Role of Prophylactic Anti Coagulants and Anti Platelets to Reduce the incidence of Thrombosis, Stroke, Myocardial Infarction in Asymptomatic Patients of COVID19

Had the Following discussion in response to my paper Role of Prophylactic Anti Coagulants and Anti Platelets to Reduce the incidence of Thrombosis, Stroke, Myocardial Infarction in Asymptomatic Patients of COVID19

Peer Review of my Paper
Peer Review of my Paper

Comment :
Anti thrombosis therapy for COVID-19 has always been a part of treatment guidelines.
https://www.covid19treatmentguidelines.nih.gov/therapies/antithrombotic-therapy/ It’s high time TN docs follow such validated ones rather than following their own cocktails.

My Response :
They are doing this only during hospital stay and stop it without checking coagulation profile But, I am asking this to be done based on coagulation profile

Use of steroids Was done by us Months before it was added to NIH
By the time they validate, We will lose another lakh
What is wrong in doing coagulation profile and treating that ??
Other than cost, Can you give any reason

Comment :
Use of steroids started because someone saw it being considered in certain trials (Solidarity trial). We ended up using it indiscriminately leading to mucor surge.

My Response :
For decades, We have been using steroids for treating pneumonia
You are answering the question : How to ignore Bruno’s recommendations
I am answering the question : How to save lives
Both are talking entirely different topics
Between The recommendation you have quoted and my recommendations, which can save more lives

Comment :
Evidence based medicine vs Eminence based medicine. What do u prefer ?
If you want to prove something then conduct a study – even a small one – look at the results and communicate widely.

My Response :
I prefer evidence based medicine
I prefer to give anticoagulants based on PT, aPTT, INR and other tests
I don’t prefer eminence based medicine – of quoting NIH guidelines – ignoring basic common sense
That is exactly what I say – Do coagulation profile, Treat as per results
What is wrong in the statement – Do coagulation profile and treat as per results
This is the evidence based medicine
Is it clear boss

Prove what ?
You want proof for the statement “Treat abnormal coagulation profile”
Come on saaar. . . It is 2nd year mbbs stuff

Comment :
Treat abnormal coagulation profile – is part of inpatient management boss – done routinely everywhere

My Response :
Perfect
That is what I am also saying
So
What did you really want me to prove

Comment (quoting my journal article) :
this – the prophylactic part

My Response :
The first statement is Do Coagulation profile for those at risk

The second Statement is Treat abnormal coagulation profile

Which statement are you asking proof
Which statement is not evidence based medicine
Read again
I never ask to give drugs
I ask to first do tests and give drugs only when results indicate it
What is the problem there

Yet to get response . . Will update if I get one

BCG (Bacille Calmette-Guerin) Vaccine Trial. FAQ (Frequently Asked Questions)

BCG (Bacille Calmette-Guerin) Vaccine Trial. FAQ (Frequently Asked Questions)

BCG (Bacille Calmette-Guerin) Vaccine Trial. FAQ (Frequently Asked Questions)
BCG (Bacille Calmette-Guerin) Vaccine Trial. FAQ (Frequently Asked Questions)

Question : Will BCG vaccine really benefit to control COVID in elderly ?
My Answer : Yet, It will. But, “control”, (like Prevent or Save) is a wrong word to be used. The Right word is “Reduce”

BCG Vaccine won’t benefit to control COVID in elderly
BCG Vaccine won’t benefit to prevent COVID in elderly
BCG Vaccine won’t save elderly from COVID
But
BCG Vaccine will reduce Mortality and Morbidity in Elderly

To Substantiate this, they are planning to start a trial

பிசிஜி தடுப்பூசி போட்டால் கொரோனாவை தடுக்க முடியாது
பிசிஜி தடுப்பூசி போட்டால் கொரோனாவை ஒழிக்க முடியாது
பிசிஜி தடுப்பூசி போட்டால் கொரோனாவில் இருந்து பாதுகாக்க முடியாது

ஆனால்
பிசிஜி தடுப்பூசி போட்டால் கொரோனாவினால் ஏற்படும் நோய் பாதிப்புகள் குறையும்
பிசிஜி தடுப்பூசி போட்டால் கொரோனாவினால் ஏற்படும் நோய் தீவிரங்கள் குறையும்
பிசிஜி தடுப்பூசி போட்டால் கொரோனாவினால் ஏற்படும் மரணங்கள் குறையும்

இதை உறுதிப்படுத்தத்தான் ஆய்வு தொடங்கவுள்ளது

-oOo-




Question 2 : That too not proven right.? And many countries didn’t accept that experiment …
Answer 2 : Proven with Observational Studies
Example : Low Mortality and Morbidity in Portugal as compared with Spain

Question 3 : If it prevents mortality it’s fine. Otherwise experimenting on elderly those are already more riskier will not be accepted.
Answer 3 : Actually

We need to define the word experiment here

For Example

Experiment 1
If you give BCG to 10000 people in August 2020
and Take 10000 people as control
Do nothing else
And see the difference in Outcome in Feb 2021

Experiment 2
If you give BCG to 10000 people in August 2020
and Take 10000 people as control
Expose them to Corona Virus Filled Air in Jan
And see the difference in Outcome in Feb 2021

  • 1 is OK
  • 2 is wrong

This is the difference we need to understand

-oOo-