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Management of COVID-19 a Handbook for Family Physicians

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Management of COVID-19 a Handbook for Family Physicians Management of COVID-19 A Handbook for Family Physicians Dr. Alok Sharma, MS, Mch Dr. Hemangi Sane, MD, (Internal Medicine) Dr. Nandini Gokulchandran, MD Dr. Balaji Tuppekar, MD (Pulmonary Medicine) Dr. Prakash Gote, DA Ms. Pooja Kulkarni, M.Sc. Scientic and Editorial Co-ordinator Dr. Apeksha Kalvit, B.P.T., M.P.T. (Neuro-Paediatric) Physiotherapist NeuroGen DCH & KLS Wellness Institute Publication Navi Mumbai, Maharashtra, India. www.neurogenbsi.com Management of COVID-19 1 Management of COVID-19 A Handbook for Family Physicians © 2021 by NeuroGen Brain and Spine Institute All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for the brief quotations embodied in critical articles and reviews. This book is basically a compilation of information / literature on the available on the topic, from various sources (which have been acknowledged duly). However, this is by no means an exhaustive resource, since the eld is evolving at a very rapid pace. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). Published by NeuroGen DCH, Navi Mumbai, India Cover Page by John Julius Printed by Surekha Press, A-20, Shalimar Industrial Estate, Matunga Labour Camp, Mumbai 400 019. Tel.: 2409 3877, 2404 3877 2 Management of COVID-19 Management of COVID-19 3 CONTENTS Section (A) - About Covid 1. Introduction Chapter for Book Management of COVID for family physicians................................................................................................. 17-22 2. Pandemic and Challenges...................................................................... 23-25 3. SARS-CoV-2 Structure and Invasion.................................................... 26-28 4. Cytokine storm and disease progression............................................. 29-31 5. Complications of COVID-19.................................................................. 32-36 Section (B) - Preventive measures 6. Preventive measures for Healthy people.............................................39-47 7. Preventive measures for Covid Contacts............................................. 48-52 8. Preventive measures for Healthcare Workers.....................................53-59 Section (C) - Management of Covid patients 9. Management of Covid Suspects............................................................ 62-68 10. Management of Covid positive patients in home isolation...............69-77 11. Management of Mild and Moderate Covid positive patients...........78-99 12. ICU management of severe COVID patients....................................100-122 13. Pediatric Management........................................................................ 123-131 14. Post Covid Complications..................................................................132-134 15. Convalescent Plasma Therapy...........................................................135-137 Section (D) - Adjuvant Therapies 16. Diet.........................................................................................................140-153 17. Physical and Pulmonary Rehabilitation..........................................154-174 18. Psychological Counselling for Covid patients................................ 175-182 19. Yoga....................................................................................................... 183-187 Section (E) - Medicines 20. Antivirals...............................................................................................190-198 21. Corticosteroids..................................................................................... 199-201 22. Anti-coagulants....................................................................................202-206 23. IL6 inhibitors........................................................................................ 207-212 4 Management of COVID-19 24. Antibiotics.............................................................................................213-227 25. Vitamins and Minerals........................................................................228-256 Section (F) - Futuristic Therapies 26. Vaccines.................................................................................................259-283 27. Ozone therapy......................................................................................284-288 28. Stem Cell Therapy............................................................................... 289-306 Section (G) - Biomarkers and Radiological Findings 29. Factors affecting prognosis of COVID-19.........................................309-315 30. Clinical indicators of disease progression........................................316-331 31. Importance of Blood biomarkers.......................................................332-342 32. Radiological Findings..........................................................................343-353 Section (H) - Preventive Measures at Healthcare Set Up 33. Family Physician Clinic Set Up......................................................... 356-360 34. Non Covid set up.................................................................................361-367 35. Covid and Non Covid Hospitals.......................................................368-384 36. Dedicated Covid Hospitals.................................................................385-397 Section (I) - Miscellaneous 37. Oxygen Therapy and Other Novel Equipments Used For Patient Care...........................................................................................400-416 38. Personal Protective equipment..........................................................417-431 39. Ongoing Clinical Trials.......................................................................432-464 Management of COVID-19 5 About Authors Dr. Alok Sharma, MS, Mch Dr. Alok Sharma is a Neurosurgeon and is presently the [a] Professor & Head of Department of Neurosurgery at the LTMG Hospital & LTM Medical College in Sion, Mumbai as well as the [b] Director of the NeuroGen Brain & Spine Institute in Navi Mumbai [c] President of Indian Society of Regenerative Science (ISRS) and [d] Vice President International Association of Neurorestoratology (IANR) He completed his graduate and post graduate studies from the Seth G.S. Medical College and KEM Hospital of Mumbai University. Subsequently he did Trained Overseas in Sweden, England, Germany, USA, & Japan. He has written/edited 20 books, has over 150 scientic publications in medical journals and has made over 200 scientic presentations in India and overseas. He has been conferred with numerous honors and awards in his distinguished career. He has dedicated his life to doing research on incurable disease and injury of the brain and spine and to providing the latest and most advanced treatments for patients who are paralyzed and disabled from incurable neurological conditions. Is the pioneer of Stem cell therapy in India. He setup the Stem cell and Genetic research laboratory at the LTMG hospital & LTM Medical College which was the rst of its type in Mumbai. He has also created India's rst dedicated Stem Cell Therapy and Neurorehabilitation center in Navi Mumbai. He is a staunch believer that Stem cell therapy can relieve a lot of human suffering of neurological patients and makes every attempt to popularize this new approach amongst the medical community. His special interest in Neurosurgery are Stereotactic and Functional Neurosurgery, Psychosurgery, Neuroendoscopy, Spinal Fixations and Surgery for Cerebral Ischemia. He has a special personal interest in Neurobiology of the mind and lectures extensively on the relationship of the brain/ mind to health and disease. He is a strong advocate of the role of yoga, meditation, natural therapy and diet in the prevention of various modern illnesses. Contribution during Covid 19 pandemic (A) Scientic research 1. Dr Alok Sharma got approval for the rst DCG(I) approved, CTRI registered clinical trial on the use of Mesenchymal Stem cells in Covid 19. This trial is currently ongoing, showing good safety and satisfactory efcacy. 2. Dr. Alok Sharma also completed India’s rst CTRI registered clinical trial on the use of IV Ozone in Covid 19. 3. He completed a study on role of IV ozone as prophylaxis for healthcare workers (HCWs) in a dedicated Covid Hospital. The results have been accepted for publication in European Review for Medical and Pharmacological Sciences. 4. He has completed a comparative study comparing outcome of conventional treatment and conventional treatment combined with IV ozone in 680 Covid-19 patients. (B) Clinical Service 1. Dr Alok Sharma volunteered to have NeuroGen Brain and Spine Institute of which he is the director, to be converted into a dedicated Covid Hospital from June 2020 onwards where a total of 900 patients were treated. 2. Presently, he is involved in studying post Covid sequelae and offering a comprehensive treatment plan for post Covid. 6 Management of COVID-19 Dr. Hemangi Sane, M.D. (Internal Medicine, USA) (Medical Physician) Dr. Hemangi Sane is Deputy Director and Head of Research and Development, Consultant Physician at NeuroGen Brain and Spine Institute, Navi Mumbai. She acquired MBBS degree from esteemed G S Medical College more than 20 years ago. Dr.Sane has completed her MD from the renowned
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