Now, a shortage of anti-fungal injection in Mumbai

After remdesivir steroids and oxygen the city is facing a shortage of an antifungal injection mdash Amphotericin B mdash used to treat mucormycosis the black fungal infection hitting an increasing number of Covid19 patients and those who have recovered midday had earlier reported about several cases of mucormycosis where patients lost their vision or suffered facial disfigurementThe fungal infection affects the nose cheekbones eye orbit and then the brain Representation picSuddenly the demand for Amphotericin B has gone up Earlier it was not even five per cent of the current demand Some time is needed to produce the medicine We are told that seven pharma companies are relentlessly working to meet the demandrdquo said Prasad Danave president Retail and Dispensing Chemists AssociationDanave said that there is no stock in the market and supplies coming in are being distributed through government channels ldquoThe government is analysing the situation and in coordination with the Food Drugs Administration FDA distributing it to hospitalsrdquo said DanaveIn the preCovid19 era mucormycosis was a rare disease seen in immunocompromised patients It is caused by a group of moulds known as mucormycetes naturally present in the environment They invade the facial bones the eye orbit and can spread to the brain rapidly The disease has a 70 per cent mortality rate which means seven out of 10 patients dieICMR gives guidelinesThe Indian Council of Medical Research ICMR has formed guidelines on the screening diagnosis and management of mucormycosis The state too is forming a multidisciplinary team comprising an internal medicine expert ENT surgeon infectious disease expert and an endocrinologist to manage the disease and bring numbers downDr Shashank Joshi a consultant endocrinologist at Lilavati Hospital and a member of the state Covid19 Task Force said ldquoThe task force is mindful of the rise The key is prevention and early diagnosis While treating Covid19 steroids need to be given in the right dosage and for the right time to ensure they taper offrdquoOnce the infection progresses surgery or long term antifungal treatment is the only solution ldquoThere should be strict sugar control and mouth nose and throat hygiene in diabetic patients the oxygen administered must be in distilled or sterile waterrdquo Dr Joshi saidPrivate hospitals like Global Hospitals in Parel have started a clinic dedicated to mucormycosis Dr Milind Navlakhe ENT surgeon heading Global Hospitalsrsquo clinic said ldquoWe have 25 patients admitted with mucormycosis One of the patients is a 60yearold woman whose eyeball will have to be removed to save herrdquolsquoFree treatment regulation of cost of medsrsquoPeople covered under the statersquos Mahatma Phule Public Health Scheme will be treated free of cost for mucormycosis The medicine required in its treatment is very expensive Health Minister Rajesh Tope said on Monday that the department has taken serious note of the disease ldquoDiabetic Covid19 patients who donrsquot control their sugar properly are largely affected by mucormycosisrdquo Tope said from Jalna The minister said he received complaints of overcharging from patients who needed the injection for treatment ldquoWe will regulate the prices of drugs needed for mucormycosis and treat patients at 1000 hospitals that provide free treatment under the state public health schemerdquo he saidmdash Dharmendra JoreWhat to watch out forgtgt Pain redness around the eyes or nose with fever headache coughing shortness of breath bloody vomits altered mental statusgtgt Sinusitis mdash nasal blockage or congestion nasal discharge blackishbloodygtgt Local pain on the cheekbone onesided facial pain numbness or swellinggtgt Blackish discolouration over bridge of nosepalategtgt Loosening of teethgtgt Blurred or double vision with pain thrombosis necrosis skin lesion7037Mortality rate for mucormycosis which means seven out of 10 patients die