BackgroundAYUSH formulations have a potential role in symptomatic treatment, preventing disease progression and improving quality of life in COVID-19 patients.ObjectiveTo study the effect of AYUSH formulation (Kabasura Kudineer tablets, Shakti drops and Turmeric plus) as an add-on treatment in patients with mild COVID - 19MethodologySingle centre, two arms, open labelled randomized controlled trial with a total of 30 patients (15 in the intervention arm and 15 in the standard care arm). Intervention arm received a combination of 3 AYUSH formulation along with the standard of care treatment for 21 days. All patients were followed for 28 days. Symptom severity (using Modified Jackson scale), negative conversion of SARS-CoV-2 RNA (using RTPCR) and quality of life (WHOWOL BREF questionnaire) was assessed.ResultsFifteen patients (93.8%) in the intervention group and twelve patients (92.3%) in the standard care arm had complete resolution of symptoms (P value= 0.36). Negative conversion for SARS-CoV-2 was seen in thirteen patients (92.9%) in intervention arm and eleven patients (100%) in standard care arm at day 28 (P value = 0.56). There was no difference in the quality of life scores between the 2 groups.ConclusionThe use of Ayush interventions as add-on therapy did not negatively impact the clinical outcomes in COVID-19. This trial confirmed the safety and tolerability of Kabasura Kudineer tablets, Shakti drops and Turmeric plus tablets when used use among mild to moderate symptom category, of COVID-19. There were no serious adverse events in the treated group. There was no clinical progression of disease from baseline status and all trial participants recovered fully by day 28. A longer follow up and a larger sample size is recommended for future definitive trials with this alternative medicine (AYUSH) combination.
Our hospital is a referral centre for Jehovah's Witnesses (JW) patients, who as a matter of religious belief refuse transfusions of blood/blood components. We have treated JW patients with dengue fever (DF) and thrombocytopenia without platelet transfusion, without any mortality or major morbidities. We retrospectively compared the duration needed for platelet recovery and duration of hospitalization of DF with thrombocytopenia in those treated with prophylactic platelet transfusion and JW patients who were managed without these. Among JW patients, platelet counts recovered to >50,000 in 2.57 days (Mean) as compared to those who received prophylactic platelet transfusion, who recovered in 4.43 days (P value < 0.0001). They also had significantly less number of days of hospitalization (3.68 days vs 5.13 days, P value < 0.0001). These differences persisted even when a subgroup analysis of patients who had nadir platelet count less than 10,000 were done. Most importantly, none of the patients in either group suffered any significant morbidity or mortality. Prophylactic platelet transfusion in clinically stable DF patients was associated with significant delay in platelet recovery and increased duration of hospitalization, even though was not harmful in terms of morbidity or mortality. Though number of subjects involved in the study was small, this brief report further adds to the current evidence that prophylactic platelet transfusion in clinically stable DF patients with a platelet count more than 10,000/cmm is not indicated.
The coronavirus pandemic has become a challenge to all the healthcare systems in the world. Urgent creation of an intensive care unit (ICU) for the same is the need of the hour. The ideal ICU for COVID -19 should be isolated, fully equipped with invasive and noninvasive monitoring, with 24/7 trained medical personnel, nursing staff and laboratory support. As the coronavirus infection is transmitted by droplets and is highly contagious, protection of healthcare workers is crucial. Personnel working inside the ICU should get personal protective equipment (PPE). Strict guidelines for donning and doffing of PPE should be followed to prevent cross-contamination. Respiratory failure being the commonest complication of COVID-19, knowing the ventilator management for the same is essential. It is of great importance to meticulously manage all the resources to combat this contagion.
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