Innholdsfortegnelse for Volume 2 Issue 5-6 i Aster Medical Journal (AMJ)

The largest contact tracing study in the world has thrown up lesser-known findings that can help us understand the way COVID-19 spreads in India and across the globe. A latest study conducted by US-based Centre for Disease, Dynamics and Economic Policy (CDDEP) in Andhra Pradesh and Tamil Nadu has revealed that not all individuals infected with COVID-19 transmit the virus. A team of investigators from CDDEP, the Government of Tamil Nadu and Andhra Pradesh and the University of California at Berkeley studied disease transmission patterns in 575,071 individuals exposed to 84,965 confirmed cases of COVID-19. The study has found that two-thirds of the covid cases are spread by just 8% of the people and that children are active transmitters. The study, titled ‘Epidemiology and transmission dynamics of COVID-19 in two…

Vaccines typically require years of research and testing before reaching the clinic, but scientists are racing to produce a safe and effective coronavirus vaccine by next year. Work began in January with the deciphering of the SARS-CoV-2 genome. The first vaccine safety trials in humans started in March, but the road ahead remains uncertain. Some trials will fail, and others may end without a clear result. But a few may succeed in stimulating the immune system to produce effective antibodies against the virus. Here is their progress. HOW ARE VACCINES TESTED? The development cycle of a vaccine, from lab to clinic. PRECLINICAL TESTING Scientists test a new vaccine on cells and then give it to animals such as mice or monkeys to see if it produces an immune response. We…

Most patients with COVID-19 have a mild or asymptomatic disease course; however, about 10% require admission to an intensive care unit (ICU) because of acute respiratory distress syndrome (ARDS).1,2 Mortality rates of up to 60% have been reported for this subgroup.3,4 Lung transplantation remains the ultimate treatment option for various chronic end-stage lung diseases. In addition, it can be considered as a salvage therapy for carefully selected patients who have severe treatment-refractory ARDS.5 However, wide uncertainty exists as to whether lung transplantation could have a place in the treatment of severe COVID-19 and, if so, what the optimal timing for such a treatment should be. Herein, we report the first case of lung transplantation for a patient with a persistently positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time RT-PCR…

In the early days of the New York COVID-19 outbreak, as March turned to April, hematologist Jeffrey Laurence was called to consult on the case of a 32-year-old bodybuilder. Nurses had noticed an odd rash on his buttocks, “as if you had kind of peeled away the skin layer and were seeing what blood vessels look like on his bottom,” recalls Laurence, who works at Weill Cornell Medicine in New York City. The vessels were outlined so clearly because the blood inside was coagulating, almost jelly-like. Within a couple of weeks, Laurence observed several similar, striking cases — making some of the earliest observations that the blood-clotting process could go horribly awry in severe instances of COVID-19. Researchers and clinicians are working to understand why, and trying medications to tamp…

The ongoing pandemic has given us a unique opportunity to transform India’s health system, which needs to be prioritised and escalated through infrastructure, investment and manpower. By undertaking radical reforms, India will not only be able to save lives and protect households slipping into poverty due to catastrophic illnesses but also significantly boost economic growth. The Indian healthcare story has achieved notable successes. We are the pharmacy of the world; doctors and nurses from India have excelled and distinguished themselves across the US and Europe; private hospitals provide healthcare to almost 70% of India and have been a key driver of medical tourism. Yet, the Indian healthcare system suffers from major weaknesses. The government (Centre and states together) spends a mere 1.13% of GDP on health. Almost 62% of healthcare…

Africa is free from wild poliovirus, the World Health Organization (WHO) announced on 25 August — leaving just two countries where the virus remains endemic, Afghanistan and Pakistan. The Africa Regional Certification Commission, an independent body responsible for overseeing the eradication of polio, has certified that all 47 countries in the WHO’s Africa Region have eradicated the virus after a long programme of vaccination and surveillance. There is no cure for the disease, which can cause irreversible paralysis and can be fatal if breathing muscles are affected, but vaccination can protect people for life. The certification is a “historic” achievement, says Pascal Mkanda, coordinator of the polio-eradication programme at the WHO Regional Office for Africa in Brazzaville, Republic of Congo.…

Aster DM Healthcare has been at the epicentre of managing COVID-19 pandemic in India and Gulf Cooperation Council countries ever since the pandemic hit in mid-March. This paper is a fascinating organisational case study and report about how Aster DM healthcare navigated the challenge of COVID - 19 Pandemic. INTRODUCTION The 2020 COVID-19 Pandemic has made society and the global economy volatile, uncertain, and ambiguous, even though high levels of preparedness have been developed for the situation. Late 2019, and early 2020, when the Coronavirus outbreak was limited to China, there was little expectation that it would grow to such pandemic proportions. No aspect of life, including business ventures, has been left untouched by this scourge. While the world stands still due to the COVID-19 pandemic, the impact that this…

The challenge The COVID-19 pandemic is an ongoing challenge to public health systems around the world. It has exposed the stark reality that many of these systems could be better prepared to make effective and coordinated responses to combat and contain the spread of a novel infectious disease. COVID-19 has caused severe and immediate health and economic consequences. Millions have been infected and hundreds of thousands have died. At the same time, massive unemployment and supply chain challenges have pushed social safety nets to the breaking point. And the long-term physical and psychological effects of the pandemic will only become clear over time. In the midst of this crisis, “infodemics” − rapidly spreading outbreaks of false, misleading, or unsafe information on the pandemic and its fallout − have left many…

Two Americans and a British scientist have been awarded the Nobel prize in medicine for their groundbreaking work on blood-borne hepatitis, a health problem that causes cirrhosis and liver cancer around the world. Harvey J Alter at the US National Institutes of Health in Maryland, Charles M Rice from Rockefeller University in New York, and Michael Houghton, a British virologist at the University of Alberta in Canada, discovered the hepatitis C virus, a major cause of liver inflammation. The three researchers share the 10m Swedish kronor award (?870,000) that was announced on Monday by the Nobel assembly from the Karolinska Institute in Stockholm. The World Health Organization estimates that more than 70 million people are infected with hepatitis C, with 400,000 dying each year from related conditions such as cirrhosis…

Hadia Mundri, South Sudan, 2018 Four-month-old Hadia was born with spina bifida, hydrocephalus (fluid in the brain) and club foot. Sophia, a community rehabilitation expert, is showing her mother, Zaina, a treatment called the Ponseti method, which uses stretches and casts to correct Hadia’s feet. Birth defects like Hadia’s often result from a lack of folic acid during early pregnancy. Hydrocephalus, which causes the child’s head to swell, is common in parts of South Sudan, but a sense of stigma surrounding the condition can deter parents from seeking treatment. Surgery and physiotherapy can help, although access may be hard, and better nutrition – like adding folic acid supplements to staple foods – can prevent it The winner of the Wellcome Photography Prize 2020 Medicine in Focus category by Julia Gunther…

An epidemic of fear can occur even without an epidemic of illness. Dr. Susan Murray, of the Royal College of Surgeons in Dublin, saw that firsthand in 2014 when she was a fellow at a rural hospital in Ireland. In the preceding months, more than 11,000 people in West Africa had died from Ebola, a terrifying viral disease that was highly infectious and often fatal. The epidemic seemed to be waning, and no cases had occurred in Ireland, but the public fear was palpable. “On the street and on the wards, people are anxious,” Dr. Murray recalled recently in an article in The New England Journal of Medicine. “Having the wrong color skin is enough to earn you the side-eye from your fellow passengers on the bus or train. Cough…

Imagine being young and healthy, a nonsmoker with no preexisting health conditions, and then waking up one morning feeling like you were being suffocated by an unseen force. Back in March, this was my reality. I had just returned from Europe, and roughly 10 days later started having flu-like symptoms. I became weak overnight and had trouble breathing. It felt like jogging in the Rocky Mountains without being in condition, only I wasn’t moving. I went to the hospital, where I was tested for COVID-19. More than four months later, the symptoms have not gone away. My heart still races, even though I am resting. I cannot stay in the sun for long periods; it zaps all of my energy. I have gastrointestinal problems, ringing in the ears and chest…

Neonatal sepsis remains a major problem in NICUs, as possibly the most commonly diagnosed/suspected and treated illness in NICUs around the world. Being a developing country and with its own limited resources, sepsis-related mortality and morbidity are perhaps the most prevalent in India. We often use a number of “sepsis variant” diagnoses in clinical practice-definite sepsis, probable sepsis, early onset neonatal sepsis, late onset neonatal sepsis, suspect sepsis and even culture negative sepsis! One drawback of being “over familiar” with sepsis is that many of us tend to attribute each and every symptom and illness to sepsis in some way. We often resort to our own clinical acumen or gut instinct rather than using evidence-based methods to reach such a diagnosis. Many of us are hypocritical in that we take…

Long before the world had ever heard of COVID-19, Kay Tye set out to answer a question that has taken on new resonance in the age of social distancing: When people feel lonely, do they crave social interactions in the same way a hungry person craves food? And could she and her colleagues detect and measure this “hunger” in the neural circuits of the brain? “Loneliness is a universal thing. If I were to ask people on the street, ‘Do you know what it means to be lonely?’ probably 99 or 100% of people would say yes,” explains Tye, a neuroscientist at the Salk Institute of Biological Sciences. “It seems reasonable to argue that it should be a concept in neuroscience. It’s just that nobody ever found a way to…

Corresponding author Dr Roopa R Shinde Specialist, Fetal medicine, Institute – Medcare Women and Children, Dubai Email: roopa.shinde@medcarehospital.com Key words Monochorionic twin, twin to twin transfusion syndrome, selective intra uterine restriction. Conflict of interest There are no conflicts of interest to report and no external funding sources. INTRODUCTION Monochorionic twin pregnancies, by virtue of vascular anastomoses, are at risk of unique complications. These include Twin-To-Twin Transfusion Syndrome (TTTS), Selective Intrauterine Growth Restriction (sIUGR), and Twin Reverse Arterial Perfusion (TRAP) sequence. Vascular anastomoses are present in every monochorionic placenta; these represent a state of imbalance in the shunting of blood, or an abnormality in the nature of anatomising vessels, which forms the basis for these unique clinical entities. The extreme circumstances of these complications eventually lead to single foetal demise in…

In Richard Selzer's fictional story "Whither Thou Goest," a widow searches for the man who received her late husband's heart. The liver, kidney and corneas were in other people, but she needed to be with the heart. When she and the stranger ultimately connect, it's as if she's recovered lost love. I, on the other hand, always considered the heart a pump, much the way a doctor explained it to Sandeep Jauhar during his cardiology fellowship. "In the end," the doctor said, "cardiology is mostly a problem of plumbing." Jauhar quickly learned otherwise. His gripping new book, "Heart: A History," had me nearly as enthralled with this pulsating body part as he seems to be. The tone — a physician excited about his specialty — takes a sharp turn from…