Evidence based medicine is not being practised enough in India. Many "official COVID19 treatments" in India have already been discarded by the world, but patients still receive long lists of drugs that only add to cost & side effects.
1/10
scroll.in/article/993859… via @scroll_in
1/10
scroll.in/article/993859… via @scroll_in
Chloroquine, Ivermectin, plasma, steam inhalation, 'coronil', azithromycin, doxycycline, oseltamivir, vitamin D (for people without proven deficiency), Zinc, vitamin C, PP inhibitors are still prescribed in India, despite lack of evidence. This is called polypharmacy.
2/10
2/10
"There is no harm in giving it" is not a scientific explanation that can justify irrational use. Besides, all harms need not be obvious to the prescriber.
Doctors are trained to use the minimum number, dose & duration of medication for any disease, and only if necessary.
3/10
Doctors are trained to use the minimum number, dose & duration of medication for any disease, and only if necessary.
3/10
In other words, NOT giving a 'prescription medication' is perfectly acceptable for many medical conditions, as long as the doctor is able to diagnose and educate the patient about the treatment plan to be followed.
Simply put, "treatment ≠ prescription"
Less can be More.
4/10
Simply put, "treatment ≠ prescription"
Less can be More.
4/10
'Opinion-based' treatments not only add to cost, but also increase the chance of side effects & interactions (some of which can be dangerous). This is unethical. With all the evidence, it is time to stop such unscientific practices.
['opinion' is not the same as evidence]
5/10
['opinion' is not the same as evidence]
5/10
In COVID-19, there are only 4 established life-saving treatments. They are oxygen, steroids (oral or IV), prophylactic LMW heparin & vaccines.
We must focus on giving these in the right dose to the right patient, as they are not useful for everyone.
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We must focus on giving these in the right dose to the right patient, as they are not useful for everyone.
6/10
There are a few other drugs like Tocilizumab & others that are used only by experts under certain circumstances; this thread is not meant to discuss these.
Will link the Massachusetts General Hospital guideline for those with academic interest.
7/10
massgeneral.org/assets/MGH/pdf…
Will link the Massachusetts General Hospital guideline for those with academic interest.
7/10
massgeneral.org/assets/MGH/pdf…
In modern medicine, we follow evidence. It is important to systematically DISCARD treatment modalities that do not work, without prejudice.
It is not advisable to "fall in love with" certain 'favourite' drugs and continue to prescribe them against all accumulated evidence.
8/10
It is not advisable to "fall in love with" certain 'favourite' drugs and continue to prescribe them against all accumulated evidence.
8/10
On this note, it is important to reiterate that antivirals (Remdesivir, Lopinavir) do not reduce mortality.
When observing a few patients, it is common for doctors to be fooled into thinking that a particular drug 'made a difference'.
That is why we do randomised trials.
9/10
When observing a few patients, it is common for doctors to be fooled into thinking that a particular drug 'made a difference'.
That is why we do randomised trials.
9/10
The advantage of randomised trials is that they study large numbers of people, which means any chance of erroneous conclusion is removed, and bias by the treating team is also eliminated. Unfortunately, some people continue to act against such evidence.
This has to stop.
10/10
This has to stop.
10/10
@jayalal10 @JayeshLele @IMAIndiaOrg @PMOIndia @malini_aisola @IndiaAheadNews @PIB_India @RemaNagarajan @doctorsoumya
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