Health & Fitness Corona is in full swing and its not Joke !

Did you guys do d dimer and LDH ?
We managed our patients on this simple test which are available everywhere.
I could prognosticate my patient basis LDH and it rarely failed me.
Initial days I used ferritin as marker but I myself broke my own observation of mortality if ferritin more than 1000.

Later on basis of LDH,I could prognosticate and manage patient with severe covid.
 
burntwingzZz said:
so if both of you are doctors ,than i have a question how are our doctors or in general our medical diagnosis different ,are western & European m report and test oriented and indian medicine practice is thorough physical checks symptoms etc or its vice versa
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It's a misconception. I've practiced both in India and Europe. Private hospitals in India mostly operate with investigation based approach as nobody is going to question you ( unless you go completely nuts and trigger those moron doctors of health insurance companies..they are possibly called TPA, but I may be wrong)
In Europe, at least in my country, 99 percent of the legal population is under state health policy...basically free treatment...similar to NHS but more advanced due to our awesome and helpful neighborhood country..Germany..here everything is protocol based, if you modify something, you may have to sit in front of some inquiry commission, but those people are usually good ,knowledgeable and follows logic.
Neither approach is perfect. Both has pros and cons.
But Europe has one very good policy for most countries...there is no legal small nursing homes owned by a doctor or group of doctors.
Everything is huge...proper hospitals...even in rural remote areas with all modern amenities.
 
I lost patients for sure if LDH was above 1500 and I could save d dimers of 27000 also. And they all re doing fine 4 months post discharge. Not yet one has needed to go to chest rehabilitation.
Screenshot_20210105-203131503.jpg
 
pratikb said:
Did you guys do d dimer and LDH ?
We managed our patients on this simple test which are available everywhere.
I could prognosticate my patient basis LDH and it rarely failed me.
Initial days I used ferritin as marker but I myself broke my own observation of mortality if ferritin more than 1000.

Later on basis of LDH,I could prognosticate and manage patient with severe covid.
Click to expand...
Of course d dimer. Possibly they are doing LDH now. I was doing IL6 on a regular basis with bad patients, found the CT scoring useless.
 
I rarely did IL6 As it was difficult to get correct picture and depended on logistics and delay in processing sample would give huge error in values.
My protocol was simple and not more than 2 ct scans in entire hospitalisation. It's nothing more than radiation which is unindicated.
 
covaxin is based on entire genome and not just spike protein structure,it will provide better protection from covid and if you see chart which i posted,we are at less than 1.5% mortality.
 
pratikb said:
I lost patients for sure if LDH was above 1500 and I could save d dimers of 27000 also. And they all re doing fine 4 months post discharge. Not yet one has needed to go to chest rehabilitation.
View attachment 97790
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This is the kind of reporting which makes no sense to a statistician. What kind of data interpretation is this?
We are reporting mortality as any death who had covid in previous 15 days.
Suppose a CRF pt. on HD was tested positive during screening (for the HD machine to be used ) dies of uremic pericarditis etc. or arrest due to hyperkalemia he will incuded as covid death.
Isn't it natural that our mortality rate would be much higher?
The person who made that graph had no idea of the definition of covid mortality in different countries.
See, I was trained in India completely, and there's no significant difference in treatment approach except very strict antibiotic policy.
 
i don't know what shit we are doing from our childhood doing has helped us in this pandemic ,maybe our food habits, TB vaccines don't know ,but what will take us down would be those idiots who are returning from Uk and running away and giving false phone numbers ,idk what indian govment is doing ,bloody take the details number from airline why from the passengers. And stop the passenger flights from UK
 
What!! You are fighting against interleukin surge, yet IL6 is not giving you adequate prognostication?
LDH as far as I can remember has 5 isoenzymes ( LDH 3 from lung), yes it should rise in lung injury and can be a guide. But it can rise in heart ( commonest) or liver conditions too.
If LDH3 is quickly available, why not? But here LDH3 report takes at least 3 days. But I'm sure some are using it.
www.ncbi.nlm.nih.gov

Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: A pooled analysis

Coronavirus disease 2019 (COVID-19) infection has now reached a pandemic state, affecting more than a million patients worldwide. Predictors of disease outcomes in these patients need to be urgently assessed to decrease morbidity and societal burden. ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
This is the LDH study done with some care, but look closely at their calculations, their inference is in percentages without any P value, take your time, go through their calculations very carefully ( I understand as a clinician you have no interest, but try once, you will see the fallacies.... remember we idiot bio statistics guys have conclusively shown cholesterol is not associated with atherosclerosis as we read in Harrison, the entire lipitor study was flawed)
 
burntwingzZz said:
i don't know what shit we are doing from our childhood doing has helped us in this pandemic ,maybe our food habits, TB vaccines don't know ,but what will take us down would be those idiots who are returning from Uk and running away and giving false phone numbers ,idk what indian govment is doing ,bloody take the details number from airline why from the passengers. And stop the passenger flights from UK
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No, nothing is protecting Indians, it's a false sense of security, as the reporting system is completely different in India from EU/UK/US.
Take all the precautions. If UK start to follow Indian teporting system, their mortality rate will come down drastically.
Regarding people coming from UK..you can't board a flight in UK without "fit to fly" certificate, which requires a negative PCR report ( 48 hours). If someone was negative while boarding and becomes positive after landing, what's the fault of the person?
The story of giving false number is a complete lie. If you apply for a visa now, they are checking the provided contact number from UK by directly calling and some OTP thingy.
Please don't blame a person for getting infected during a worlwide pandemic.
If UK can trace everyone coming from India using the same system, why can't India do the same?
pratikb said:
Il6 above 1000 also have survived.
And it was not psudorise but actual
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1000!! I've seen values over 2500..with complete recovery. On the other hand 18 cycles of ECMO with fairly clear lung ( from whitewashed) died...many times.
Nah!! I will stay away from these covid threads.
 
mRNA vaccines are such a rushed in business and it was never used before on such wide scale.
Vaccine development is multiyear program and not few months business.
When flu virus mutates lot faster,how new vaccine is going to save ?
mRNA virus is targeting just the spike protein and what would you do if your mutation is at that very same protein. ?

You need to practise hygiene’s practice and nothing else for this covid virus.
I had this dirty disease twice so I know what I am talking about.
How I got my covid is huge viral load and I could manage to beat it despite 16 score on hrct scan. I never needed oxygen or anything. Just routine medications.
 
It's not fair to compare influenza vaccine and covid 19 vaccine.
Flu vaccines has a protection rate of 40-60 percent as influenza mutates like crazy ( and the vaccines in EU only protects against H1NI, H3N2 both type A , and 2 strains of type B) yet they are used rather successfully for organ recipients, elderly with chronic heart failure and other ailments etc.
Covid 19's mutation rate is a lot slower than influenza till now. And it's a completely different scenario.
burntwingzZz said:
so what are the routine medications ?
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Nothing, absolutely NOTHING except paracetamol. Everything else is just guesswork with ABSOLUTELY NO EVIDENCE BASED CONCLUSIVE BENEFIT OF ANYTHING INCLUDING DEXAMETHASONE/ METHYL PREDNISOLONE/ ANY OTHER STEROIDS.
 
OK Docs!!! Question for you both.

I had CORADS of 12/40. Got myself admitted into a hospital even though the doctor said it is manageable at home. My CRP was 26 when I was admitted to the hospital. I was the given 2 doses of remdesivir on day one and one each the following days. On day 3 my CRP was 56. Does that mean remdesivir had no impact in reducing my COVID? The day of discharge 4th day my CRP came down to 53. Today 1 week after home quarantine, my CRP is 2.7.

I was given lots of other medication such as Thiamine, Vitamin D, something of gas, acidity, zinc etc. I just had my RT-PCR results in and I am now told I am COVID negative. The questions are:
  1. Did the remedesivir even work on me?
  2. When does a patient decide to get admitted to a hospital or chose to stay at home for the treatment?
  3. Are there any post treatment complications that I should worry about? (I currently feel that my tongue gets numb around the end of the day but it is OK in the morning. I also feel a little of shortness of breath towards the evening but again everything is great in the morning. I was asked to stop the Zinc and Montkelucast+Levocetrizine to avoid this).
Another question: I was suffering from frozen shoulder and having difficulty for the past 10 months but it was getting better with no medication. It is painful enough that I cannot lift my hand over the shoulder or scratch my back. Now after the COVID treatment the pain in shoulder has miraculously gone! Is it because of the blood thinners I was given? Will the pain come back once I stop using them?

Thanks,
Srikanth
 
1.https://www.nejm.org/doi/full/10.1056/NEJMoa2007764
How are we fooling ourselves!!
2. Get admitted if you are having SOB with minimal exertion. Don't trust ANY PULSE OXYMETER, I only trust ABG, nothing else for hypoxia.
3. NO, YOU SHOULD NOT WORRY and stop taking vitamin D, it's a fat soluble vitamin and often cause hypercalcemia ( your tongue numbness may be an early sign, but I'm not sure)
Unless you are not having SOB, stop worrying. And NEVER TAKE ANY anti lung fibrosis medication. They JUST DON'T WORK.
Live a normal and careful life to avoid another infection, that's it!! All the best.
 
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