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1.
Lung India ; 39(SUPPL 1):S12, 2022.
Article in English | EMBASE | ID: covidwho-1857697

ABSTRACT

Background: The use of nebulizers is an important and useful method for delivering drugs to the lungs in patients with various airway and lung parenchymal disorders. Use of nebulization had markedly increased during the COVID-19 pandemic. This had raised concerns about the potential spread of infection to others in the surroundings exposed to the virus dissemination through aerosolized particles. We considered it necessary to ensure appropriate use of nebulizers by primary care physicians and therefore developed a simple nebulization score to decide when to use nebulizers. Methods: An expert working group (EWG) of pulmonologists was formed who using a semi-Delphi method developed a list of variables and a cut-off score. The EWG started with 55 variables developed through an exhaustive review of literature. These were further reduced to smaller number that had the maximum score as well as concordance with the EWG. The scores ranged from 1-10 (completely disagree to completely agree) and only those above 7.5 were selected. Results: A total of 8 variables with the highest scores were selected [Table 1] which had a total maximum score of 40. A score of <15 was suggested to indicate not-to use and >20 to suggest a definite-use of nebulizer. A score between 15-20 was suggested to use as per physician judgement. A separate table of 12 conditions was made where use of nebulizers was mandatory. Conclusion: This first of its kind nebulizer score should be used by primary care physicians to decide which patients should be put on nebulization treatment.

2.
Journal of the Indian Medical Association ; 118(9):70-76, 2020.
Article in English | GIM | ID: covidwho-984920

ABSTRACT

The COVID-19 pandemic continues to have a serious impact on the lives of millions of people worldwide. Empirical therapy is being used to reduce morbidity and mortality of COVID-19 patients. Favipiravir, which is an oral broad-spectrum anti-viral agent with proven efficacy against various RNA viruses, acceptable tolerability profile and favorable benefit-risk ratio in short term use, has got an emergency use authorization in many countries including India for the treatment of mild to moderate cases of COVID-19. It has demonstrated promising results in terms of rapid viral clearance, quick symptom control, and pulmonary radiographic improvement. Due to reasons such as lockdown, isolation, diagnostic delays, fear of quarantine or getting tested, cost, etc., the golden time period (first 24-48 hrs) is lost in COVID-19 patients which is crucial for initiating antiviral therapy. Therefore, the panel members of 'Academy of Advanced Medical Education' propose that favipiravir can be recommended in confirmed, early probable and possible cases of mild and moderate severity as an empirical therapy during current pandemic. It is important to counsel the patients and explain to them about the limited clinical evidences with favipiravir, therefore, a signed consent form from patient must be kept before initiating treatment. Well-designed double-blind controlled trials are urgently required to understand this further.

3.
Journal of the Indian Medical Association ; 118(9):70-76, 2020.
Article in English | EMBASE | ID: covidwho-875422

ABSTRACT

The COVID-19 pandemic continues to have a serious impact on the lives of millions of people worldwide. Empirical therapy is being used to reduce morbidity and mortality of COVID-19 patients. Favipiravir, which is an oral broad-spectrum anti-viral agent with proven efficacy against various RNA viruses, acceptable tolerability profile and favorable benefit-risk ratio in short term use, has got an emergency use authorization in many countries including India for the treatment of mild to moderate cases of COVID-19. It has demonstrated promising results in terms of rapid viral clearance, quick symptom control, and pulmonary radiographic improvement. Due to reasons such as lockdown, isolation, diagnostic delays, fear of quarantine or getting tested, cost, etc., the golden time period (first 24-48 hrs) is lost in COVID-19 patients which is crucial for initiating antiviral therapy. Therefore, the panel members of ‘Academy of Advanced Medical Education’ propose that favipiravir can be recommended in confirmed, early probable and possible cases of mild and moderate severity as an empirical therapy during current pandemic. It is important to counsel the patients and explain to them about the limited clinical evidences with favipiravir, therefore, a signed consent form from patient must be kept before initiating treatment. Well-designed double-blind controlled trials are urgently required to understand this further.

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