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Kasaragod, Apr 19: Kasaragod, Kerala's COVID-19 hotspot, is the only district in the southern state lacking adequate health infrastructure.

In spite of treating the highest number of COVID-19 patients in the state with meagre infrastructural facilities and even without the support of a medical college in the north Kerala district, no deaths have been reported due to coronavirus.

The state health department views the performance of M Kunhiraman and his team, consisting of Janardhana Naik and Krishna Naik, at the General hospital in Kasaragod as a success story.

"Not only did they control the situation quickly with minimum infrastructure, they also started turning out a large number of negative cases within a few weeks and creditably ensured zero mortality.

This can be showcased as a best global model," Chairman of the Information Education and Communication (IEC) Committee and Project Director Kerala State Aids Control Society, R Ramesh said.

Recalling the ordeal, Janardhana Naik said his first major challenge was the physical examination of a patient with suspected COVID-19.

"Even with the PPE kit, nobody knew how effective they were and it took a whole 30 minutes to wear them properly.

But as time passed, we got accustomed to it," he said.

The traditional method of dealing with a patient involved knowing his or her history, observation and physical examination.

For hundreds of years, the hands-on body approach has been the soul of the doctor-patient relationship -- taking the pulse, tapping on and listening to the chest, feeling lumps.

With the onset of COVID-19 all that has changed.

"In fact, the whole exercise was fraught with grave risks because everything connected with COVID-19 was new.

Doctors have to keep a distance even though the physical examination wearing a Personal Protective Equipment (PPE) is difficult.

Sounds from the body are inaudible, vision is blurred through the smog-covered goggles and a stethoscope seldom has any use," Janardhana Naik said.

It was from March 15 that the hospital started receiving COVID-19 patients, primarily from Dubai.

By the time the first person came, the hospital was ready for him.

Soon, patient numbers began to swell and in a couple of weeks they reached about 91.

From then on, it was teamwork.

Committees were formed for each and every task, including the help desk, IT, treatment, medical board, training, food, waste disposal and data maintenance.

Initially, patients had many misgivings about the hospital.

"Some were disillusioned and even aggressive. Some were not happy with the facilities the hospital had to offer.

But gradually through good treatment and counselling by a psychiatrist, who visited the hospital on alternate days, the confidence and mood of the patients changed and they became friendly with the staff," Naik elaborated.

Counselling was also given to the concerned family members of the patients.

Besides treatment, the medical staff had to spend a considerable amount of time clearing the doubts of patients.

When they got discharged some patients insisted on seeing the faces of the medical staff, who till then were anonymous entities covered from head to toe.

Some even wanted to take selfies with them.

However, the medical team politely turned down their requests and preferred to remain hidden in their work attires.

The mood of the patients also rubbed off on the doctors and hospital staff.

All the physicians and hospital staff are now more confident of dealing with contagious diseases after treating COVID-19 patients.

"Our previous experience of treating H1N1, Chikungunya and Dengue cases helped us a lot.

Words of encouragement from the Health Minister K K Shailaja, Health Principal Secretary Dr Rajan N Khobragade and Health Services Director Dr Sarita R L gave us the impetus to build up confidence.

Moreover, the field health workers did a wonderful job in containing the viral spread," Naik added.

As the number of coronavirus cases rose, the state government on April 5 deputed a 26-member medical team from Thiruvananthapuram to set up a COVID-19 hospital in the district.

They turned a block of the under construction Government Medical College as a hospital-like facility, setting up a 200 bed facility to treat coronavirus patients.

Bengaluru, Mar 25: The COVID-19 count in Karnataka went up by 10 on Wednesday, reaching 51. The 10 new positives included two girls aged seven and nine who contracted the infection from their father.

The 34-year-old man had returned from Amsterdam on March 19 and tested positive as the 17th confirmed case in Karnataka.

Though his family were kept in isolation and under quarantine in their house, the children developed a cold. They were confirmed for COVID-19 infection while their mother is still negative.

The government remained tightlipped over whether or not a 70-year-old woman from Gouribidanuru who was put under house quarantine and died on Wednesday morning, tested positive for COVID-19. Government officials would neither confirm nor deny anything on the results of tests on the woman.

This evening’s bulletin issued by the Karnataka health department continued to indicate the strong correlation of coronavirus infection and foreign travel.

Among the positive cases identified today were

A 63-year-old Bengaluru man and his 59-year-old wife, with a history of travel to Brazil and Argentina.
Two 26-year-old men with a history of travel to Spain and arrived back in Bengaluru via Dubai.
Two others, a 63-year-old woman and her 69-year-old husband, had a history of travel to Athens and London.
A 34-year-old man, a resident of Udupi, who returned from Dubai
A 37-year old woman, a resident of Chitradurga, with a history of travel to Guyana and arrived back in Bengaluru via Delhi
Speaking to the media, medical education minister K Sudhakar said health officials were apprehensive the positives may go up tonight.

Of the corona positive cases detected in Karnataka so far, three have been discharged after quarantine, and 47 patients are in isolation at designated hospitals in a stable condition. There has been one fatality.

As per a recommendation by the high-level health committee, the government has decided to convert the Bowring Hospital into a coronavirus treatment hospital facility along with the Rajiv Gandhi Hospital for Chest Diseases and Victoria Hospital. 

“The number of positive cases are growing at an alarming rate and the government needs more treatment facilities. The government is for burning of COVID-19 death cases. However, due to some religious practices, it has been decided they would be buried in 8 ft deep pits,'' Dr Sudhakar said.

Washington D.C., May 8: The prime time for brain development in a child's life is the first year, where the infant spends most of the time asleep. It is the time when neural connections form and sensory memories are encoded.

However, when sleep is disrupted, as occurs more often among children with autism, brain development may be affected, too.

New research led by the University of Washington finds that sleep problems in a baby's first 12 months may not only precede an autism diagnosis but also may be associated with altered growth trajectory in a key part of the brain, the hippocampus.

The study, which was published in the American Journal of Psychiatry, researchers report that in a sample of more than 400 taken of 6- to 12-month-old infants, those who were later diagnosed with autism were more likely to have had difficulty falling asleep.

It also states that this sleep difficulty was associated with altered growth trajectories in the hippocampus.

"The hippocampus is critical for learning and memory, and changes in the size of the hippocampus have been associated with poor sleep in adults and older children.

As many as 80 per cent of the children with autism spectrum disorder have sleep problems," said Annette Estes, director of the UW Autism Center and senior author of the study.

"In our clinical experience, parents have a lot of concerns about their children's sleep, and in our work on early autism intervention, we observed that sleep problems were holding children and families back," added Estes, who is also a UW professor of speech and hearing sciences.

"It could be that altered sleep is part-and-parcel of autism for some children. One clue is that behavioural interventions to improve sleep don't work for all children with autism, even when their parents are doing everything just right. This suggests that there may be a biological component to sleep problems for some children with autism," said Estes.

To consider links among sleep, brain development, and autism, researchers at the IBIS Network looked at MRI scans of 432 infants, surveyed parents about sleep patterns, and measured cognitive functioning using a standardized assessment.

At the outset of the study, infants were classified according to their risk for developing autism: Those who were at higher risk of developing autism -- about two-thirds of the study sample -- had an older sibling who had already been diagnosed.

Infant siblings of children with autism have a 20 per cent chance of developing autism spectrum disorder -- a much higher risk than children in the general population.

In the current study, 127 of the 432 infants were identified as "low risk" at the time the MRI scans were taken because they had no family history of autism.

They later evaluated all the participants at 24 months of age to determine whether they had developed autism. Of the roughly 300 children originally considered "high familial risk," 71 were diagnosed with autism spectrum disorder at that age.

Problems with sleep were more common among the infants later diagnosed with an autism spectrum disorder, as were larger hippocampi. No other subcortical brain structures were affected, including the amygdala, which is responsible for certain emotions and aspects of memory, or the thalamus, a signal transmitter from the spinal cord to the cerebral cortex.

The authors note that while parents reported more sleep difficulties among infants who developed autism compared to those who did not, the differences were very subtle and only observed when looking at group averages across hundreds of infants.

Sleep patterns in the first years of life change rapidly as infants transition from sleeping around the clock to a more adult-like sleep/wake cycle. Until further research is completed, Estes said, it is not possible to interpret challenges with sleep as an early sign of increased risk for autism.