during a virtual questions and answers session.

She further cautioned that even though there is some information that Omicron causes less severe disease than Delta, “it's not a mild disease” because “people are still being hospitalized for Omicron.”

The Covid-19 Weekly Epidemiological Update, released by the WHO, said that over 15 million new Covid-19 cases were reported globally in the week of January 3-9, a 55 per cent increase as compared to the previous week when about 9.5 million cases were reported.

Over 43,000 new deaths were reported in the past week. As of 9 January, over 304 million confirmed Covid-19 cases and over 5.4 million deaths have been reported.

The highest numbers of new cases were reported from the US (4,610,359 new cases; a 73 per cent increase), France (1,597,203 new cases; a 46 per cent increase), the UK (1,217,258 new cases; a 10 per cent increase), Italy (1,014,358 new cases; a 57 per cent increase) and India (638,872 new cases; a 524 per cent increase), the update said.

Kerkhove said the 15 million cases reported in the last seven days are a “record high in this pandemic” and are an “underestimate” given the challenges in surveillance around the world and COVID-19 self-tests at home that are not registered.

The WHO update said that the Omicron variant has a substantial growth advantage and is rapidly replacing other variants.

“This variant has been shown to have a shorter doubling time as compared to previous variants, with transmission occurring even amongst those vaccinated or with a history of prior SARS-CoV-2 infection; there is increasing evidence that this variant is able to evade immunity,” the update said.

It said that in terms of disease severity, there is growing evidence that the Omicron variant is less severe as compared to other variants.

Citing a non-peer-reviewed retrospective cohort study from the US, the update said the findings suggest that while the absolute number of cases and hospitalisations among children are currently increasing in the US, the risk of hospitalisation still remains lower compared to other age groups during the period when Omicron is circulating as compared to the period when the Delta variant was dominant.

The update also noted that since December, six studies have provided evidence of reduced vaccine effectiveness (VE) of Covid-19 vaccines against the Omicron variant.

"While early VE estimates against the Omicron variant should be interpreted with caution due to potential biases, these preliminary results provide evidence of reduced overall effectiveness of vaccines against the Omicron variant, with greater declines in effectiveness with increasing time since vaccination, relative to Delta... While a booster vaccination appears to improve VE against infection and hospitalisation due to the Omicron variant, more data are needed to assess both the magnitude and duration of the protection,” the update said.

The WHO Technical Advisory Group on Covid-19 Vaccine Composition (TAG-CO-VAC) said that as coronavirus evolves, the composition of current Covid-19 vaccines may need to be updated, to ensure that “Covid-19 vaccines continue to provide WHO-recommended levels of protection against infection and disease by VOCs, including Omicron and future variants.”

Kerkhove added that as Omicron enters and circulates among vulnerable populations, “we will see increase in hospitalisations and deaths. So please treat this virus as seriously as it needs to be treated.

The narrative that it's the common cold is not true. The narrative that it is just mild is not true. So we have to really fight against it. It’s not the time to give up.” Source : ht

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A new study developed a consensus statement to identify the key issues regarding HIV patients that should be addressed immediately.

The research has been published in the 'Nature Communications Journal'.

To guide stakeholders in improving health system responses to achieve the best possible long-term health outcomes for people living with HIV, a global multidisciplinary group of HIV experts led by CUNY SPH Senior Scholar Jeffrey Lazarus and including distinguished Professor Denis Nash and Associate Professor Diana Romero developed a consensus statement identifying the key issues health systems must address in order to move beyond the long-time emphasis on viral suppression to instead deliver integrated, person-centred healthcare for people living with HIV throughout their lives.

Following a rigorous, multi-stage Delphi process, the research team established a diverse panel of experts with expertise in the long-term health needs of people living with HIV. The panel reviewed the literature on multimorbidity and stigma and discrimination in order to identify priority issues to incorporate in the Delphi process to develop a consensus statement.

"An important strength of this consensus statement is that it was generated through this rigorous process, incorporating quantitative and qualitative data from experts from over 20 countries," said Dr Romero.

The panel found that multimorbidity, health-related quality of life, and stigma and discrimination continued to be major issues for people living with HIV, including those who have achieved viral suppression and in particular those from marginalized populations.

"These factors can lead to depression, social isolation, and barriers in accessing health and support services," said Dr Lazarus, who is also an associate professor at the Barcelona Institute for Global Health.

"Many of these issues are not currently addressed in HIV monitoring, strategies, or guideline," Lazarus added.

"There is ample evidence that addressing things like mental health, stigma reduction, quality of life, and in many settings, housing, and food security, will also improve HIV outcomes like adherence to antiretroviral medications and viral suppression," Dr Nash said.

"The field of HIV implementation science can play a key role in assessing the impact of strategies integrated into HIV service delivery to mitigate these issues," Nash added.

The World Health Organization (WHO) and UNAIDS should create new HIV monitoring processes and guidelines, and Member States should commit to reporting on the indicators and implement policies to enhance health system performance and ensure the long-term well-being of the millions of people around the world living with HIV, the authors noted.

This story has been published from a wire agency feed without modifications to the text. Only the headline has been changed. Source : ht

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MMC Act to be implemented in state to control mosquitoes

Written by Thursday, 14 September 2017 06:06

With mosquito-borne diseases on the rise in the state, the public health department is planning to expand the scope of the Mumbai Municipal Corporation Act (MMC Act), 1888, to the entire state to effectively act against offenders allowing mosquito breeding in private spaces.

In a meeting held by state Health Minister Deepak Sawant and senior state health officials on Monday, it was decided to seek the opinion of the law and judiciary department on enforcing sections of the Brihanmumbai Municipal Corporation’s Act in state.

“This will be similar to Bombay Nursing Homes Registration Act initially limited to only Mumbai and later enforced in the entire state,” said Dr Satish Pawar, director at the Directorate of Health Services. The state government plans to pick specific sections from MMC Act, such as reporting of certain communicable diseases, sections on water and sanitation, and legal action taken for allowing mosquito breeding.

The most important section the state hopes to implement is Section 381 of MMC Act that allows civic body to prosecute a person found guilty of allowing mosquito breeding in public or personal space. The fine ranges between Rs 2,000-10,000. Section 381(B) of the Act deals with those who default on making water tanks mosquito proof.
In June, BMC found maximum mosquito breeding in public buildings.

The public works department buildings had 536 non-mosquito proof spots, central railways had 446 spots and central public works department was found with 252 breeding spots. Western railways owned 636 buildings, where 3.7 per cent tanks had no mosquito proofing. Central railways, which owns 577 premises, had a significant 23.5 per cent breeding spots. All government agencies were issued notices by BMC.

“The fine is minimal. Offenders are let off easily which is why we have been asking to increase it to prevent multiple offences,” Dr Rajan Naringrekar, insecticide officer, BMC, said. With monsoon receding and weather conducive for viral infection to multiply, the state is taking special efforts to control malaria and dengue, both spread by mosquito. In Mumbai itself, 271 malaria cases and 102 dengue cases were recorded since September 1.

While malaria is carried by anopheles, dengue is spread by aedes aegypti. Indoors, aedes mosquito breeds in feng-shui plants, flower pots, fish tanks, unused tyres and petri-dishes. “We are expecting a spike in dengue, leptospirosis and gastroenteritis in the coming days because of flooding in Mumbai. Steps have been taken to ensure medicines are adequately stocked,” a civic official said. Dr Pradeep Awate, state epidermiologist, said H1N1 cases have also been high. In the state, 4,628 have been diagnosed with H1N1 infection, including 488 who succumbed until August end.

 

 

 

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Member of Parliament (MP) Kirron Kher has submitted proposals to Union Minister of State for Health and Family Welfare Ashwini Kumar Chaubey, regarding setting up of a 300-bedded trauma centre in Chandigarh, apart from construction of a sports injury centre at Government Medical College and Hospital(GMCH), Sector 32.
A statement issued Tuesday said Kher met Chaubey Monday and submitted the proposals.

“In one of the letter addressed to Chaubey, she mentioned that the Trauma Centre already running at PGIMER is over burdened and not sufficient to cater to the needs of the region (i.e Punjab, Haryana, Himachal Pradesh and Jammu & Kashmir). Construction of the proposed trauma centre is need of the hour. In a separate letter, she has written that Chandigarh Administration has proposed to construct sports injury centre in GMCH, Sector-32,” the statement said. It further said that the project report has already been submitted to the Director General Health Services, Government of India, for approval.

Kher, during the meet, requested Chaubey to look into the matter and arrange requisite approval for the project.
The MP also told Chaubey that Ministry of Health and Family Welfare has already granted its approval regarding setting up of a Trauma Centre as an extension of GMCH. “Chandigarh Administration has already earmarked a plot measuring 9.6 acres for setting up of a Trauma Centre in Sector 53, Chandigarh, and a detailed Project Report (DPR) of the Trauma Centre has also been prepared. Whereas the project related to construction of Sports Injury Centre is pending with the Ministry of Health and Family Welfare, New Delhi, since April 2013,” the statement said.

The statement further stated that GMCH has established itself in the region in the field of sports injuries and on an average is performing 100 surgeries on elite players of different games coming from all over the country.

“Presently, there is only one dedicated Sports Injury Centre in the country which is based at Safdarjung Hospital, New Delhi. Chandigarh Administration has already earmarked a plot measuring 1.43 acres for setting up of this centre. Accordingly, a Detailed Project Report (DPR) of the proposed centre has been prepared. It is felt that setting up of a similar centre in Chandigarh, which caters to the needs of Punjab, Haryana, Himachal Pradesh, Rajasthan, Jammu & Kashmir and Uttarakhand, will go a long way in restoring the health of athletes in the region so that they can go back to the pre-injury level of games at the earliest,” the statement added.

 

 

 

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CHENNAI: AIADMK general secretary V K Sasikala's husband M Natarajan is in a critical condition after sufferingmultiple organ failure on Sunday. Natarajan, 74, has been admitted to Gleneagles Global Health City in Perumbakkam, where he is under intensive care.

According to a medical bulletin released by the hospital administration, Natarajan suffers from chronic liver disease and has been receiving treatment for it for the past six months. "He is admitted at the Liver Intensive Care Unit with decompensated liver disease leading to liver and kidney failure and lung congestion. He is receiving dialysis and other intensive care therapies," the hospital statement said.

Natarajan has been registered with the Tamil Nadu Organ Sharing (TNOS) waiting list for deceased donor liver transplantation. "He is being taken care by a multidisciplinary team of liver specialists headed by Prof. Mohamed Rela," the hospital note said.

According to hospital sources, Natarajan had undergone a dialysis session for more than eight hours on Sunday. This is not the first-time Natarajan has been hospitalised this year. On February 5, he was brought to Apollo Hospitals on Greams Road after complaining of breathing problems.

 

 

 

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Swine flu spurts in Delhi: 1,066 cases last month

Written by Saturday, 19 August 2017 06:15

 

Swine flu has surged sharply in the capital with 1,066 cases being confirmed in the last one month, which is more than four times the number reported during the rest of this year.

The total number of cases till August 13 this year stands at 1,307, more than six times the corresponding period of 2016.

Nationally, 18,855 cases of theH1N1 influenza have been reported this year, claiming 929 lives.

But despite the spurt in cases in the capital, the number of deaths has not risen significantly. "Only four deaths have been reported: two from Delhi and two patients from outside have died," Delhi health minister Satyendra Jain said in the assembly last week. At a review meeting on Friday , Delhi health department officials told their counterparts in the Centre that the city has sufficient training and stocks of medicines to tackle the swine flu outbreak.

Health experts said there was no cause for panic over the sudden spurt in swine flu in Delhi. "People should not panic if they suffer normal viral infection. The high risk groups include people with heart diseases, pregnant women, children below eight years of age, senior citizens, diabetics and kidney disease patients. These patients need special treatment," said a doctor.

Dr Jagdish Prasad, director general of health services, told TOI that the Centre had offered to train doctors of Delhi government and private hospitals on treating swine flu cases. "If any hospital wants training, we can send our doctors," he said. Delhi health minister Sandar Jain said in the as tyendar Jain said in the assembly last week that the government had enough stocks of medicines and vaccines to tackle the outbreak.

"Adequate facilities for treatment are available in Delhi. We have placed orders for advance purchase of medicines," Jain said. He added that there were reserved beds for patients in government hospitals and not even 5% of these beds had been occupied.

The spike in the cases at this time of the year has come as a surprise because swine flu usually peaks in the postmonsoon season and early winter. Some health conscious people have started maintaining caution when they are in public places because the H1N1 virus, which causes swine flu, transmits from human to human.

"The spike in swine flu at this time is also due to infection coming in from states where a very high number of cases have been reported.Such a big outbreak in the month of August is a matter of concern since swine flu usually rises in October and November," said Dr K K Aggrawal, national president of the IMA. The association has planned to launch a poster campaign against swine flu."

 

 

 

 

 

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A study has warned that cloudy drinking water is linked to increased cases of gastrointestinal illness. Cloudiness in water is caused by material floating in it. The undissolved particles may actually provide some protection for harmful pathogens against disinfectants.

Researcher Anneclaire De Roos from Drexel University in Philadelphia, US found associations between acute gastrointestinal illness (AGI) and water turbidity, a term meaning cloudiness or opacity. Turbidity is the cloudiness or haziness of a fluid caused by large numbers of individual particles that are generally invisible to the naked eye, similar to smoke in air.

The results revealed that exposures through drinking water caused a low but detectable number of AGI cases in the regions. There is no clear, alternative explanation for the patterns of associations — particularly when a similar pattern was seen multiple times. Acute gastrointestinal illness could be caused by waterborne pathogens like norovirus, Giardia, or Cryptosporidium and carry symptoms like diarrhoea and vomiting. Researchers looked into a collection of studies that had been done on the topic.

These studies were designed to evaluate risks from contamination of source waters (usually rivers in the cities studied), before the water entered cities’ distribution systems. They found that turbidity of drinking water was linked to increased AGI in multiple studies, and not just when there was increased cloudiness. “As expected, the association between turbidity and AGI was found in cities with relatively high turbidity levels, often in unfiltered drinking water supplies,” De Roos noted.

 

 

 

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AHMEDABAD: Gujaratgovernment and theAhmedabad Municipal Corporation (AMC) once again got a rebuke from Gujarat high court on Wednesday "for taking its direction lightly" in response to a petition seeking prompt measure to curb spread of swine flu, which has already claimed over 200 lives across the state.

A bench headed by Justice M R Shah told government's law officers that everything looks all right on paper, but the reality is different. The court asked the state government to state what measures have been taken to curb the spread of the disease.

The court said that so many people dying of the disease is really serious, and the authorities must take prompt steps in public interest. The court has sought a report in this regard by Monday.

The court also expressed concern about testing facilities and commented whether there is a provision to provide this facility free of cost to the poor.

The court's chiding came after advocate K R Koshti urged the court to issue directions to arrest further damage due to swine flu spread in absence of proper facilities. By adding the issue of swine flu in his last year's PIL to curb vector-borne diseases, the lawyer submitted that the state government and AMC machinery was never prepared to fight against H1N1 virus, and to prevent loss of life.

The PIL has demanded appointment of a committee of experts for field visit to take stock of the situation and to report to the court about the reality.

It seeks directions for creating facilities of diagnosis and free treatment for the poor. It has also asked for compensation for the victims.

Meanwhile, Justice Shah recalled the directions issued last week to AMC to clear roads of stray cattle and garbage.

The judge said that heaps of garbage have not been removed yet, though the authorities had promised to bring in visible change in a week's time.

The PIL stated that despite World Health Organization (WHO) warning, no effective measure has been chalked out by the administration to tackle the outbreak. Till August 15, 208 people died out of total 1,883 swine flu patients in Gujarat.

The petitioner complained that the government has not set up laboratories at districts across the state for testing the virus, and delay caused in diagnosis proves fatal in most cases. The PIL has complained that AMC does not have enough staff in its health department to deal with the situation.

 

 

 

 

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