Australia PM, Muslim leaders spar over his terror barb

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."

Jaipur/New Delhi, Jul 12: The crisis in Rajasthan Congress has deepened with state Chief Minister Ashok Gehlot and his deputy Sachin Pilot at loggerheads.

While Gehlot is blaming BJP for trying to destabilise the state government by poaching MLAs, Pilot is camping in Delhi to speak to the party leadership regarding the political turmoil in the state.

According to sources, Pilot has sought an appointment with party's interim president Sonia Gandhi but time for the meeting has not yet been given by her. Although Pilot met another party leader to apprise him about the situation in the state and spelled out his grievance.

As of now, many MLAs, who are believed to be in the Pilot camp, are also in Delhi to meet the party leadership. According to sources, the deputy chief minister has the support of nearly 30 Congress MLAs along with many independent legislators.

It is important to note that the controversy broke out in Rajasthan after Special Operation Group (SOG) sent a notice to Sachin Pilot to record his statement in the case registered by SOG in the alleged poaching of Congress MLAs in the state. The clash between Gehlot and Pilot is also over the post of PCC Chief as Gehlot Camp wants that 'One Leader One Post' formula to be implemented in Rajasthan. Currently, Sachin Pilot is heading the PCC besides holding the Deputy CM post.

Sources close to Sachin Pilot have informed that the young leader is upset with the notice issued to him. He believes it is aimed to record his phone calls and keep him under surveillance. Many of Pilot's supporters feel indignation and told Pilot that they cannot work with Ashok Gehlot. Also, Pilot is unlikely to attend the meeting called by Gehlot today, according to sources.

While the top leadership of the party is keeping mum, sources say it is keeping a watch on the development. General Secretary KC Venugopal has taken up the matter of the rift with the party's top brass with them not happy about it.

Rajasthan AICC Incharge Avinash Pandey told media persons: "Everything is under control. Few MLAs had issues and after discussion, they have returned back to Jaipur and others are also in touch. BJP's attempt of destabilising the government will not be successful in Rajasthan and government is stable."

Gehlot also held a meeting with ministers last night in Jaipur.  According to Gehlot camp, the top leadership is apprised of the development of the poaching attempt in the state. Amid Political Crisis Rajasthan CM Ashok Gehlot called a meeting of Ministers and all Cong MLAs tonight at his residence.

The Rajasthan crisis has alerted the other senior leaders of the party who have opined that the Madhya Pradesh incident should not get repeated in Rajasthan.

Former Union Minister and Rajya Sabha MP Kapil Sibbal tweeted, "Worried for our party. Will we wake up only after the horses have bolted from our stables?"

Brasilia, Jul 14: Brazil has reported new 20,286 coronavirus cases in last 24 hours taking the country's total to 1.8 million, Sputnik reported citing the health ministry.

The country's death toll has increased by 733 in the same period of time. The death toll from the infection has touched 72,833.

Over 1.1 million people have recovered from COVID-19 in Brazil since the start of the epidemic in the country, according to the health ministry.

Brazil has the second-highest coronavirus death toll, it is surpassed only by the United States.