UK based Atlantic Data Bureau opens unit in Mangalore

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.

Mangaluru, Apr 15: For the convenience of the public during the lockdown period, the Department of Posts has been providing essential services to the public at its various branch offices which are functioning from 1000 hrs to 1400 hrs.

Medicines and other essential items can be sent via parcel from any town to any place in Dakshina Kannada and Udupi districts.

Arrangements are also being made to extend this facility to nearby districts. In case of sending medicines and other essentials to other states from Mangaluru, the transportation has to be done via Bengaluru and can be expedited if a request for urgency is made, says a press release from the Senior Superintendent of Posts of Mangaluru Division on Wednesday.

May 12: Children suffering from non-respiratory disease symptoms like diarrhea and fever, or those with a history of exposure to the novel coronavirus, should be suspected of having COVID-19, a new study says.

According to the research, published in the journal Frontiers in Pediatrics, gastrointestinal symptoms first suffered by some children hints at potential infection with SARS-CoV-2 through the digestive tract.

"This case series is the first report to describe the clinical features of COVID-19 with non-respiratory symptoms as the first manifestation in children," the scientists from Tongji Hospital in China wrote in the study.

They explained that the gastrointestinal symptoms could be arising since the type of receptors in lung cells targeted by the virus can also be found in the intestines.

Most children are only mildly affected by COVID-19, and the few severe cases often have underlying health issues, the researchers said.

"It is easy to miss its diagnosis in the early stage, when a child has non-respiratory symptoms, or suffers from another illness," said study co-author Wenbin Li, who works at the Department of Pediatrics, Tongji Hospital.

"Based on our experience of dealing with COVID-19, in regions where this virus is epidemic, children suffering from digestive tract symptoms, especially with fever and/or a history of exposure to this disease, should be suspected of being infected with this virus," Li said.

In the study, the scientists described the clinical features of children admitted to hospital with non-respiratory symptoms, who were subsequently diagnosed with pneumonia and COVID-19.

"These children were seeking medical advice in the emergency department for unrelated problems, for example, one had a kidney stone, another a head trauma," Li said.

The study noted that all the children had pneumonia, which was confirmed by chest X-ray scan before or soon after admission.

These children were then confirmed to have COVID-19.

While their COVID-19 symptoms were initially mild or relatively hidden before their hospital admission, four out of the five cases had digestive tract symptoms as the first manifestation of this disease, the researchers said.

Li hopes that doctors will use the findings to quickly diagnose and isolate patients with similar symptoms, which may aid early treatment and reduce transmission.

According to the researchers, the children's gastrointestinal symptoms, which have also been recorded in adult patients, could be an additional route of infection.

"The gastrointestinal symptoms experienced by these children may be related to the distribution of receptors and the transmission pathway associated with COVID-19 infection in humans," Li explained.

Since the virus infects people via the ACE2 receptor, which can be found in certain cells in the lungs as well as the intestines, COVID-19 might infect patients not only through the respiratory tract in the form of air droplets, but also through the digestive tract by contact or fecal-oral transmission, the study noted.

While COVID-19 tests can occasionally produce false positive readings, Li said all the five children assessed in the study were infected with the disease.

However, he cautioned that more research is needed to confirm their findings.

"We report five cases of COVID-19 in children showing non-respiratory symptoms as the first manifestation after admission to hospital. The incidence and clinical features of similar cases needs further study in more patients," he said.