Sir when rebamipide 100 mg is taken-before or after meal

Hello everyone, Here are some important facts about COVID-19. From Clinical presentations to treatment. Please check it out and feel free to add more points. CLINICAL PRESENTATION: In a study describing 1099 patients with COVID-19 pneumonia in Wuhan, the most common clinical features at the onset of illness were: •Fever in 88% •Fatigue in 38% •Dry cough in 67% •Myalgias in 14.9% •Dyspnea in 18.7% Pneumonia appears to be the most common and severe manifestation of infection. In this group of patients breathing difficulty developed after a median of five days of illness. Acute respiratory distress syndrome developed in 3.4% of patients. Other symptoms •Headache •Sore throat •Rhinorrhea •Gastrointestinal symptoms About 80% of confirmed COVID-19 cases suffer from only mild to moderate disease and nearly 13% have the severe disease (dyspnea, respiratory frequency ≥30/minute, blood oxygen saturation≤93%, PaO2/FiO2 ratio <300, and/or lung infiltrates >50% of the lung field within 24-48 hours). Critical illness (respiratory failure septic shock, and/or multiple organ dysfunction/failure) is noted in only in less than 6% of cases. INCUBATION PERIOD: The exact incubation period is not known. It is presumed to be between 2 to 14 days after exposure, with most cases occurring within 5 days after exposure. THE SPECTRUM OF ILLNESS SEVERITY: Most infections are self-limiting. COVID-19 tends to cause more severe illness in the elderly population or in patients with underlying medical problems. As per the report from the Chinese center for disease control and prevention that included approximately 44,500 confirmed Infections with an estimation of disease severity. • Mild illness was reported in 81% of patients. • Severe illness (Hypoxemia, >50% lung involvement on imaging within 24 to 48 hours) in 14%. • Critical Disease (Respiratory failure, shock, multi-organ dysfunction syndrome) was reported in 5 percent. • Overall case fatality rate was between 2.3 to 5%. AGE AFFECTED: • Mostly middle-aged (>30 years) and elderly. • Symptomatic infection in children appears to be uncommon, and when it occurs, it is usually mild. **The 4th version of Belgian guidance for COVID 19 is published on19th March 2020. It is one of the most precise guidelines published yet. Some points from that: 1. Chloroquine is found to have good efficacy in vitro and it reduces the duration of viral shedding. But the drug has a narrow therapeutic window and cardiac toxicity is the most limiting side effect. 2. Hydroxychloroquine is more potent and is superior to chloroquine according to the very recent Gautret’ study. 3. Azithromycin may have a viral suppressive effect, but this needs to be proved as it was noticed accidentally in 6 patients of Gautret’ study. But I think it is a good choice for coverage of bacterial pneumonia. 4. Lopinavir/Ritonavir recently shown not to provide clinical benefit in hospitalized patients with COVID-19. It may reduce ICU stay if given within 10 days of infection but not beyond. 5. Remdesivir is promising but the studies are ongoing. Also, availability is a key issue. 6. Corticosteroids are not recommended as a systemic adjunctive treatment. 7. Paracetamol is the first-line analgesic and antipyretic over NSAIDs which are used with caution. 8. No need to stop ACEIs/ARBs in non-hospitalized patients. CONSIDER changing ACEIs/ARBs to another equivalent antihypertensive in hospitalized patients. 9. Antiviral therapy is not indicated in all patients with suspected/confirmed COVID19.

Dear Actor Vijay sir, Silambarasan sir and the respected Govt. of TamilNadu, I am tired. We are all tired. Thousands of doctors like me are tired. Health care workers are tired. Police officials are tired. Sanitary workers are tired. We have worked so hard at the ground level to make sure the damage done is kept to as low as possible amidst an unprecedented pandemic. I am not glorifying our work for I know there is nothing so great about it to the onlooker’s eyes. We don’t have cameras in front of us. We don’t do stunt sequences. We aren’t heroes. But we deserve some time to breath. We don’t want to fall prey to someone’s selfishness and greed. The pandemic isn’t over and we have people dying till today to the disease. A hundred percent theatre occupancy is a suicide attempt. Rather homicide , for none of the policy makers or the so called heroes are going to put themselves under the pump, to watch the movie amidst the crowd. This is a blatant barter system, trading lives for money. Can we please slowly try and concentrate on our lives and make sure we tide through this pandemic peacefully and not reignite the slowly burning out flame, that is still not completely put out? I wanted to make this post scientific and explain why we are still in danger. But that’s when I asked myself, “what’s the point?” Yours tiredly A poor, tired resident doctor https://www.facebook.com/aravinth.srinivas/posts/3937347876284519

Which one of the following medications is most likely to be responsible for this appearance? A) Clarithromycin B) Dexamethasone C) Doxorubicin D) Efavirenz E) Ferrous sulfate

Post such a question from discussion posting page. Try now and let me know your feedback.

Hi Curofians! I'm Dr. Nasir, a Family Medicine practitioner working in Singapore. This post is regarding the zone arrangements for the patients during and after the circuit breaker in running the OPD. In patient clinic, you should have 3 zones. 1. Red zone - For Suspected cases with travel or contact history with fever, should be straight asked to go to the hospital for a swab. 2. Orange zone - URTI symptoms without fever. 3. Green zone - No fever, no URTI symptoms. -In all these 3 zones patients shouldn't mix up with each other. - Full PPE in the orange and red zone is recommended. - Partial PPE in the green zone is recommended. - You should have additional staff in PPE to segregate patients in 3 zones, another staff to make sure these 3 zones patients should not mix up with different waiting areas. - The doctor going to see the patient will know in advance what type of patient he or she going to see. I hope it helps.