AirAsia jet's black box found, to be retrieved tomorrow

Washington, Apr 28: After nearly three weeks in an intensive care unit in Los Angeles, doctors treating 41-year-old Broadway actor Nick Cordero for COVID-19 were forced to amputate his right leg.

The flow of blood had been impeded by a blood clot: yet another dangerous complication of the disease that has been bubbling up in frontline reports from China, Europe and the United States.

To be sure, so-called "thrombotic events" occur for a variety of reasons among intensive care patients, but the rates among COVID-19 patients are far higher than would be otherwise expected.

"I have had 40-year-olds in my ICU who have clots in their fingers that look like they'll lose the finger, but there's no other reason to lose the finger than the virus," Shari Brosnahan, a critical care doctor at NYU Langone said.

One of these patients is suffering from a lack of blood flow to both feet and both hands, and she predicts an amputation may be necessary, or the blood vessels may get so damaged that an extremity could drop off by itself.

Blood clots aren't just dangerous for our limbs, but can make their way to the lungs, heart or brain, where they may cause lethal pulmonary embolisms, heart attacks, and strokes.

A recent paper from the Netherlands in the journal Thrombosis Research found that 31 percent of 184 patients suffered thrombotic complications, a figure that the researchers called "remarkably high" -- even if extreme consequences like amputation are rare.

Behnood Bikdeli, a doctor at New York-Presbyterian Hospital, assembled an international consortium of experts to study the issue. Their findings were published in the Journal of The American College of Cardiology.

The experts found the risks were so great that COVID-19 patients "may need to receive blood thinners, preventively, prophylactically," even before imaging tests are ordered, said Bikdeli.

What exactly is causing it? The reasons aren't fully understood, but he offered several possible explanations.

People with severe forms of COVID-19 often have underlying medical conditions like heart or lung disease -- which are themselves linked to higher rates of clotting.

Next, being in intensive care makes a person likelier to develop a clot because they are staying still for so long. That's why for example people are encouraged to stretch and move around on long haul flights.

It's also now clear the COVID-19 illness is associated with an abnormal immune reaction called "cytokine storm" -- and some research has indicated this too is linked to higher rates of clotting.

There could also be something about the virus itself that is causing coagulation, which has some precedent in other viral illnesses.

A paper in the journal The Lancet last week showed that the virus can infect the inner cell layer of organs and of blood vessels, called the endothelium. This, in theory, could interfere with the clotting process.

According to Brosnahan, while thinners like Heparin are effective in some patients, they don't work for all patients because the clots are at times too small.

"There are too many microclots," she said. "We're not sure exactly where they are."

Autopsies have in fact shown some people's lungs filled with hundreds of microclots.

The arrival of a new mystery however helps solve a slightly older one.

Cecilia Mirant-Borde, an intensive care doctor at a military veterans hospital in Manhattan, told AFP that lungs filled with microclots helped explain why ventilators work poorly for patients with low blood oxygen.

Earlier in the pandemic doctors were treating these patients according to protocols developed for acute respiratory distress syndrome, sometimes known as "wet lung."

But in some cases, "it's not because the lungs are occupied with water" -- rather, it's that the microclotting is blocking circulation and blood is leaving the lungs with less oxygen than it should.

It has just been a little under five months since the virus emerged in Wuhan, China, and researchers are learning more about its impact every day.

"While we react surprised, we shouldn't be as surprised as we were. Viruses tend to do weird things," said Brosnahan.

While the dizzying array of complications may seem daunting, "it's possible there'll be one or a couple of unifying mechanisms that describe how this damage happens," she said.

"It's possible it's all the same thing, and that there'll be the same solution."

Washington, Feb 22: US President Donald Trump will raise the issue of religious freedom with Prime Minister Narendra Modi during his visit to India next week, the White House said on Friday, noting that the US has great respect for India's democratic traditions and institutions.

"President Trump will talk about our shared tradition of democracy and religious freedom both in his public remarks and then certainly in private. He will raise these issues, particularly the religious freedom issue, which is extremely important to this administration," a senior official told reporters in a conference call.

The official was responding to a question on whether the president was planning to speak to Modi on the Citizenship (Amendment) Act or the National Register of Citizens.

"We do have this shared commitment to upholding our universal values, the rule of law. We have great respect for India's democratic traditions and institutions, and we will continue to encourage India to uphold those traditions," the official said, requesting anonymity.

"And we are concerned with some of the issues that you have raised," the senior administration official said, in response to the question on CAA and NRC.

"I think the President will talk about these issues in his meetings with Prime Minister Modi and note that the world is looking to India to continue to uphold its democratic traditions, respect for religious minorities," the official said.

"Of course, it's in the Indian constitution -- religious freedom, respect for religious minorities, and equal treatment of all religions. So this is something that is important to the president and I'm sure it will come up," said the official.

Pointing out that India has a strong democratic foundation, the official said India is a country rich in religious, linguistic, and cultural diversity.

"In fact, it's the birthplace of four major world religions," the official noted.

Washington, May 29: US President Donald Trump while speaking with reporters at the White House on Thursday said that he is more liked in India than the media in his own country --the United States.

"I know. And they like me in India. I think they like me in India certainly more than the media likes me in this country, " Trump told reporters at his Oval office.

"And I like Modi (Prime Minister Narendra Modi). I like your prime minister a lot. He's a great gentleman. A great gentleman," he added further while briefing the reporters.

But when asked over ties between India and China, the US President said, "They have a big conflict going with India and China. Two countries with 1.4 billion people. Two countries with very powerful militaries. And India is not happy, and probably China is not happy."

Reiterating his offer to mediate between India and China on the border issue, Trump said that he spoke to Prime Minister Narendra Modi, who is not in "good mood" about the ongoing situation with Beijing.

However, informed sources from the Ministry of External Affairs told ANI on Friday that there has been no recent contact between Prime Minister Modi and the US President. The last conversation between them took place on April 4, 2020, on the subject of hydroxychloroquine.

Asked about his Wednesday's tweet regarding his offer to mediate between India and China, Trump said, "I would do that. If they (China and India) thought it would help." However, Trump did not clarify when did he speak to Modi.

Trump on Wednesday tweeted that he is "ready, willing and able to mediate" between India and China."We have informed both India and China that the United States is ready, willing and able to mediate or arbitrate their now raging border dispute," the US President said.

In response to Trump's mediation offer, India said on Thursday that it is engaged with the Chinese side to resolve the border issue peacefully.

India's Ministry of External Affairs spokesperson Anurag Srivastava said that the two sides have established mechanisms both at military and diplomatic levels to resolve situations that may arise in border areas peacefully through dialogue and "continue to remain engaged through these channels."

Indian and Chinese field commanders have been holding talks on de-escalating the tensions.

China has also struck a conciliatory tone on the border issue with India, saying the two countries pose no threat to each other and should resolve their differences through communication, while not allowing them to overshadow bilateral relations.

"We should never let differences overshadow our relations. We should resolve differences through communication. China and India should be good neighbours of harmonious coexistence and good partners to move forward hand in hand," said Chinese Ambassador to India, Sun Weidong, on Wednesday.

The tensions escalated between India and China following a number of confrontations between soldiers of both armies.

Troops of India and China were engaged in two face-offs in Eastern Ladakh and North Sikkim along the disputed Line of Actual Control (LAC), where troops from both sides suffered injuries early this month.

Studies over the anti-malarial drug, which is believed to cure the highly contagious coronavirus, have shown side-effects, according to the Centers for Disease Control and Prevention and the World Health Organisation. But Trump continues to defend his decision to take hydroxychloroquine saying he believes that it gives an additional level of safety.