The ECMO is a procedure that oxygenates a patient's blood outside the body.
According to Dr K.R. Balakrishnan, Chairman-Cardiac Sciences Director, Institute of Heart and Lung Transplant & Mechanical Circulatory Support, the 37-year-old male patient Deepak Kumar Keshav was from Rajkot, Gujarat.
He tested positive for Covid-19 in March 2021 and was shifted to MGM Healthcare here in April and was being treated for Covid pneumonia and was put on ventilator support.
He was put on ECMO support and slowly the support was withdrawn as the patient's health condition improved, said Balakrishnan.
Subsequently, Keshav developed a fungal infection and his condition started worsening.
As he was breathless and his oxygen saturation was low, he was put on ECMO support for a second time.
Gradually his clinical condition improved and the ECMO support was taken off.
According to the hospital, the patient is now undergoing active physiotherapy and has been discharged recently.
His health has shown good signs of recovery and will soon be able to fly back to his native Rajkot, the hospital said.
He also said the drug reduces the oxygen dependency of Covid-19 patients.
"The 2-DG drug impacts the cells that are affected by coronavirus and prevent their multiplication. The drug will not affect the good cells," Rakesh Kumar Sharma, Vice Chancellor, Saveetha Institute of Medical and Technical Sciences (SIMTS) here.
Sharma was one of the co-inventors of the improved process of 2-DG when he was with the Defence Research Development Organisation (DRDO).
The technology was later transferred to drug major Dr. Reddy's Laboratories in 2004 for Rs.25 lakh.
He and other team members had developed a process of its synthesis and upscaled it in collaboration with the Defence Research Development Establishment, Gwalior. It was granted Indian Patent No.187908 dated 28-2-2003.
The 2-DG drug comes in powder form packed in sachets.
Initially the drug was tested for treating cancer. The cancer cells multiply fast like that of the coronavirus infected ones.
Sharma said the coronavirus needs energy to multiply. Last year when Covid-19 pandemic broke out, the drug was reviewed and phase I and II clinical studies were made on 110 patients.
The 2-DG does not result in production of energy or prohibits energy production in the cells and hence resulting in its death.
According to Sharma, a total of 110 patients were part of the Phase-II clinical trials of this drug. In terms of improvement in vital signs of symptomatic patients who were administered the drug, a difference of 2.5 days was seen compared to Standard of Care (SoC).
It has shown better efficacy in phase two itself as compared to the standard care.
Approval for Phase-III trials was given in November and trials were conducted at 27 Covid hospitals in Delhi, Uttar Pradesh, West Bengal, Gujarat, Rajasthan, Maharashtra, Andhra Pradesh, Telangana, Karnataka and Tamil Nadu.
In the third phase, 220 patients were enrolled. It was started on 12-01-2021, Sharma said.
Saveetha Medical College & Hospital is the only private Hospital in Tamil Nadu to be selected for the Phase-III Clinical trial by DRDO and Dr. Reddy's Laboratories.
Sharma said three patients participated in the clinical trial at Saveetha Medical College & Hospital. The three were clinically categorised as "moderate Covid-19 patients".
"All the three patients were successfully discharged within three to seven days once they were completely cured with RTPCR- Negative reports," he said.
Data pertaining to these trials showed reduced dependence on oxygen among moderate cases of Covid-19, even in patients aged 65 and above.
After its entry, the virus reprogrammes the host cell metabolism. The metabolic demand of virally infected cells is upregulated primarily through high glucose uptake and glycolysis for rapid and higher viral replication.
Virus-infected cells consume 30-50 fold more oxygen and adenosine triphosphate (ATP) than the normal cells.
Sharma said the rates of glucose transport and glycolysis are increased to meet the increased energy demands for its rapid replication similar to malignant cells.
2-DGA acts as a decoy/mimic for glucose and selectively inhibits Glycolysis.
The changed metabolic state allows for selective accumulation of 2- DG in virally infected cells.
2-DG also inhibits the synthesis of anabolic intermediates required for the viral replication process.
There is some evidence that it interferes with N-linked glycosylation of viral proteins in the endoplasmic reticulum of infected cells, causing misfolding of viral glycoproteins leading to non-infective or non-virulent virus particles (virions), he added.
"Before DRDO conducted trials on the drug, scientists and experts from Patanjali Ayurved Ltd, Jain Vishwa Bharti Institute, and Saveetha Institute of Medical and Technical Sciences hadApublishedAa paper in March 2020 on the possible use of the molecule for COVID-19,a Sharma remarked.
Giridhar Aramane, Secretary, Ministry of Road, Transport and Highways informed while presenting the current scenario of LMO production, allocation and supply during the 25th meeting of the high-level Group of Ministers (GoM) on Covid-19 through video-conference.
Union Health Minister Harsh Vardhan chaired the meeting that was also virtually attended by External Affairs Minister S. Jaishankar, Civil Aviation Minister Hardeep S. Puri, Minister of State for Ports, Shipping and Waterways and Fertilizers Mansukh Mandaviya, Minister of State for Home Nityanand Rai, and Minister of State for Health Ashwini Kumar Choubey. Vinod K. Paul, Member (Health), NITI Aayog was present virtually.
At the outset, the Health Minister apprised other members of GOM about the steadily growing trajectory of daily recoveries and also observed that "180 districts have showed no fresh cases in the last seven days, 18 districts in 14 days, 54 districts in 21 days and 32 districts were bereft of any fresh cases in the last 28 days."
The number of critical cases thus far includes 4,88,861 patients who required ICU beds, 1,70,841 patients who required ventilator support and 9,02,291 patients who were given oxygen support, the Minister added.
As on date, Vardhan said, 1.34 per cent of the active caseload is in ICU, 0.39 per cent of them are on ventilators and 3.70 per cent of them are on oxygen support.
Vardhan informed the GOM that, "the cumulative number of Covid-19 vaccine doses administered in the country has crossed 16.73 crore on Saturday which includes nearly 23 lakh doses given on Friday".
"A total of 17,49,57,770 doses have been delivered to the states, out of which 16,65,49,583 doses have been consumed and 84,08,187 doses are still available with the states," said the Minister, adding a total of 53,25,000 doses are on the pipeline and will be supplied to the states soon.
He requested the states to set aside 70 per cent of the vaccines received through GoI channel for administration of the second dose.
On the tests being conducted in India, the Health Minister noted that the country has reached a testing capacity of 25,00,000 tests per day. He informed that a total of 30,60,18,044 tests have been conducted so far in India, which includes 18,08,344 tests in the last 24 hours. From just one lab at NIV Pune, the country is presently served by 2,514 labs.
A bench comprising Justices D.Y. Chandrachud and M.R. Shah said: "A consensus has emerged that there is a need to ensure that the allotments of medical oxygen to the states and UTs are made on a scientific, rational and equitable basis. At the same time, it must allow for flexibility to meet unforeseen demands due to emergencies which may arise within the allocated territories."
The top court said: "It is necessary that an effective and transparent mechanism is set up within the Union Government for the purpose of allocating medical oxygen to all states and UTs for being used during the Covid-19 pandemic.
"The Union Government has agreed to set up a National Task Force to streamline the process. This Task Force would be tasked inter alia with formulating a methodology for the scientific allocation of oxygen to the states and UTs."
The SC bench said the establishment of this task force will enable the decision makers to have inputs which go beyond finding ad-hoc solutions to the present problems.
"The likely future course of the pandemic must be taken into contemplation at the present time. This will ensure that projected future requirements can be scientifically mapped in the present and may be modulated in the light of experiences gained," said the bench.
"The rationale for constituting a task force at a national level is to facilitate a public health response to the pandemic based on scientific and specialised domain knowledge. We expect that the leading experts in the country shall associate with the work of the task force both as members and resource persons," the top court noted in its order.
The bench added: "The Union Government has made its suggestions on the possible names for inclusion in the composition of the task force, while leaving its final composition to the court. The National Task Force which is being constituted in pursuance of the above suggestion shall consist of the following members...
"(i) Dr Bhabatosh Biswas, Former Vice Chancellor, West Bengal University of Health Sciences, Kolkata.
(ii) Dr Devender Singh Rana, Chairperson, Board of Management, Sir Ganga Ram Hospital, Delhi.
(iii) Dr Devi Prasad Shetty, Chairperson and Executive Director, Narayana Healthcare, Bengaluru.
(iv) Dr Gagandeep Kang, Professor, Christian Medical College, Vellore, Tamil Nadu.
(v) Dr J.V. Peter, Director, Christian Medical College, Vellore, Tamil Nadu.
(vi) Dr Naresh Trehan, Chairperson and Managing Director, Medanta Hospital and Heart Institute, Gurugram.
(vii) Dr Rahul Pandit, Director, Critical Care Medicine and ICU, Fortis Hospital, Mulund (Mumbai) and Kalyan (Maharashtra).
(viii) Dr Saumitra Rawat, Chairman & Head, Department of Surgical Gastroenterology and Liver Transplant, Sir Ganga Ram Hospital, Delhi.
(ix) Dr Shiv Kumar Sarin, Senior Professor and Head of Department of Hepatology, Director, Institute of Liver and Biliary Science (ILBS), Delhi.
(x) Dr Zarir F Udwadia, Consultant Chest Physician, Hinduja Hospital, Breach Candy Hospital and Parsee General Hospital, Mumbai.
(xi) Secretary, Ministry of Health and Family Welfare, Government of India (ex officio member.
(xii) The Convenor of the National Task Force, who shall also be a member, will be the Cabinet Secretary to the Union Government. The Cabinet Secretary may nominate an officer not below the rank of Additional Secretary to depute for him, when necessary."
The top court said the task force is at liberty to draw upon the human resources of the Union Government for consultation and information, including the following: (i) A member of Niti Aayog to be nominated by the Vice-Chairperson; (ii) Secretary, Ministry of Human Affairs; (iii) Secretary, Department for Promotion of Industry and Internal Trade; (iv) Secretary, Ministry of Road Transport and Highways; (v) Director, All India Institute of Medical Sciences, New Delhi; (vi) Director General, Indian Council of Medical Research, New Delhi; (vii) Director General of Health Services; (viii) Director General, National Informatics Centre; and (ix) Head, Centre for Development of Advanced Computing (C-DAC).
"The establishment of this task force will enable the decision makers to have inputs which go beyond finding ad-hoc solutions to the present problems. The likely future course of the pandemic must be taken into contemplation at the present time," the top court added.
Ananya Aprameya from Bhanjanagar in Ganjam district along with some of his friends came up with this uniquely designed portable ventilator attached to a pumping air-bag to help Covid-infected people and other patients facing asphyxia. They started the project after enforcement of the nation-wide lockdown and finally the device 'Swasner' is ready. Another benefit of this pumping-ventilator is it's available at much cheaper price than the ones available in market.
"Due to lack of resources or knowledge regarding the application/operation, there seems to be a shortage of ventilators in hospitals. Focusing on this issue, we had 4-5 designs ready but then came up with this bubble helmet device which we had already researched on. We were inspired by the research being done at the University of Chicago (Medicine) and we started developing it under the guidance of our teacher Prof Sura Sharma. We had to go with this idea because we think there's a huge difference between Indian and US market and medical industries. We developed this device according to the medical needs and requirements of patients here," said Ananya, who is now in his 3rd year B.Tech.
"The materials used have been certified by Central Institute of Plastics Engineering and Technology (CIPET), Bhubaneshwar. The device has the potential to meet the demand for ventilators across the country. We are open for rigorous trials at the hospitals too, and so far two trials have been conducted at hospitals in Cuttack. We want this to be well-equipped and more developed, in case required, so that common people are benefited and the number of deaths due to lack of ventilators also comes down," the student added.
"In case there is shortage of ventilators, people encountering breathing issues can use this air-pumping device. It will ensure there is constant supply of oxygen at least for some hours. I hope this will prove to be extremely beneficial for patients," says Bishnupriya Senapati, Ananya's mother.
Speaking on the device, Dr Pranabananda Patra posted at the Bhanjanagar hospital as a medicine specialist, said, "When the device is connected to oxygen cylinders, the supply will be more concentrated and it will help Covid patients and all those suffering from breathing problems. So, I think it will be helpful."
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