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He is just 48 years of age; father of two boys aged 12 and 16 respectively ; the only breadwinner of the middle class family. His entire family of four tested positive around 10 days ago.
He and his wife had to get admitted as their spo2 dropped to 90 suddenly on day 3. 1/n
He and his wife had to get admitted as their spo2 dropped to 90 suddenly on day 3. 1/n
The hospital stay was uneventful for him except that he got to know he was suffering from an undiagnosed Diabetes. They received the necessary doses of steroids and Remdesivir which definitely saved their life.
2/n
2/n
Gradually he got better and was discharged after 5 days. His wife though experienced severe weakness and couldn't get up from the bed. Her spo2 remained around 92 at best. She is still in the hospital.
3/n
3/n
He returned home 2 days ago. Hoping everything would be fine with his wife too and she too would be home soon. Suddenly on that night he started having difficulty in vision in his left eye. He thought it would be due to fatigue and just slept off. 4/n
The panic set in next morning when he just couldn't see anything through his left eye. He called up his physician who asked him to immediately see him. He got MRI done and these were the findings.
5/n
5/n
His is not a one off story. While we are all talking about COVID19 pandemic there is something else unfolding which is even more dangerous- Mucormycosis.
6/n
6/n
As the writers of this article write in the title, this is indeed like limping from frying pan(COVID19) into the fire (mucormycosis) 7/n
https://www.japi.org/x27464c4/post-covid-19-mucormycosis-from-the-frying-pan-into-the-fire
https://www.japi.org/x27464c4/post-covid-19-mucormycosis-from-the-frying-pan-into-the-fire
What is mucormycosis?
It is a serious but rare fungal infection caused by group of molds called mucormycetes which live throughout the environment and mainly affects people who have health problems or take medicines that lower the body's ability to fight germs and sickness. 8/n
It is a serious but rare fungal infection caused by group of molds called mucormycetes which live throughout the environment and mainly affects people who have health problems or take medicines that lower the body's ability to fight germs and sickness. 8/n
The hallmark is tissue necrosis manifested as eschar or black discharge in the nasal or oral cavity. Orbital, ocular and cranial nerve involvement are ominous signs that must be taken seriously. If not removed at the earliest, it quickly spreads to brain and can be fatal. 9/n
The landmark RECOVERY trial published in June 2020 has served as a ‘license’ to use steroids in patients with COVID-19 and there has been no bigger life saving drug apart from steroids. Sorry, Remdesivir and Tocilizumab! 10/n
Here's the link to the RECOVERY trial. 11/n https://www.nejm.org/doi/full/10.1056/NEJMoa2021436
But the downside of steroids is that coupled with newly diagnosed Diabetes and COVID19 here it led to proliferation of mucormycosis. He was operated yesterday and lost his left eye. The surgeons had no other option but debride all the necrotic area it spread to brain. 12/n
“It’s raining mucor. It’s really painful to see young and elderly suffering. People are losing their battle to mucor post Covid,” Dr. Ashwini Tayade writes here. 13/n https://m.timesofindia.com/city/nagpur/8-operated-for-mucormycosis-half-of-them-have-lost-eyesight/amp_articleshow/82334039.cms#amp_tf=From%20%251%24s&aoh=16199289377278&referrer=https%3A%2F%2Fwww.google.com
The even more unfortunate part is that there are very few signs and symptoms by which you can diagnose mucormycosis and the infection spreads like a wildfire. Even sadder is the fact that it has higher mortality rate than the COVID19 itself. 14/n https://m-timesofindia-com.cdn.ampproject.org/v/s/m.timesofindia.com/city/nagpur/mucormycosis-spreading-like-wildfire-meds-costly-govt-must-step-in/amp_articleshow/82334046.cms?amp_gsa=1&_js_v=a6&usqp=mq331AQHKAFQArABIA%3D%3D#amp_tf=From%20%251%24s&aoh=16199289377278&referrer=https%3A%2F%2Fwww.google.com
So how can we minimize the risk of mucormycosis?
1. Don't get infected by COVID19.
For that - Wear masks, practice social distancing and take vaccines whenever available.
2. If you are above 40 and have never got your routine blood investigations done because.. 15/n
1. Don't get infected by COVID19.
For that - Wear masks, practice social distancing and take vaccines whenever available.
2. If you are above 40 and have never got your routine blood investigations done because.. 15/n
.."Apun to ekdum fit hai" then sorry but you are living in denial. Get your blood sugar and lipid profile tested. India is the diabetes capital of the world. The good thing about Diabetes is that it can be managed. But the later you diagnose it, the worse are the outcomes. 16/n
3. Doctors should exercise caution while writing prescription for steroids after weighing the risk:benefit ratio adequately. I'm sorry to say this but I have seen doctors precribing steroids to even people isolating at home with spo2 levels above 97 and no other symptoms. 17/n
The fine print of the RECOVERY trial clearly revealed some important messages that we seem to have overlooked. Benefit was specifically shown with low dose, short duration dexamethasone in moderate to severe illness. Doctors need to know when not to precribe steroids. 18/18
@HaryaxPathak @omlakhani @somu_somu @hard_dil @DrDeepakKrishn1 @iamcrazydoc @pankti4299 @AlishaAkhani @veeronco @nihardesai7 @raval_atri @himanshidTOI @ImTheSkylord @AdityaParikh1 @TheBaileyLover @Shivamda @drvyomika @Paramomycin
Patients discharged after COVID-19 should be taught to seek immediate medical attention, should they notice any symptoms such as: facial swelling, pain, numbness, eye swelling, bloody or black- brown discharge from the nose. Though sometimes the symptoms can be silent.
Just to mention the most important point of the thread -
STEROIDS AND ANTICOAGULANTS ARE THE MOST LIFE SAVING DRUGS IN COVID19.
We need to have ways to quickly identify and treat Mucormycosis, manage blood sugar levels and do not take steroids without consulting physician!
STEROIDS AND ANTICOAGULANTS ARE THE MOST LIFE SAVING DRUGS IN COVID19.
We need to have ways to quickly identify and treat Mucormycosis, manage blood sugar levels and do not take steroids without consulting physician!
As more and more people suffer and recover from COVID19, let's not forget another important disease that can be equally dangerous - Mucormycosis.
Read this story to find out more and please share it amongst the medical fraternity. https://psychidiaries.wordpress.com/2021/05/02/lets-not-forget-mucormycosis/
Read this story to find out more and please share it amongst the medical fraternity. https://psychidiaries.wordpress.com/2021/05/02/lets-not-forget-mucormycosis/
