Doctors are already administering limited doses of other such immunosuppressant corticosteroids in inflammatory complications in covid cases where it can help in terminal cases. That should be the doctor's choice. And here what is the new thing?

A drug for cytokine storm, dexamethasone is commonly used for inflammation in asthmatic exacerbations and arthritis, giving relief. Now the finding is it works in coronavirus, but in advanced stage needing ventilator, and saves one-third of those terminal patients! Difficult to comprehend?

NEW DELHI, June 29: The Health Ministry has revised the clinical management protocol to include a re-purposed dexamethasone in the therapeutic course for terminal patients of coronavirus on ventilator or oxygen support.

Universally available, cheap, safe and well-known, it is commonly used as anti-inflammatory in asthmatic exacerbations and arthritis since 1960s. True, it helps in the management of inflammation associated with critical corona cases too.

The Ministry's decision follows the Oxford researchers' finding in the RECOVERY (Randomised Evaluation of COVid-19 thERapY) clinical trial that dexamethasone saves the lives of one-third of patients on ventilator and one-fifth of patients on oxygen support. The Phase II/III randomised trial had begun in March last. In 175 NHS hospitals in the UK, 2,104 patients were given 6 mg per day of dexamethasone for 10 days. The trial found mortality rate was reduced from 40% to 28% in patients on ventilators and 25% to 20% in those on oxygen. Patients who did not need respiratory assistance did not respond to the medicine!

(Because it is not a medicine for coronavirus. On the contrary, it can be fatal for coronavirus patients. It only helps in associated complications - but not all - acting against cytokine storm. That the treating doctor has to decide. While the British Prime Minister's announcement was misguiding, WHO Director-General Dr Tedros Adhanom Ghebreyesus' encore, "green shoots of hope," showed a lack of adequate medical knowledge a second time!)

There are over 2,000 clinical trials/research going on to find a vaccine or medicine for Covid-19, the new viral disease of which nothing much is known, except what China has provided. After Wuhan, the epidemic has engulfed the world, claimed lakhs of lives, ruined the global economy, and is still on the rampage.

So far the result has been zero. And therefore existing drugs are being re-purposed. Re-purposing usually a doctor's prerogative on a case-to-case basis, has turned into a research industry, re- inventing, re-naming and re-packaging old drugs. Sales are instant and worldwide, needs no other advertisement. Harvest time for the pharmaceutical industry, when the world is on fire!

Dexamethasone works by decreasing extreme response of the immune system to infections and traumas thereby reducing symptoms such as inflammation, swelling and allergic reactions and thereby saving the patient from resulting complications like bleeding, clotting, strokes and abrasions like damage to various organs. That is to say, in the case of covid, these complications and damage caused to other organs is not by the infectious disease but by the body's own defensive system going into an overdrive. Dexamethasone calms the immune system and reduces the inflammation. That's it. But, coronavirus can be become more virulent.

There is nothing new about dexamethasone. Doctors are already administering limited doses of other such corticosteroids in inflammatory complications in covid cases where it can help, not routinely. Why the British Government and the WHO are resorting to such a publicity blitz?

In the absence of a medicine for the new viral disease, our immune system is the only defence against coronavirus. Dexamethasone is an immunosuppressant that dumps down the immune system. Therefore, dexamethasone can be fatal for corona patients when administered as a standard medicine.

Oral dexamethasone is commonly used for inflammation in asthmatic exacerbations and arthritis. It is a common steroid used since 1960, cheap and universally available and well-known. It acts against cytokine storm. A glucocorticosteroid, classified as corticosteroid and more potent than prednisone, it starts acting in 8-24 hours. It has also a role to play as a palliative in hospices at the end of life.

However, remdesivir, favipiravir, hydroxychloroquine, lopinavir- ritonavir, azithromycin, tocilizumab, convalescent plasma etc are being symptomatically administered to patients in India and elsewhere by doctors as experimental drugs in good intention in the absence of a medicine for the new epidemic.

Betting through Dubai-based Mahadev Book in India is conducted through a countrywide network. Probes reveal that the online gambling is worth several millions and top politicians, officials and celebs have been beneficiaries.

TAILPIECE: Polling dates for some States are round the corner. Top politicians have begun their acrimonious debate who looted more, even as Mahadev is washing their dirty laundry in the open ghat. Come what may, one needs to seize power to amass "thy wretched pelf!" One simple question is, why else one should spend lakhs or crores to get elected! A question every Indian should ask to oneself at least once a day!

His inaction amounts to defeating the rights of the people of the State to welfare measures sought to be implemented through the Bills, the Kerala Government's petition submitted, while the State of Tamil Nadu remarked that its "Governor is acting as a political rival."

Tailpiece: Coming up back to back, the petitions in their totality seem to question the provision of Raj Bhavan, and not motives of a Governor as a person.

Hundreds of cars piled up behind the wreckage of crashes occurring one after other in backing up - continuous crashes to the rhythm of metallic clanks and bangs back to back. According to reports, some ops required 'Jaws of Life' to pull apart the mangled cars to save lives inside.

The pilots struggled with Emerson to thwart a shut-off as he reached for the T-handles (see pix). Later he admitted to police he had taken psychedelic mushrooms and had a "nervous breakdown."

Doctors reasoned how the incidence of heart attacks is spiking over time and advise the simple way to play safely is to take a break and rehydrate yourself.

But how come ten people, including children, die of cardiac arrest at Garba in 24 hours, and that at different places of Gujarat? Garba had been going on for six days, and every year it is celebrated.

The killing of a teacher in France by an Islamic radical last Friday is linked to the Israel-Hamas war in West Asia, say authorities.

Shocking news from the UK: Leading grocers have started bribing policemen with free food and drinks to persuade them to take action against shoplifters.

Shoplifting has risen by about 27 per cent in 10 major cities across the UK this year. The cost of retail crime last year was $2.15 billion. Besides, “We are seeing organised gangs threatening staff with weapons and emptying stores," Helen Dickinson, chief executive of the British Retail Consortium, said. Data shows that the police failed to respond to 73 per cent of serious retail crimes that included assault and abuse of workers, apart from shoplifting.

Isar Mohammad allegedly picked up a banana offered to Ganesh idol on Chaturthi at a makeshift temple in Delhi and consumed it.

Harris said hip-hop is “the ultimate American art form” that “shapes every aspect of American popular culture.” “Hip-hop culture is American culture,” she said in a talk at her official residence at the US Naval Observatory in Washington, D.C.

The social media had mixed reaction. There was much appreciation that she dances better than any VP in American history. But some called her "moves" as “cringe” while others did not like her pink pants - "pink pants don’t look good.” In fact, her ensembles have always been incongruous.

"Let’s see how the (Governor's) Vice-Chancellors are given salary." Mamata's extreme statements will put the Marxist Government in Kerala, which is also facing similar issues, to shame. Has she begun the countdown for a war on the streets?

It's true Mamata has come to see a conspiracy to demolish the established systems across the country, but lacks the ability to foresee what exactly is being pushed.

Brandishing a sword, Mahant Paramhans told reporters on Tuesday he himself will behead MK Stalin's son for his remarks against Sanatan Dharma in case nobody came forward to accept his offer he made in his video. Udhayanidhi reacted to the saint's Monday video, "I will speak more. I am the grandson of the artist who put his head on the rail track for Tamil Nadu."

Somanath elaborated, "I am an explorer. I explore the Moon. I explore the inner space. So it's a part of the journey of my life to explore both science and spirituality. So I visit many temples and I read many scriptures. So try to find the meaning of our existence and our journey in this cosmos. So it's a part of the culture that we are all built to explore, find out the inner self as well as outer self. So for the outer, I do science, for the inner I come to temples." (See videos)

Rao the mathematical legend had fathered the path-breaking Rao-Blackwell theorem, one of the most important theorems in mathematical statistics, at the age of 25. That brought him global fame. He is also famous for his Cramér-Rao Bound inequality theorem relating to quality of estimators in statistics which has had a profound bearing on applications of modern economics and several other diverse fields. Simply put, with the pioneering statistician computation became a tool to analyse even socio-economic challenges of modern times.

The alleged incident has received such a flash publicity that a standardised city's hugely middle class population will have second thoughts about eating outside for some time. Now everything on the table looks suspicious!

“All subjects directly connected to the people should be shifted to the State List. Particularly the subject of education. Only if this is done can cruel exams like NEET be abolished,” Stalin said. Education was moved from the State List to the Concurrent List with the 42nd Constitution Amendment made by the Central Government in 1976.

Decentralisation has been at the core of Tamil politics since the times of CN Annadurai. Stalin indicated there will be political changes in the offing.

TAILPIECE: While the Centre and the States are at loggerheads, it takes a different cognitive acumen to know that entrance tests are not the way for students' admission to courses.

As recently as Tuesday Craig Robertson had posted on Facebook: "Perhaps Utah will become famous this week as the place a sniper took out Biden the Marxist." Biden was scheduled to make his first visit to Utah as President Wednesday afternoon.

Maruti is recalling 87,599 S-Presso and Eeco vehicles to inspect and possibly replace parts in the steering system. All reputed companies around the world do recall their products when a defect comes to light.

Meanwhile, a question arises why just in about a year so many accidents have taken place involving Mercedes sent to India while the car has won safety awards abroad? In most cases, the vehicle collided with divider, while manoeuvring a turn. Was there a split second delay in the steering system coming to a grip when at high speed? Did anybody in India bother to study a pattern in several of these accidents that took place one after other?

Former Tata Sons chairman Cyrus Mistry died when his Mercedes-Benz-SUV hit a divider in Gujarat. Cricketer Rishabh Pant's Mercedes-Benz-SUV rammed a divider in Uttarakhand and smashed. It went up in flames but he escaped with injuries. Brother of PM Narendra Modi, Prahlad Modi's Mercedes-Benz-SUV met with a similar accident in Mysuru. And many more.

• Experts blame violation of the Visual Flying Rules (VFR) for most of the chopper crashes in the mountains as the leading cause. VFR means fly only visually - because of the lack of navigation aids in remote areas or unreliability of GPS-like aids in hilly terrains or a remote manipulation of instruments in cases of sabotage - as the topography plays havoc especially in the monsoon (mid-June to September).
• Even when VFR is followed, most crashes occur due to CFIT (Controlled Flight into Terrain) - that is, everything else is OK but the aircraft collides with hills or trees hidden by the clouds. This also occurs mostly in the monsoon.
• On Tueday with Manang, the chopper was brand new, pilot was highly experienced. But it hit an 'invisible' tree and then crashed against a hillside. This CFIT occurred when the pilot tried to dodge patches of clouds even as he was following the VFR.
• Simply put, everyone knows flying in the hills during the monsoon is risky, but the companies want to make more money in any which case. This type of tragedy is very frequently invited in the Indian hill State of Uttarakhand as well, where pilots are even made to fly without the mandatory rest.

• Curfew was clamped on areas in Paris on Thursday lasting till Monday. The police apprehend an escalation of volence in the coming days. There will be "actions targeted at the forces of order and the symbols of the State", they said.
• Under present law, the police have brute powers to deal with traffic violators. Young Nahel was shot point-blank by a cop for purported traffic violation and an anticipated crime.