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Rajeev Jayadevan Profile picture
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23 May, 7 tweets, 3 min read
Steam inhalation can have serious side effects both on skin and in our respiratory tract. See thread.
Apart from perceived symptomatic relief in cough, it has no scientific benefit in COVID-19.
A boy suffered burns from steam inhalation @
Hyderabad.
1/5
 thehindu.com/news/cities/Hy…
Every year, an average of 3 people are hospitalized in Burn Centres in Netherlands for burns resulting from a popular home-remedy: steam inhalation. Most victims were children; needing skin grafting more than adults. See thread for a report from India.
2/5
 ncbi.nlm.nih.gov/pmc/articles/P…
This report from Ireland is again about children suffering severe burns as a result of steam inhalation as a home remedy. See thread.
3/n
 ncbi.nlm.nih.gov/pmc/articles/P…
While steam inhalation may seem like a benign remedy, when done in excess (ref. fake WhatsApp messages urging us to 'kill the virus using steam'), it can damage the delicate layer of mucus (our natural protection against bacteria & viruses) & respiratory mucosal cell lining.
4/5
“We have seen patients coming in with scalding of airways after steam inhalation. Unscientific steam inhalation is probably going to burn the airways, causing problems much worse than Covid,”

-Dr Satyanarayana, HOD, Pumonology, Manipal Hospitals

5/5
 thehindu.com/news/cities/Hy…
Dr Satyanarayana’s interview in Times of India on the potential dangers of excessive steam inhalation. See thread above.

m.timesofindia.com/city/bengaluru…
Good works as always @sunithaTOI

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More from @RajeevJayadevan

Rajeev Jayadevan Profile picture
25 May
The rise of variants in India, 2021. Monthly genomic analysis of multiple districts in Kerala.

Over 5 months, the B.1.617 has had a steep growth, now standing tall at ~60% of genomes.

B.1.1.7 rose quickly in February, but is slowly being replaced by B.1.617.

Thread 👇
1/15 ImageImageImageImage
I have manually modified the graphs to accommodate the latest numbers to put them all in one picture. The bar on the right end shows a high prevalence of variants (approx %).

The bars on the left (each representing one month of 2021) are smaller.

2/15 Image
In the beginning of 2021, there were very few variants; the bars are almost flat. Then came the rise of B.1.1.7 (UK), and the B.1.617(India) in April.

But now the “India variant” B.1.617 is fast-replacing all other viruses in circulation, accounting for ~60% of genomes.

3/15
Read 21 tweets
Rajeev Jayadevan Profile picture
23 May
The first series on “Black Fungus” mucormycosis courtesy Prof. VP Pandey Indore. 210 patients.

Antibiotics had been used in 100% patients, steroids NOT used in 14%, 21% were NOT diabetic, 36% were @ home, oxygen only by 52%, Zinc status not checked.

See thread for details. 1/n
Immensely grateful to Prof. VP Pandey HOD Medicine at MGMMC Indore for analysing this series of 210 mucormycosis patients.

Clearly there are factors beyond steroid use & diabetes here.

The obvious question is, what other forms of treatment did these patients receive? 👇

2/8
3 potential offenders that must be looked for in studies:

1. Concurrent antibiotic use: not indicated in viral infections like COVID-19.

Azithromycin, Doxycycline , even carbapenems are seen on prescriptions. Antibiotics are known to increase risk of fungal infections. 👇

3/8
Read 10 tweets
Rajeev Jayadevan Profile picture
22 May
Are Zinc supplements to blame for "Black Fungus"? (this is an interesting hypothesis, NOT an assertion) See thread for summaries of papers from 1996, 2013.
Fact: Fungi feed on Zinc.
Mammalian cells try to escape fungal invasion by "starving" the fungus of zinc, by hiding it.

1/9
Thread
Vertebrate cells (includes mammals) keep zinc "out of sight" of fungi.
In fact, some fungi dispatch "zinc-fetching molecules" ("Zincophores") into the vicinity, which search for "any zinc that's lying around" & bring it back.
See 2012 paper:
2/9
 ncbi.nlm.nih.gov/pmc/articles/P…
These self-defence processes against invading fungi, collectively known as "nutritional immunity" help us limit microbial growth, and enhance killing of the invader. Successful pathogens have developed strategies to counteract this and acquire essential micronutrients.
3/9
Read 12 tweets
Rajeev Jayadevan Profile picture
21 May
"Black Fungus" is the wrong term for Mucormycosis. The back color refers to tissues turning dark from destruction of blood supply. Risk factors include immunosuppression by uncontrolled diabetes, chemotherapy, transplantation, steroids.
See thread.
1/11
ncbi.nlm.nih.gov/pmc/articles/P…
The above 2019 review article by Dr Arunaloke Chakrabarti of PGI Chandigarh is a comprehensive resource on mucormycosis.

The current situation, linked with COVID-19, requires systematic (and really quick) review of all the cases.

The details must be made available ASAP.

2/11
Will post a quick thread on "Black Fungus" see above.

1. Until an audit of all the present cases are done, it will be impossible to make firm statements. Speculation is not always accurate.

2. The fungus attacks blood vessels, and does not respect anatomical boundaries.

3/11
Read 11 tweets
Rajeev Jayadevan Profile picture
21 May
P-hacking is an unethical research practice where non-significant results are dressed-up to appear “significant” - like it really matters. Not all research is ethical; this thread explains. Without knowledge of biostatistics, it is easy to be fooled by the authors ‘conclusions’.
This paper explains p-hacking in detail. I will add some easy tips to escape being fooled by fraudulent research. See below Also see Dr Gohel’s thread above.

2/n
journals.plos.org/plosbiology/ar…
Thread 3/n

Tip#1

Never blindly believe the authors conclusions. Typically authors write it in a way that grabs the most attention. We know the “spade example”.

A spade can be described as “a device that can amplify your muscle power at least a hundred times to lift soil”
Read 12 tweets
Rajeev Jayadevan Profile picture
20 May
How many people are vulnerable to COVID-19 in India?

This is an audit of COVID-19 serology data from 448,518 samples by a private lab from 12 cities in India:

a) Overall, 31% tested seropositive for SARS-CoV-2 antibodies till December.

see thread 1/8

medrxiv.org/content/10.110…
b) These were samples collected from self-referred people; from relatively higher socioeconomic class.

c)Their clinical detail is unknown.

d) 41% of those who tested in December were seropositive, up from 18% in July.

e)Faster rise in + rate in younger age groups (<44)

2/8
f)Different cities had different 'peak' phase of the pandemic e.g. Delhi had 2 peaks June & December; Chennai had one peak in July, Pune in September. Overall peak for India was mid September.

g)Pune had the highest: 69%. These 12 cities accounted for 1/3 of cases in India.

3/8
Read 13 tweets

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