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Treatment Protocol for Black Fungus Issued, Be Vigilant on Signs and Symptoms, Advices Health Deptt

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mucormycosis in Himachal Pradesh

Shimla-Health and Family Welfare Department, Himachal Pradesh, on Monday informed that the State Covid Clinical Committee has taken out a detailed treatment protocol for Mucormycosis/ Black Fungus. The department has urged people to be vigilant on all the signs and symptoms of black fungus so that a timely medical aid can be sorted for. So far, Himachal has reported at least three cases of Mucormycosis. 

Mucormycosis is a fungal disease which generally affects the nose, eyes and cerebral area in a human body. The immunosuppressive treatments such as steroids being used in Covid-19 patients result in decrease in immunity. The chronic respiratory disease, intubation, mechanical ventilation and coexistence of other infections during COVID-19 also increase chances of mucormycosis, the department informed.

The department said that uncontrolled diabetes mellitus, immunosuppression by steroids, prolonged ICUs stay, comorbidities like malignancy, post transplant are the major risk factors for this fungal disease.

Also Read: Himachal Pradesh Reports First Case of Black Fungus, Centre Writes to States to Declare It An Epidemic

Major Symptoms of Mucormycosis

The major symptoms that a person can be vigilant for this infection are headache, nasal obstruction which is persistent and not responding to medicines, nasal crusting and discharge, pain or loss of sensation over face, discolouration of skin, loosening of teeth, ulceration of palate or bridge of nose, black necrotic eschar in the nasal cavity and sinusitis, it informed.

In addition, the intra oral symptoms include intra oral pus discharge, ulceration of mucosa, loosening of teeth and unhealed tooth socket, mobility of maxilla. This fungal disease also affects eyes which can result in swelling and redness of eyes, double vision, loss of vision, pain in the eye, drooping eyelid.

How Mucormycosis Is Diagnosed 

Laboratory investigations that are done to confirm the disease are blood investigations, nasal endoscopic examination, X-ray, CT scan, biopsy, nasal crust sampling, bronco alveolar lavage etc, the department said.

Treatment of Mucormycosis

After recovering from COVID-19, one should closely monitor and should not miss any warning signs and symptoms mentioned above, as the fungal infection is found to emerge even weeks or months after recovery. One should make judicial use of steroids as per doctor’s advice to avoid risk of infection. Early detection of the disease can ease the treatment of the fungal infection.

“The medical management of mucormycosis is known and the disease is completely curable if detected early. This disease can be treated by injectable Antifungal amphotericin B and other medicines. The treatment also includes surgical debridement of the involved tissue,” the Health and Welfare department clarified.

The disease is preventable and controlling hyperglycaemia, monitoring blood glucose level in post Covid phase, using steroid judiciously, using mask, wearing shoes, long trousers, long sleeves, gloves while handling soil, moss or manure can ensure prevention of this disease, it added.

The Health Dept. also emphasised the patients who are on oxygen therapy or are using humidifier to ensure to use clean sterile and boiled tap water for humidifiers. Mineral water should not be used and the water should be changed in the humidifier on daily basis, it said.

A regular follow-up should be ensured in the initial three months, the Health and Family Welfare department informed.

Mucormycosis Not Contagious, 

The Ministry of Health and Family Welfare on Monday said that the Fungal infection observed in COVID-19 patients is mostly Mucormycosis. It further said that the infection is not contagious. 

“Mucormycosis is one of the general fungal infections being seen in recovering or recovered COVID-19 patients. The number of cases being reported is increasing, but it is not a communicable disease, meaning it does not spread from one person to another, like COVID-19 does,”Dr Randeep Guleria, Director, AIIMS, New Delhi, at a media briefing 

Dr Guleria says it is better not to use the term black fungus while talking of mucormycosis, as it leads to a lot of avoidable confusion. “Black fungus is another family; this term got associated with mucormycosis due to the presence of black dots among the culture of white fungal colonies. In general, there are various types of fungal infections such as candida, aspergillosis, cryptococcus, histoplasmosis and coccidioidomycosis. Mucormycosis, candida and aspergillosis are the ones observed more in those with low immunity.”

There is no definite link between oxygen therapy and catching the infection, he said. 

“90% – 95% of mucormycosis patients are either diabetic and/or taking steroids,” Dr Guleria informed.

Who is at Higher Risk of Developing Mucormycosis Infection:

  1. Uncontrolled diabetes
  2. Weakening of immune system due to use of steroids
  3. Prolonged ICU/hospital stay
  4. Co-morbidities / post organ transplant / cancer
  5. Voriconazole therapy (used to treat serious fungal infections)

Types of Mucormycosis

Mucormycosis can be categorized depending on which organ of the human body it attacks.  Signs and symptoms of the infection also vary depending on the affected body part.

Rhino orbital cerebral Mucormycosis: It infects the nose, orbit of eye / eye socket, oral cavity and can even spread to the brain. Symptoms include headache, nasal congestion, nasal discharge (green colour), pain in sinus, bleeding nose, swelling on face, lack of sensation on face and skin discoloration.                                         

Pulmonary Mucormycosis: This fungal infection affects the lungs. Causes fever, chest pain, cough and coughing of blood.

The fungus can also infect the gastrointestinal tract.

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HP Govt Employees to Get Higher Pay Scale on Completion of Two Years of Service: CM Jairam

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hp govt employess higher pay scale

Shimla-Himachal Pradesh Government employees working in different departments before January 3, 2022, would be given a higher scale at par with other employees on completion of two years tenure of regular service. A higher pay scale was also announced for the Junior Office Assistants (IT) on completion of two years of regular service.

Chief Minister Jairam Thakur made these announcements during the Karamchari Maha Sammelan of the Himachal Pradesh Non-Gazetted Employees Federation at the hotel Peterhof on Sunday.

He appreciated the role played by the employee especially frontline workers in the battle against the pandemic.

He said most of the government employees in the state have been given revised pay scales and on average, every employee has got the benefit of a 12 to 15 percent salary hike. There has also been an increase in the pension of about 1.50 lakh pensioners of the state. The financial benefits of Rs. 7801 crore have been given to state government employees and pensioners from the year 2018 to 2022. The pensioners who retired before 2016 are getting the benefit of a 15 to 20 percent increase in the pension while around 40 thousand pensioners who retired after 2016 would be benefitted soon, he said.

He said the daily wages were Rs. 210 in the year 2017 which has been increased by the present state government to Rs. 350. Similarly, 12 per cent interim relief annually has been provided to government employees and pensioners during the present government’s tenure. He said the Himachal government has provided Dearness Allowance to its employees and pensioners on the lines of Punjab and Central governments from the due date. The Punjab government has given only 5 percent interim relief to the employees while the Himachal government has provided 21 percent interim relief to its employees.

“Out of the total interim relief amount given to the employees and pensioners amounting to about Rs. 6500 crore, Rs. 3500 crore has been paid during the tenure of our government” added the Chief Minister.

He said that the state government has increased the government contribution for NPS employees from 10 percent to 14 percent benefitting more than one lakh employees. The NPS employees are being given the benefits of retirement and death gratuity at par with employees falling under the old pension scheme. The government has also increased the upper limit of death gratuity from Rs. 10 lakh to Rs. 20 lakh.

The Chief Minister said the state government has also increased the honorarium of para-workers working in various departments. The salary of outsource workers has been hiked by Rs 1,500 per month.

Non-Gazetted Employees Federation President Ashwani Thakur thanked the Chief Minister for providing various financial and other benefits to different categories of government employees.

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Most Covid Restrictions to be Lifted From March 31, Mask and Hand Hygiene to Continue

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all caovid restriction lifted in himachal pradesh

New Delhi-The Centre has issued a notification to the States informing that the provisions of the Disaster Management (DM) Act, 2005 will not be invoked in the country after March 31. The Union Health Ministry said that the use of face masks and following hand hygiene will continue.

It implies that most of the Covid-related rules and restrictions would end.

Union Home Secretary Ajay Bhalla issued the notification which said that the decision was taken following the overall improvement in the situation and the preparedness of the government in dealing with the COVID-19 pandemic.

However, local authorities and State police can still invoke fines and criminal cases against persons violating COVID-19 norms under the Indian Penal Code (IPC), a senior government official said.

The DM Act was invoked on March 24, 2020, due to the pandemic

“Over the last seven weeks or so there has been a steep decline in the number of cases. The total caseload in the country stands at 23,913 only and the daily positivity rate has declined to 0.28%. It is also worth mentioning that with the combined efforts, a total of 181.56 Cr vaccine doses have been administered,” the notification said.

“I would like to mention that in view of the nature of the disease, we still need to remain watchful of the situation. Wherever any surge in the number of cases is observed, the States/UTs may consider taking prompt and proactive action at a local level, as advised by MoHFW (Health Ministry) from time to time,” the notification said.

The Indian government had issued various guidelines and measures for the first time on March 24, 2020, under the Disaster Management Act to curb the COVID-19 situation in the country, which have been modified several times thereafter.

India currently has 23,087 active COVID-19 cases and recorded 1,778 new cases and 62 deaths in the last 24 hours. The daily positivity rate has also declined to 0.28%.

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HP Cabinet Decisions: Country Liquor Made Cheaper in New Excise Policy, Read All Decisions

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hp cABINET DECISIONS MARCH 20,2022

Shimla-A meeting of the Himachal Pradesh Cabinet was held on March 20, 2022, under the chairmanship of Chief Minister Jai Ram Thakur.

The excise policy for the financial year 2022-23 was approved. Approval was also given for the renewal of retail excise vends in the state for the financial year 2022-23 at the renewal fees of 4% of the value of unit/vend.

The State Government said that wants to enhance the government revenue and curb the smuggling of country liquor from the neighbouring states by a reduction in its price.

The brands of Country Liquor will be cheaper as license fees have been reduced. This will help in providing good quality liquor at a cheaper rate to the consumers.

In the new excise policy, the 15% fixed quota of country liquor for manufacturers and bottlers to be supplied to the retail licensees has been abolished. According to the government, this step will give the retail licensees to lift their quota from the suppliers of their choice and further assure the supply of good quality country liquor at competitive prices. The MRP of country liquor will be cheaper by 16% of the existing price.

In this year’s policy, the Gaudhan Vikas Nidhi Fund has been enhanced by Re.1/- from the existing Rs.1.50 to Rs.2.50.

The fixed annual license fee of Bars has been rationalized by abolishing the area-specific slabs of license fee. Now throughout the State, there will be uniform license slabs based upon the room capacity in hotels.

Rates of the annual fixed license fee of Bars in the tribal areas has been reduced considerably.

Further, all the above stakeholders will have to install CCTV cameras at their establishments as it was made mandatory for them.

Wholesale vends and retail vends, the penalty provisions under the H.P. Excise Act, 2011 have been made more stringent.

An end to end online Excise Administration System would be established in Himachal Pradesh, the government said.

HP Government estimates a collection of Rs 2131 crore revenue during the year, which will be Rs. 264 crores higher than the financial year 2021-22 – growth of 14% in state excise revenues.

The Cabinet also gave its nod to amend Himachal Pradesh Disaster Relief Manual-2012 to include deaths due to biting of honey bees, hornet and wasps, accidental drowning and deaths due to accidents of vehicles (including land, water and air) under this Manual.

The Cabinet gave its approval for filling up 11 posts of ‘A’ Class Tehsildar in Revenue Department through direct recruitment on regular basis through Himachal Pradesh Public Service Commission.

HP State Toll Policy 2022-23

The HP Cabinet also gave its nod to HP State Toll Policy for the year 2022-23 which envisages auction cum tender for all the toll barriers in the State. During the year 2021-22, toll revenue has registered a growth of 20 percent of the previous year’s revenue.

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