{"id":7086,"date":"2020-07-10T15:26:15","date_gmt":"2020-07-10T15:26:15","guid":{"rendered":"https:\/\/www.marrow.com\/blog\/?p=7086"},"modified":"2020-09-07T07:37:58","modified_gmt":"2020-09-07T07:37:58","slug":"qbank-newsletter-vol-1-issue-1","status":"publish","type":"post","link":"https:\/\/www.marrow.com\/blog\/qbank-newsletter-vol-1-issue-1\/","title":{"rendered":"QBank Newsletter (Volume 1, Issue 1)"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Hello!<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">We are happy to announce our first-ever QBank newsletter! In this issue we have covered some of the recent updates that have happened within and beyond the world of Qbank.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In this newsletter, the focus is entirely on COVID-19 related updates.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">1, <strong>6 new symptoms added:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Recently, the Centers for Disease Control &amp; Prevention (CDC) has added 6 more symptoms to aid the diagnosis of COVID- 19.&nbsp;These are:&nbsp;<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>Chills<\/li><li>Muscle pain<\/li><li>Headache<\/li><li>New Loss of taste or smell<\/li><li>Sore Throat<\/li><li>Diarrhoea<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:10px\"><em>Source: <a aria-label=\"undefined (opens in a new tab)\" href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/symptoms-testing\/symptoms.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/symptoms-testing\/symptoms.html<\/a><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>2, Kavach ELISA<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Indian Council of Medical Research (ICMR) and the National Institute of Virology (NIV), Pune have developed and validated the indigenous <strong>IgG ELISA<\/strong> kit called <strong>KAVACH ELISA<\/strong> for antibody detection of COVID-19. This is an important <strong>surveillance<\/strong> tool to understand the proportion of the infected population.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:10px\"><em>Source:<a href=\"https:\/\/main.icmr.nic.in\/sites\/default\/files\/press_realease_files\/ICMR_PressRelease_14052020.pdf\">https:\/\/main.icmr.nic.in\/sites\/default\/files\/press_realease_files\/ICMR_PressRelease_14052020.pd<\/a><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">3, <strong>Updated Guidelines on COVID-19 Sample Collection and Testing<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Ministry of Health and Family Welfare (MoHFW) has updated guidelines on sample collection and testing of COVID-19.&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Samples: Nasopharyngeal and Oropharyngeal swabs<\/li><li>Swab material: <strong>Dacron<\/strong> or <strong>polyester flocked<\/strong> swabs<\/li><li>Note: Calcium alginate swabs or swabs with wooden shafts are <strong>not <\/strong>used, as they may contain substances that inactivate the virus and inhibit PCR testing.&nbsp;<\/li><li>Transport to Laboratory at 4 \u00b0C<\/li><li>Storage till testing: \u22645 days at 4 \u00b0C or &gt;5 days at -70 \u00b0C<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">For the transportation of samples VTM (viral transport medium) containing antifungal and antibiotic supplements is to be used. Repeated freezing and thawing of specimens should be avoided.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The nasopharyngeal and oropharyngeal swabs should be placed in the same tube to increase the viral load.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">4,<strong> 5th version of Clinical Management Protocol<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Ministry of Health and Family Welfare (MoHFW), recently, has issued the fifth version of the clinical management protocol for COVID 19. This has been tabulated as follows:&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-table alignleft is-style-regular\"><table><thead><tr><th class=\"has-text-align-left\" data-align=\"left\">MILD<\/th><th>MODERATE<\/th><th>SEVERE<\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-left\" data-align=\"left\">Fever<br>URTI<\/td><td>Pneumonia with no signs of severe disease<br>(RR \u2265 24 SpO2 &lt;94%)<\/td><td>Respiratory distress<br>(RR \u2265 30 SpO2 &lt;90%)<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Admit to COVID Centre\/Home Quarantine<\/td><td>Admit to Dedicated COVID Health Centre<\/td><td>Admit to Dedicated COVID Hospital<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Precaution and Hygiene with Home quarantine<br><br>Symptomatic Management<br><br><strong>Tab HCQ<\/strong> 400mg BD x1 Day<br>Followed by 400mg OD x4 Days (<em>in high-risk case<\/em>*)<br><br>Watch for warning signs and seek medical attention if needed<\/td><td><strong>Oxygen:<\/strong> Target 92-96 % SpO2<strong><br><\/strong><br><strong>Daily<\/strong> monitoring<br>(CBC and RFT, LFT, Absolute lymphocyte count, ECG )<br><br><strong>48 hourly<\/strong> Monitoring<br>(CRP, D- dimer &amp; Ferritin)<br><br><strong>Tab HCQ<\/strong> 400mg BD x1 Day<br>Followed by 400mg OD x4 Days<br><br><strong>Anticoagulation<br><\/strong>(UFH or LMWH<strong>)<br><\/strong>Enoxaparin 40mg SC <strong>OD<br><br>IV Methylprednisolone <\/strong>0.5 to 1mg for 3- 5 days<strong><br><br>Investigational therapies<br> Inj Remdesivir <\/strong>200mg on Day 1 followed by 100mg for next 4 days<br><br><strong>Convalescent Plasma <\/strong>200ml\/day for every 24 hours<\/td><td><strong>CPAP<\/strong> or<strong> NIV<br><br>Intubation <\/strong>if needed<strong><br><br><\/strong>Prone ventilation considered in refractory hypoxemia<br><br><strong>IV Methylprednisolone <\/strong>1 to 2mg\/kg\/day for 7 days<br><br>High prophylactic dose of <strong>Anticoagulation<br>(<\/strong>UFH or LMWH)<br>Enoxaparin 40mg SC <strong>BD<br><br>Sepsis\/ Septic Shock: <\/strong>managed according to their protocol<strong><br><br>Sedation or Nutrition therapy<\/strong><br><br><br><strong>Investigational therapies<br>Inj Tocilizumab <\/strong>8mg\/kg one dose, repeated after 12 to 24 hour if no improvement occurs with the first dose.<\/td><\/tr><\/tbody><\/table><figcaption>High-risk cases*: Age \u2265 60, HTN, DM, Obesity (BMI \u2265 25), Immuno-compromised status, Cerebrovascular disease, Chronic lung or liver or Kidney disease<br><br><em>Source: COVID 19 Management Protocol by MOHFW version 5 (03.07.2020)<br><a href=\"https:\/\/www.mohfw.gov.in\/pdf\/UpdatedClinicalManagementProtocolforCOVID19dated03072020.pdf\">https:\/\/www.mohfw.gov.in\/pdf\/UpdatedClinicalManagementProtocolforCOVID19dated03072020.pdf<\/a>]<\/em><\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">5, <strong>New Treatment Modalities <\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The MoHFW has approved the following for treating COVID 19 patients:<\/p>\n\n\n\n<div class=\"wp-block-group\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<ol class=\"wp-block-list\"><li><strong>Remdesivir,<\/strong> an RNA polymerase inhibitor (Emergency Use Authorization issued by FDA ) may be considered in adults and pediatric patients with the moderate-severe disease who require supplemental oxygen.&nbsp; <br><strong><em>Note:<\/em><\/strong> Co-administration of Remdesivir and chloroquine phosphate or hydroxychloroquine sulfate is not recommended as it may result in the reduced antiviral activity of Remdesivir.&nbsp;<br><\/li><li>Off label use of <strong>convalescent plasma <\/strong>and <strong>Tocilizumab<\/strong> may be considered in patients with moderate disease who are not improving despite the use of steroids and oxygen requirement is progressively increasing.&nbsp;<br><strong><em>Note: <\/em><\/strong>The use of convalescent plasma therapy for the treatment of patients with Covid-19 is under open-label, randomized, controlled Phase II trial conducted by the ICMR.<br><\/li><li><strong>Hydroxychloroquine<\/strong> is to be used early in the disease in high-risk populations.<\/li><li><strong>Glucocorticoids<\/strong> can be used for a short period of time (3 to 5 days) in patients whose condition is deteriorating progressively. This is depicted by worsening oxygen indicators, imaging, and excessive activation of the body\u2019s inflammatory response.<\/li><li><strong>&nbsp;Favipiravir, the viral polymerase inhibitor<\/strong> has been approved in tablet form for mild to moderate COVID-19 infection.<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:10px\"><em>Sources:<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:10px\">1,  <em><a href=\"https:\/\/www.mohfw.gov.in\/pdf\/ClinicalManagementProtocolforCOVID19dated27062020.pdf\">https:\/\/www.mohfw.gov.in\/pdf\/ClinicalManagementProtocolforCOVID19dated27062020.pdf<\/a><\/em><br><br>2, <em><a href=\"https:\/\/www.fda.gov\/news-events\/press-announcements\/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-potential-covid-19-treatment\">https:\/\/www.fda.gov\/news-events\/press-announcements\/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-potential-covid-19-treatment<\/a><\/em><br><br>3, <em><a href=\"https:\/\/www.fda.gov\/news-events\/press-announcements\/coronavirus-covid-19-update-fda-warns-newly-discovered-potential-drug-interaction-may-reduce\">https:\/\/www.fda.gov\/news-events\/press-announcements\/coronavirus-covid-19-update-fda-warns-newly-discovered-potential-drug-interaction-may-reduce<\/a><\/em><\/p>\n<\/div><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p style=\"background-color:#fff7d0\" class=\"has-background wp-block-paragraph\"><strong><span style=\"text-decoration: underline;\">MCQ IDs of the updated MCQs in QBank:<br><\/span><\/strong><br><strong>Newly Added MCQs:<\/strong> MB3386 | MD0964 | MD3188 | MD3189 | MC4159 | MD3187 | MA8142 | MA6731 | MA7567 | MD3379 | MA6361 | Pearl No. 2444<br><br><em>You can copy the MCQ IDs and search for it on your App<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Preview of Pearl No. 2444<\/strong>:<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"696\" height=\"710\" src=\"https:\/\/www.marrow.com\/blog\/wp-content\/uploads\/2020\/07\/Screenshot-2020-07-10-at-8.47.58-PM.png\" alt=\"\" class=\"wp-image-7102\" srcset=\"https:\/\/www.marrow.com\/blog\/wp-content\/uploads\/2020\/07\/Screenshot-2020-07-10-at-8.47.58-PM.png 696w, https:\/\/www.marrow.com\/blog\/wp-content\/uploads\/2020\/07\/Screenshot-2020-07-10-at-8.47.58-PM-294x300.png 294w\" sizes=\"auto, (max-width: 696px) 100vw, 696px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Hello! We are happy to announce our first-ever QBank newsletter! In this issue we have covered some of the recent&#46;&#46;&#46;<\/p>\n","protected":false},"author":27,"featured_media":7256,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","_exactmetrics_skip_tracking":false,"_monsterinsights_skip_tracking":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[595],"tags":[],"class_list":["post-7086","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-qbank-fortnightly-newsletters-recent-updates"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>QBank Newsletter (Volume 1, Issue 1) -<\/title>\n<meta name=\"description\" content=\"We are happy to announce our first-ever QBank newsletter! 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