July 2020 - CHILD AND CHEST HEALTH CARE

Ibuprofen is safe to use during COVID 19,Dr.Dev,M.D.,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi-NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 27 Jul, 2020 - Professionals Guide, - 0 Comment

There is no specific treatment available for COVID 19,all over the world.

In such case, the only treatment which can be useful is the symptomatic treatment.

The troublesome symptoms which need to be addressed are ,fever,headache and bodyache apart from cough

The most widely used drug to get relief from fever and pain is paracetamol and acetaminophen derivatives.

Some people do not feel comfortable even after taking Paracetamol and continue to feel headache ,bodyache,and fever.

These cohort of people get relief after taking Ibuprofen.

It was believed at the outset of epidemic of COVID 19,that the use of Ibuprofen may worsen the severity of COVID 19 and people refrained from using this drug.

Researchers from Israel studied the effects of Ibuprofen in patients of COVID 19.They studied 403 patients with the median age of 45 years.They observed the patients from 1 week prior to the diagnosis to,throughout the course of disease.

44% patients developed fever who required its treatment.32% patients used Acetaminophen and 22% used paracetamol to treat their fever.

Respiratory support was needed in 11% patients in Acetaminophen group and approximately10% in Ibuprofen group(P=1).

Mortality was noticed in 2.4% patients using Acetaminophen and 3.8% using Ibuprofen(P=0.95)

So,there was no difference observed between Acetaminophen group and Ibuprofen group as far as the need for respiratory support or mortality are concerned

Although there are many limitations of this study including recall bias and no study among asymptomatic patients,this is an important study which needs further study on larger population before making a general opinion.

REFERENCES;

Rinott E, Kozer E, Shapira Y, Bar-Haim A, Youngster I. Ibuprofen use and clinical outcomes in COVID-19 patients [published online June, 11 2020]. Clin Microbiol Infect. doi:10.1016/j.cmi.2020.06.003

childern usually do not transmit coronavirus19 infection,Dr.D.k.Jha,M.D.,Pediatric Pulmonologist,Delhi,India

DR DEV KUMAR JHA - 16 Jul, 2020 - INFECTIOUS DISEASES,Respiratory, - 0 Comment

Coronavirus 19 is a potential lethal virus causing Coronavirus disease 2019.

This disease has made realisation of its presence all over the world .

All age groups are being infected with this disease with varying morbidities and mortalities.

The disease has disrupted the educational and economic activities,all over the world.Schools are closed for a long time all over the world in the fear of spread of the disease among children and then in the household.

Researchers have studied 4130 cases through hospital surveillance network between 10,March 2020 to 10,April 2020.Among them 40 cases were children below 16 years of age.Household and parents were called for contact tracing .

It was observed that,in 79% of cases, the source were an adult in the household who were either diseased or infected prior to the infection in children.

In only 8% cases,children were primarily infected who then infected adults.

It was then concluded that,children, not only suffer from mild form of the disease in majority of cases,but they are also not the source of infection to othe children or adults in most of the cases.

The study was published in PEDIATRICS,the official journal of American Academy of Pediatrics.

In conclusion,there will be very little benefit from closing the schools, but it can adversely affects the academy of growing children.

REFERENCES:Pediatrics. 2020;146:e20201576, e2020004879

Certain hand sanitizers are life threatening,Dr.Dev,M.D.,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi-NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 10 Jul, 2020 - Child Health Guides,Medical Guide,Parents’ Guide,Professionals Guide, - 0 Comment

In the Pandemic of Coronavirus disease 2019(COVID 19) , hand sanitizers are life saving.

It kills most of the micro-organisms which come in contact with hands.

It should be used when hand washing facility with soap and water is either not available or not feasible.

Hand sanitizers should be composed of ethanol and it should be at least 60% ethanol ,not methanol.

It should be rubbed over hands on all sides till the hands become dry.

Methanol containing hand sanitizers can become dangerous when absorbed through skin or ingested.If there is frequent use of hand sanitizers it can be absorbed through skin.Sometimes it can be ingested by children or inadvertently by adults.Some companies are making and selling methanol containing hand sanitizers.

There has been some reports of death,blindness and hospitalisation after ingestion of methanol containing hand sanitizers by adults and children. Methanol are used to create fuel and antifreeze.

SIGN AND SYMPTOMS OF METHANOL TOXICITY: Nausea,vomiting,headache,blurred vision.

There may be permanent blindness,seizure,coma,permanent neurological damage and death.

FDA has warned against the use of methanol containing hand sanitizers ,stating that some companies are taking undue advantages of coronavirus pandemic and selling methanol containing hand sanitizers.

It is being recalled from the market .It should be disposed properly using hazardous waste container and should not be poured into drain and should not be mixed with any fluid.

REFERENES;fda.gov

Newborns born to COVID 19 positive mother are not at risk,Dr.Dev,M.D.,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi-NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 03 Jul, 2020 - Professionals Guide, - 0 Comment

There is a common belief that infants born to COVID 19 positive mother may have COVID 19,and their immunological status is impaired.

71 Newborns were taken in study to know the facts about the disease status and immunological status.

After exclusion criteria,51 Newborns were included in the study.

All mothers were tested positive for COVID 19 during third trimester of pregnancy.

Chest X-ray of all mothers done before delivery were consistent with viral Pneuimonia.

Apgar scores at 1 minutes and 5 minutes were assessed for all infants.

All Newborns were separated from the mother and kept in isolation with formula feeds.

Caesarean section was the mode of delivery in most cases.

Non of the Newborns showed any symptom in the form of cough ,fever and breathlessness consistent with COVID19, during the course of hospital stay.

No infant required mechanical ventilation but only few needed low flow oxygen with nasal catheter for <3 days.

Blood samples were taken within 3 days of birth to assess immmunological status.

Pharyngeal swabs were taken after 30 minutes of birth to detect Corona virus by RT-PCR .

RT-PCR were negative in all infants.

The levels of lymphocytes subsets,CD3,CD4,CD8 and CD19 and their proportion were normal except for CD16-CD56 which were below normal.

ImmunoglobulinG and Immunuglobulin M were normal.

Interleukin 6 were elevated and it was very high in one Newborn who developed Necrotising enterocolitis in the third week of life.

There was no correlation between duration of COVID 19 in mother and level of lymphocyte subsets or cytokine in infants.

All Newborns were discharged after 3 consequitive samples were found negative for COVID 19.

The study was published in JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY.

REFERENCES:Liu P, Zheng J, Yang P, et al. The immunologic status of newborns born to SARS-CoV2-infected mothers in Wuhan, China [published online May 10, 2020]. J Allergy Clin Immunol. doi: 10.1016/j.jaci.2020.04.038