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ಶರಣ DR JAGADISH J HIREMATH

@Kaalateetham

26 May

#Mucormycosis
#BlackFungus

Self medication & procedures like steaming have played a big role in increasing numbers of patients getting infected with fungal infections.

Indiscriminate antibiotic use has killed the normal flora allowing opportunistic infections like fungi to grow

The normal flora has also been destroyed by the indiscriminate steaming which patients & people have done, thinking that will kill the virus.

People have taken zinc supplements indiscriminately & this has allowed fungus to grow as zinc is prerequisite for its growth.

Normally body when infected with fungi sequestrates zinc away from fungus & the monocytes which attack fungus are devoid of zinc. But with plenty of intake of zinc supplements, high blood & tissue levels it is difficult to achieve zero zinc zone around fungi by our immune system

Read 6 tweets

ಶರಣ DR JAGADISH J HIREMATH

@Kaalateetham

19 May

Lessons learnt this Pandemic

A country like US which spends 10% of GDP on healthcare could not manage the pandemic

Whereas NZ & Australia did a good job. It helped that they are islands & put in strict SOPs to quarantine people who tested +ve, also allowed in only after testing

Non pharmacological measures for prevention worked better than trying to find cure & vaccination. It is nightmare to manage a otherwise healthy adult struggling to breathe in ICU

60K ventilators of GOI could not save as much as what N95 mask could do but we never implemented it

How many ICU beds can a country add in a day?

How many Hotels can be converted to Covid Care Centers in a week?

Can India beat US in Healthcare Spending?

Did US win against Covid having spent so much?

We know the answers to above yet we do the same expecting different results

Read 9 tweets

ಶರಣ DR JAGADISH J HIREMATH

@Kaalateetham

18 May

Guidelines to prevent Mucormycosis in Covid recovery

1) Never enter damp spaces, especially if walls already has mold or mold like growth

2) If median Sr ferritin values were high during hospital stay, you are high risk as immune dysregulation is high, wear N95 mask all times

3) Cover your face with a shield & close your nose & mouth with N95 mask if you are out in the open especially dusty areas. Since dust is ubiquitous in India never come out without protection

4) Ask your doctor if you need any prophylaxis, chances are that you will not need it

5) The key to safety is "Mask", since fungal spores can be indoors, it is better to ask your doctor how long it is necessary for you to wear mask indoors too. Normally we at ACE HealthCare advise N95 mask for all patients getting discharged for 4 to 6 weeks indoors (too).

Read 4 tweets

ಶರಣ DR JAGADISH J HIREMATH

@Kaalateetham

17 Apr

So many assumptions & confusion

The solution is simple

1) Covid Appropriate Behaviour

2) Vaccination

The question is about those who already are positive now & are suffering the illness.

Solution:

1) 81% do not require hospital visit

2) 14% require oxygen only

3) 5% require additional care

In that 5% only 1% require ICU care, NIV, HFNC, Ventilator & other organ failure care

Remedisvir or Tocilucimab or plasma have not produced consistent results. At best Class 2b indication for usage

However, the hype has allowed few including companies to profiteer.

To date only Oxygen is Class 1 & Steroids are Class 1 or 2 indication for use in patients

Read 4 tweets

ಶರಣ DR JAGADISH J HIREMATH

@Kaalateetham

2 Apr

@syndicatebank

Normally nobody likes to talk about their home loans; they are personal.

Decided to talk about ours. Those taking home loans need to be very careful with banks as they overcharge you while you go on with your life.

In our case @syndicatebank & @canarabank are the culprit banks.

@syndicatebank

Ours is a high value home loan by any normal Indian standards. @syndicatebank treated it like one when we were given the home construction loan through their Syndnivas scheme.

It was sanctioned in 2015 at 10.5% floating rate of interest. In time @RBI reduced interest rates

By the time we actually used the loan rates had come down to 9.5%, so far so good. However, once the money was availed surprisingly the rate got fixed & never came down!

On our part we shifted out of TN to Bangalore in mid 2017 & requested the bank to shift our loan to Bluru too

Read 11 tweets

ಶರಣ DR JAGADISH J HIREMATH

@Kaalateetham

2 Apr

Dear friends, I have been mining to find studies which are relevant to us.

CDC has recently published one such study of 150000 subjects who suffered from #Covid

Obesity as expected is "the biggest Risk factor"

Also those patients who had very low unhealthy BMI suffered more.

BMI 23 - 25 has least morbidity & mortality
BMI 30 - 35 hospitalisation increases to 7%, ICU admissions of less than 1%
BMI > 35 associated with increased hospitalisation, ICU admissions & increased mortality.
BMI of 45+ is associated with very high ICU admissions & mortality

Also on the other hand those with BMI less than 18 had increased hospitalisation, ICU admissions & mortality.

I am certain many of us who were treating Covid patients had understood this by now. This study just shows that obesity is a big risk along with unhealthy low BMI.

Read 4 tweets

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