Centre issues covid guidelines for children; Remdesivir not recommended

News Network
June 9, 2021

New Delhi, June 9: The government has come out with comprehensive guidelines for the management of Covid-19 among children in which Remdesivir has not been recommended and rational use of HRCT imaging has been suggested.

The guidelines issued by the Directorate General of Health Services (DGHS) under the health ministry also said that steroids are harmful in asymptomatic and mild cases of infection.

The DGHS recommended steroids only in hospitalised moderately severe and critically ill Covid-19 cases under strict supervision.

"Steroids should be used at the right time, in the right dose and for the right duration. Self-medication of steroids must be avoided," it said.

The guidelines also said Remdesivir (an emergency use authorization drug) is not recommended in children.

"There is lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 years of age," the guidelines said.

The guidelines suggested rational use of High-resolution CT (HRCT) for seeing the extent and nature of lung involvement in patients with Covid-19.

"However, any additional information gained from HRCT scan of the chest often has little impact on treatment decisions, which are based almost entirely on clinical severity and physiological impairment.

"Therefore, treating physicians should be highly selective in ordering HRCT imaging of the chest in Covid-19 patients," the guidelines said.

They said Covid-19 is a viral infection, and antimicrobials have no role in the prevention or treatment of uncomplicated Covid-19 infection.

For asymptomatic and mild cases, the guidelines said antimicrobials are not recommended for therapy or prophylaxis while for moderate and severe cases antimicrobials should not be prescribed unless there is clinical suspicion of a superadded infection.

Hospital admission increases the risk of healthcare-associated infections with multidrug-resistant organisms.

For asymptomatic infection among children, the guidelines recommended no specific medication and promoted Covid-appropriate behaviour (mask, strict hand hygiene, physical distancing) and suggested giving nutritious diet.

The guidelines said that for mild infection paracetamol 10-15mg/kg/dose may be given every 4-6 hours for fever and throat soothing agents and warm saline gargles in older children and adolescents have been recommended for cough.

In case of moderate infection, the guidelines suggested initiating immediate oxygen therapy.

"Corticosteroids are not required in all children with moderate illness; they may be administered in rapidly progressive disease and anticoagulants may also be indicated," the guidelines said.

For severe Covid-19 among children, the guidelines said if Acute Respiratory Distress Syndrome (ARDS) develops, necessary management to be initiated.

"In case shock develops, necessary management should be initiated. Antimicrobials to be administered if there is evidence/strong suspicion of superadded bacterial infection.  May need organ support in case of organ dysfunction, e.g. renal replacement therapy," it said.

The guidelines also recommended a six-minute walk test for children above 12 years under the supervision of parents/guardians.

"It is a simple clinical test to assess cardiopulmonary exercise tolerance and is used to unmask hypoxia.  Attach a pulse oximeter to his/her finger and ask the child to walk in the confines of their room for six minutes continuously," it said. 

Comments

Add new comment

  • Coastaldigest.com reserves the right to delete or block any comments.
  • Coastaldigset.com is not responsible for its readers’ comments.
  • Comments that are abusive, incendiary or irrelevant are strictly prohibited.
  • Please use a genuine email ID and provide your name to avoid reject.
News Network
June 14,2021

New Dehi, June 14: Fuel prices were increased again on Monday after a day's pause. Petrol in the national capital Delhi is now priced at Rs 96.4 a litre (after a 38 paise rise) while diesel costs Rs 87.28 a litre, up by 30 paise.

In Bhopal, a litre of petrol now costs Rs 104.59 while diesel costs Rs 95.91. Petrol in Ladakh costs Rs 101.95 per litre and diesel Rs 93.90 a litre.

In India's financial capital, Mumbai, petrol is priced at Rs 102.58 and diesel at Rs 94.70 a litre each.

Fuel prices differ from state to state depending on the incidence of local taxes such as VAT and freight charges. The increase in prices is due to a combination of rising international oil prices and central and state taxes.

Global oil prices held near multi-year highs on Monday, underpinned by an improved outlook for demand as several nations eased coronavirus curbs.

Brent crude was up 14 cents, or 0.2 per cent, at $72.83 by 0123 GMT. US West Texas Intermediate was also up 14 cents, or 0.2 per cent, at $71.05 a barrel, after reaching the highest since October 2018 at $71.24 on Friday and rising 1.9 per cent on the week. 

Comments

Add new comment

  • Coastaldigest.com reserves the right to delete or block any comments.
  • Coastaldigset.com is not responsible for its readers’ comments.
  • Comments that are abusive, incendiary or irrelevant are strictly prohibited.
  • Please use a genuine email ID and provide your name to avoid reject.
News Network
June 8,2021

Agra, June 8: A hospital director in Agra, Uttar Pradesh, has allegedly been caught on camera speaking about how a 5-minute oxygen mock drill in April caused the death of 22 patients, prompting outrage and an inquiry into the issue.

In the short 1.5-minute video clip, Arinjay Jain, the owner of Paras Hospital, which includes a Covid-19 facility, can be heard saying his hospital cut off oxygen supply to patients for a 5-minute mock drill on April 27, amid a crippling oxygen shortage in the state and the entire country when the second Covid wave was still on the rise.

"We were told that even the Chief Minister cannot get oxygen, so start discharging patients. Modi Nagar is dry,” Jain is heard saying on the clip recorded on April 28 that has since gone viral on social media.

“We started counseling families. Some were willing to listen, but the others said they would not leave. I said okay let's do a mock drill. We will find out who will die and who will survive. So we did that at 7 am. A mock drill was done. No one knows. Then we identified 22 patients. We realised they would die. This was done for 5 minutes. They started turning blue."

Scenes of desperation broke out in Uttar Pradesh in late April and early May as people ran from pillar to post in search of oxygen for family and friends who had contracted Covid, leading to an acute scarcity of the life-saving gas.

Agra District Magistrate Prabhu N Singh, in a statement to the media, however, refuted any deaths due to oxygen shortage on the day the video was recorded but promised a probe into the issue.

"Initially, there was some panic and shortage but we sorted all that out in 48 hours. In this hospital, there have been seven Covid deaths on the 26th and 27th of April. The hospital also has a lot of other ICU beds. There is no truth that 22 people died but we will carry out an inquiry," Singh said in the statement.

The incident was met with much outcry on social media, with Congress leader Rahul Gandhi also hitting out against the ruling party in the state. However, the owner of the hospital said his words had been misinterpreted.

“We had to find out the oxygen dependency of the patients to understand how we can handle the situation if there was an oxygen shortage or if the supply gets over... Mock drill means taking stock of the situation before facing an issue, to understand how to work in an emergency,” Jain said.

“We had categorised the patients... We categoried Covid patients to see which patient needs how much oxygen... A mock drill does not mean switching off a patient's oxygen. We did not switch off oxygen. I did not clearly say so in the video. I said a mock drill was done at 7 am. In this, 22 patients died."

Comments

Add new comment

  • Coastaldigest.com reserves the right to delete or block any comments.
  • Coastaldigset.com is not responsible for its readers’ comments.
  • Comments that are abusive, incendiary or irrelevant are strictly prohibited.
  • Please use a genuine email ID and provide your name to avoid reject.
News Network
June 10,2021

Kavaratti, June 10: The Lakshadweep administration has withdrawn its order to deploy government officials on fishing boats for intelligence gathering following the widespread protests from the employees and the locals.

An order to increase security on ships has also been withdrawn. Amid protests by islanders against the proposed "reforms" by Lakshadweep administrator Praful Khoda Patel, the island administration had taken a set of decisions, including deputing government officials onboard local fishing boats for intelligence gathering.

The order to increase security on ships has also been withdrawn.

Hitting out the administration for its new directives, Lakshadweep MP Mohammed Faizal termed them as a "mockery" and urged the authorities to withdraw them immediately. It was on May 28, a meeting chaired by Principal Secretary cum Advisor to the Administrator decided to depute responsible government servants onboard local fishing boats for intelligence gathering.

It had also ordered measures for the installation of CCTV cameras at berthing ports and the helibase and baggage and passenger checking facility at Mangalore and Beypore ports.

The Lakshadweep administrator has been facing severe criticism from the Opposition leaders over his "anti-people" policies in the islands. However, the administration has refuted all the allegations levelled by the Opposition against Patel. 

Amid the huge public outcry, the Lakshadweep administration last week justified its reform push saying that it wants to develop islands on the lines of Maldives in two decades.

Calling the latest reforms "draconian", Congress leader Rahul Gandhi earlier today said the latest "regulations penalise dissent and undermine grassroots democracy".

Comments

Add new comment

  • Coastaldigest.com reserves the right to delete or block any comments.
  • Coastaldigset.com is not responsible for its readers’ comments.
  • Comments that are abusive, incendiary or irrelevant are strictly prohibited.
  • Please use a genuine email ID and provide your name to avoid reject.