A simple scoring system to check if you have Obstructive Sleep Apnoea (OSA) is the
Stop Bang Scoring System .
1/ S - Do you SNORE while you sleep?
T - Do you feel TIRED on waking up or sleepy for most part of your day?
O - Has anyone OBSERVED you having choking spells/stop breathing while you were asleep?
P - Do you have high blood PRESSURE?
2/

Many male patients complain of blackouts/fainting post urination after deep sleep .
This is known as Post-micturition syncope and occurs due to a severe drop in blood pressure. Micturition syncope is most common in older men and occurs at night after a deep sleep.1/ The exact cause of micturition syncope isn't fully understood. But it may be due to opening of the blood vessels that occurs when standing at the toilet after emptying of bladder. This is thought to result in a sudden drop in blood pressure. 2/

Falls are a threat to the health of older adults and can reduce their ability to remain independent.
Common causes of falls in elderly are :
Poor vision or hearing .
Diseases like Diabetes , Heart Disease.
Side effects of medication.
Lack of exercise .
Environmental hazards. 1/ To prevent falls older adults have to ensure :
They remain active .
Get regular eye/hearing checks.
Get regular medical checks.
Know side effects of medications.
Limit alcohol intake.
Wear comfortable shoes.
Use a cane/stick.
Be careful when walking on wet surfaces. 2/

I have never liked the idea of young people taking protien powder to build muscle.
Here's why:
A protein powder is dietary supplement.The FDA leaves it to manufacturers to evaluate the safety/labeling. So,there's no way to know if the powder contains what manufacturers claim.1/ There is limited data on the side effects of high protein intake from supplements.Researchers screened 134 products for toxins and found that many contained heavy metals (lead,arsenic,mercury), bisphenol-A used to make plastic,pesticides.Though not all powders contain toxins.2/

Breaking down Behavioral Economics in a Pandemic:
In an ideal world, people wil always make optimal decisions that provide them with the greatest benefit and satisfaction.Rational choice theory assumes that people are capable of making rational decisions effectively. 1/ The rational person has self-control and is unmoved by emotions and external factors and, hence, knows what is best for himself. Alas behavioral economics explains that humans are not rational and are incapable of making good decisions.2/

Covid Vaccine: So as everyone knows we are racing against time to make a vaccine for Covid 19.
Producing effective vaccines is a lengthy process and takes years.
So what is the different thing being done now.1/ Typically a vaccine is made by creating a weakened virus/bacteria which has lost its ability to make you sick.Once injected,the immune system recognizes it as foriegn entity &produces antibodies.
The antibodies can fight future infections as long as the virus doesn’t evolve 2/

Rapid Antigen Test: If positive means you have Covid 19.
If negative does not mean you don't have Covid.
You need to get RT PCR test done to confirm. 1/ Rapid Test detects the presence of Covid proteins if it is present in sufficient concentration in the sample.The result is available in 45 minutes.
The antigens detected are expressed only when the virus is actively replicating.
Sensitivity of this test varies from 40 to 80%.
2/

Significance of Ct value in RTPCR tests for Covid 19:
The RT PCR results as of now was giving positive and negative reports but ICMR has advised labs to also report the Ct (cycle threshold) value.
Ct value is the number of cycles required to detect viral antigen.1/ With this value,we can identify high/moderate/low viral load.
Ct levels are inversely proportional to the amount of target nucleic acid in the sample (lower the Ct, greater the number of target nucleic acid in the sample).Lower the value,more the viral load,higher the risk . 2/

Why we get false negative tests:The diagnosis of COVID19 using RT PCR method is made based on the threshold cycle (Ct) value. Ct is defined as the cycle number when the sample fluorescence exceeds a standard threshold above the calculated fluorescence.1/ So lower the Ct value of a specific gene, the more of the gene exists in the swab .Unfortunately a Ct-based diagnosis has no constant cut-off value, & Ct cut-off values are different for each diagnostic reagent even for the same gene. 2/

Donating plasma is not the same as donating blood. The two are different and require different techniques.
During blood donation, the whole blood is collected in a bag and its components are later separated in the laboratory. 1/ via @YouTube In plasma donation, blood drawn from your body goes through a machine where plasma is separated from the rest of the blood and is stored in a bag ready to be transfused into the patient and the rest of the blood components are returned via the same tube back to the donor .2/

Clinical Trials :
A clinical trial is a type of research that studies treatment/tests given to people. Clinical trials study how safe and helpful tests and treatments are. When found to be safe and helpful, they may become tomorrow’s standard of care. 1/ Clinical trials can study many things,such as:

New drugs not yet approved by the U.S. FDA,
New uses of drugs already approved by the FDA,
New ways to give drugs,such as in pill form,
New tests to find and track disease, and
Drugs or procedures that relieve symptoms.2/

The Govt is unable to control or manage Covid 19 cases . 1.3 billion population is a number difficult to manage .
So let’s all help each other out .
We all belong to a RWA.
RWA s are like a mini district . 1/ 1) When a person tests positive , inform the RWA.The RWA should notify the District Administration.
2) Don’t PANIC .
3) Contact your Doctor for further treatment .
3) Self Isolate and Quarantine your family x 14 days .2/

A simple mask is good , an N95 is even better, but please do not use masks with exhaust valves. The valve provides “breathability” when you exhale by releasing your breath and its contagion carrying respiratory droplets. These masks protect no-one.1/ If you’re using a cotton/fabric mask, make sure it’s not sieve-like.This leaks virus carrying droplets. Make sure the mask covers your nose and mouth. Masks help prevent you from getting and transmitting the virus. 2/

There is a circumstantial evidence that the Kawasaki like illness affecting children in the USA and Europe is related to Covid 19 , and is being called Pediatric Multi system Inflammatory Syndrome (PMIS).1/ Experts suspect that in children with PMIS, the virus may trigger the immune system to overreact and cause widespread inflammation throughout the body.
2/

Covid 19 is a new evolving virus. And everyday we are learning new things about this virus.
Going by past pandemics,all have had multiple waves.Covid 19 is following a similar trajectory,going by its resurgence in Spore/China/HK.
1/ The ratio of susceptible &immune individuals in a population at the end of a wave determines the potential magnitude of a second wave.The problem is the real rate of infection is unknown & with no vaccine available,people remain vulnerable to both resurgence &subsequent waves.2/

R refers to the “effective reproduction number” and, basically put, it’s a way of measuring an infectious disease’s capacity to spread. The R number signifies the average number of people that one infected person will pass the virus to. 1/ Remember that R0 is not an intrinsic factor of the virus--it's dependent on host behavior, population immune status, and other factors.
This is why distancing & hygiene have reduced spread in some areas to/below 1, meaning it's either steadily spreading but not yet decreasing.2/

What is herd immunity?
When most of a population is immune to an infectious disease, this provides indirect protection or herd immunity to those who are not immune to the disease. 1/ So if 80% of a population is immune to a virus,4out of 5 people who are exposed to someone with the disease won’t get sick &won’t spread the disease.In this way infections are kept under control. Usually70%-90% of population needs immunity to achieve herd immunity.2/

What are vaccines and how are they developed:
Vaccines contain the same germs that cause disease. But they are killed/weakened to the point that they don’t make you sick.
A vaccine stimulates your immune system to produce antibodies,similar to if you were exposed to the disease.1 After getting vaccinated you develop immunity to the disease,without having to get the disease first.
Vaccine development&testing follow a set of steps
Exploratory Stage
Pre-Clinical Stage
IND Application
Phase I Trials
Phase IITrials
Phase III Trials
VAERS
2

Since covalescent plasma trials have started for treatment of Covid 19:
What is Convalescent Plasma :

When pts recover from COVID-19,their body produces antibodies to fight the virus and help them get well. These antibodies are found in plasma,which is a component of blood.1/4 This antibody-containing plasma is given by transfusion to a patient who is suffering from COVID-19. The donor antibodies helps the patient fight the illness, possibly shortening the length or reducing the severity of the disease.2/4

There has been a lot of talk of Hydroxychloroquine for the treatment of Covid 19.
And like Trump says"Try it,what's there to lose ?"
Let me tell you that it is being used,& unfortunately one doesn't need to be a rocket scientist to know that it is not working as effectively.1/4 There's still no proven treatment for Covid19,but a number of trials are ongoing.
1) Hydroxycloroquine+Azithromycin
2)Remdesivir,an antiviral medicine which may work by blocking the virus' ability to replicate.
3)Antiretroviral meds :Lopinavir+Ritonavir
4)Convalescent Plasma.2/4

Covid 19 has made everyone aware that we need to keep all our surfaces clean. One of them is your phone.
Turn off your phone.
Remove phone from case .
Dampen a microfibre cloth with water & soap or use 70 % isopropyl alcohol wipes as advised by Apple.1/4 Rub all the surfaces of the phone with the damp cloth.
Take care not to get moisture in any openings .
Dry your phone with a dry microfibre cloth.
Even using just soap and water effectively removes bacteria and viruses.2/4