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Severe Covid infection can lead to delirium: Study

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New York, Sep 22: Patients hospitalised with severe Covid-19 infection are highly at risk of developing cognitive impairment — including depression and delirium — both during the treatment and after it, finds a study.

Delirium is a serious disturbance in mental state wherein a patient is confused, agitated and unable to think clearly.

The study, published in BMJ Open, looked at nearly 150 patients hospitalised for Covid at the beginning of the pandemic. Of these, 73 per cent had delirium.

Patients with delirium tended to be sicker, with more comorbidities like hypertension and diabetes, and appeared to have more severe Covid-related illness as well, said study author Phillip Vlisides, from the Department of Anesthesiology at Michigan Medicine, University of Michigan.

“Covid is also associated with a number of other adverse outcomes that tend to prolong hospitalisation and make recovery difficult,” he added.

Using patient medical records and telephone surveys following hospital discharge for a group of patients hospitalised in the intensive care unit between March and May 2020, the team attempted to identify common threads amongst patients who developed delirium.

The disease itself can lead to reduced oxygen to the brain as well as the development of blood clots and stroke, resulting in cognitive impairment. In addition, inflammatory markers were greatly increased in patients with delirium. Confusion and agitation could be a result of inflammation of the brain.

In addition, care teams often were unable to perform standard delirium reduction techniques, such as exercises designed to get a patient moving or allowing visitors or objects from home to orient patients while in the hospital due to the infectious Covid disease.

Further, there was a correlation between the use of sedatives and delirium — patients with delirium were sedated more often and frequently at higher doses, the team found.

The study also found that cognitive impairment can persist even after discharge. Almost a third of patients did not have their delirium marked as resolved in their chart upon leaving the hospital and 40 per cent of these patients required skilled nursing care. For many the condition lasted for months.

“Overall, this study highlights another reason why getting vaccinated and preventing severe illness is so important. There can be long term neurological complications that perhaps we don’t talk about as much as we should,” Vlisides said.

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Delhi hospital saves 2 patients who accidentally ingested sanitiser

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New Delhi, Oct 8: Two patients who accidentally ingested sanitiser mistaking it for water, rendering them unable to swallow food and water for months, were given a new lease of life after doctors at Fortis Hospital here performed an oesophageal reconstructive surgery.

A 24-year-old boy, hailing from Karnataka accidentally ingested sanitiser four months back. Treatment at local hospital inserted a pipe in his intestine and he was fed with liquids via the pipe.

On admission at Fortis Shalimar Bagh, he was found to have complete scarring and obstruction of the entire food pipe and portion of the small intestine and stomach. Doctors performed a reconstructive surgery, where a portion of his small and large intestine was used to create a new food pipe.

The surgery lasted for more than five hours post which the patient was kept under observation. The patient has recovered very well and is now able to eat normal food, said Dr Amit Javed, Director, Laparoscopic and Minimal Access Surgery, Fortis Hospital Vasant Kunj and Shalimar Bagh, in a statement.

In a separate case, a 20-year-old girl from Kashmir, also ingested sanitiser accidentally. She was even unable to swallow her saliva, and had become emaciated from malnutrition and lost a lot of weight.

Her survival was dependent on glucose which was being given to her intravenously.

The challenging surgery lasted for more than six hours as the patient suffered from severe burns and scarring in her throat and stricture (an abnormal tightening of the oesophagus) in her food pipe. Doctors reconstructed a new food passage by using a part of her stomach and intestine.

She has recovered well, the doctor said.

According to Javed, an oesophageal reconstructive surgery done by the laparoscopic technique can be a hope for patients with damaged food pipes.

“Corrosives are irritant substances which when ingested either intentionally or by accident results in severe burns of the oesophagus (food pipe) and the stomach. Early symptoms include difficulty in breathing, hoarseness of voice, mouth and throat pain, drooling of saliva, vomiting and abdominal pain. In severe cases, there can be perforation of the oesophagus and the stomach,” Javed explained.

However, as the acute injury heals, there are formation of strictures, which results in narrowing of the food passage and leads to obstruction. The unfortunate patient is unable to eat food and drink water. In severe cases, the patient is unable to swallow their own saliva.

The treatment involves initial sessions of endoscopic dilatations.

“In patients who have tight strictures, long length of strictures or in those where endoscopic dilatation is not successful, a surgery is done to create a new food pipe. This new food pipe can be reconstructed using either the stomach or portion of the large intestine. It is a complex surgery. We routinely perform this surgery by the laparoscopic technique which results in excellent functional results and very good cosmesis. The patient is able to eat and drink a normal diet,” Javed said.

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Gurugram: Notice to 11,311 households for larvae-breeding

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Gurugram, Oct 7: To prevent the outbreak of mosquito-borne diseases, the district Health Department in collaboration with the district administration examined over 22.70 lakh households and issued notices to 11,311 households where mosquito larvae were found.

Civil Surgeon Gurugram, Dr Virender Yadav said that so far 1,897 samples of dengue have been sent for testing in the district, out of which 83 dengue and two malaria patients have been confirmed.

Yadav informed that more than two lakh people have been tested so far. The team of the health department is also running a campaign for the prevention of mosquito-borne diseases.

“The team is carrying out anti-larva activities under which Temephos medicine is being sprayed at mosquito prone areas. Gambusia fish is very effective in preventing the breeding of mosquitoes, keeping this in mind the health department, in collaboration with the fisheries department, has put seeds of gambusia fish in 173 reservoirs located in the district,” Yadav said.

Health officials said for the prevention of mosquito-borne diseases in the district, area wise fogging is being done through 56 machines. They said for fogging, the helpline numbers of the Municipal Corporation Gurugram (MCG) can be contacted on 18001801817 and 0124-44055779.

Apart from this, free testing and treatment of dengue, malaria and chikungunya are available in Sector-31 Polyclinic and Sector-10 Civil Hospital.

Instructions have been given not to charge more than Rs 600 for NS-1 and LGI test for Chikungunya and Rs 1,000 for test for dengue. Action will be taken against the concerned hospitals for violating this,” said a health official.

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Gambusia fish to check mosquito-borne diseases in UP district

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Amroha (Uttar Pradesh), Oct 6: The Amroha district administration has decided to release 7,000 gambusia or mosquito fish in drains in the populated areas to check the spread of dengue and malaria.

According to Amroha chief medical officer Sanjay Agarwal, mosquito fish, generically known as Gambusia, eat larvae of dengue-breeding mosquitoes.

Health officials claim that these fishes will check the spread of viral fever in the district.

According to health department statistics, over 300 patients have been diagnosed with viral fever, 17 with malaria and 32 with dengue in the past one and half month.

The district administration is also carrying out a door-to-door survey to ask the people to drain out stagnant water from coolers, pots and other utensils.

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