Dawood Ibrahim linked to British properties: Report

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."

Mar 16: An investigation into Coffee Day Enterprises Ltd., initiated by its board after the death of founder V.G. Siddhartha, is likely to conclude that at least Rs 2,000 crore is missing from its accounts, according to people familiar with the matter.

The months-long probe following the suicide of Siddhartha in July examined the financial transactions of India’s largest coffee chain and its dealings with dozens of private companies owned by the entrepreneur. The draft report, running more than a hundred pages, points to thousands of rupees that have gone missing, said the people, asking not to be named because the details aren’t public. It also details hundreds of transactions between the founder’s listed and personal businesses that were not conducted at arm’s length, they said.

Though the report is in its final stages, the precise details could change before its release, expected as early as this week, the people said. The missing funds could total more than Rs 2500 crore, one person said.

“The investigation report is still a work in progress, and not finalized,” a spokesman for the company said. “The board of directors and the company are unaware of its content at this point of time. Hence it would be premature to speculate on the investigation findings.”

The priority for management and Siddhartha’s family “is to keep the business running in a challenging environment and meet all stakeholder commitments, including 30,000 jobs associated with the group,” the spokesman added.

The disappearance of the 59-year-old founder last year stunned India’s business community. He had last been seen telling his driver he was going for an evening walk along a bridge in southern India; his body was found by local fishermen two days later. A letter delivered to Coffee Day’s board and employees, which appeared to be signed by Siddhartha, described massive debts and complained of pressure from lenders and tax authorities. It claimed he bore sole responsibility for the company’s financial transactions.

The probe began about a month later when the company brought in Ashok Kumar Malhotra, a retired senior official from India’s federal enforcement agency, to investigate. A senior lawyer practicing in India’s top court is assisting, the company said in a regulatory filing at the time.

The publicly traded Coffee Day was supposed to be India’s answer to Starbucks Corp. More than 1,500 of its Café Coffee Day outlets blanketed cities and highways, with affordable options for the country’s aspiring middle classes. The chain’s tagline: “A lot can happen over coffee.”

But the empire has been battered since the founder’s death. Its shares plummeted about 90% and its market value dropped to about $80 million. Trading was suspended in February.

India’s regulators are tracking the situation and may use the company’s final report as part of a deeper dive into its internal affairs, the people said. Coffee Day showed about Rs 2400 crore in cash and cash equivalents on its balance sheet as of March 2019, the most recent figures the company has issued.

After the death of Siddhartha however, the company faced a severe liquidity crunch and had “zero cash in the bank,” according to one of the people. It struggled with day-to-day expenses and paying salaries has been a strain, the person said.

The draft report details personal guarantees by Siddhartha for loans taken by Coffee Day, and his unsecured loans at high interest rates from local money lenders, the people said. It also probes Coffee Day’s defaults to coffee growers and other vendors, they said.

A related issue is that coffee estates owned by Siddhartha and several employees had been used as collateral for bank loans. The report found that valuations for properties were inflated to get the loans, one person said.

Investigators have examined several theories about what happened to the company’s money, including whether Coffee Day was manipulating its finances to show cash and profit and whether Siddhartha was taking cash out of the listed company to pay off a large investor to whom he had guaranteed a return, the person said. From the filings of his listed and private companies, the entrepreneur’s loans had totaled more than Rs 10,000 crore, and he had been squeezed by borrowing to repay interest on earlier loans, the person said.

In the letter purportedly from Siddhartha, the entrepreneur said he had tried his best but failed as an entrepreneur. “I am solely responsible for all mistakes,” the letter read. “Every financial transaction is my responsibility. My team, auditors and senior management are totally unaware of all my transactions. The law should hold me and only me accountable, as I have withheld this information from everybody including my family.”

As the report nears release, Coffee Day is finalizing a deal with Blackstone Group Inc. for real estate assets. A large tranche of the payment is due in about a week, one person said.

Coffee Day said it is working to reduce its debt load by divesting non-core enterprises.

“The aim is to save employment and preserve this iconic Indian brand,” the spokesman said.

New Delhi, Jul 18: With 34,884 people testing positive for coronavirus in the last 24 hours, India's Covid-19 caseload surged to 10,38,716 while 6,53,750 patients have recovered from the disease so far, according to data by the Union Health Ministry.

The death toll due to Covid-19 rose to 26,273 with 671 fatalities reported in a day, the data updated at 8 am on Saturday showed.

At present, there are 3,58,692 active cases in the country, while 6,53,750 people have recovered so far and one has migrated.

"Around 62.94 per cent of patients have recovered so far," an official said.

The total number of confirmed cases includes foreigners.

This is the third consecutive day when the number of Covid-19 cases increased by more than 30,000.

According to the Indian Council of Medical Research (ICMR), a cumulative total of 1,34,33,742 samples have been tested for COVID-19 up to July 17 with 3,61,024 samples being tested on Friday.

Of the 671 deaths reported in the last 24 hours, 258 are from Maharashtra, 115 from Karnataka, 79 from Tamil Nadu, 42 from Andhra Pradesh, 38 from Uttar Pradesh, 26 each from West Bengal and Delhi, 17 from Gujarat, nine each from Jammu and Kashmir and Punjab, and eight each from Madhya Pradesh and Rajasthan.

Telangana has reported seven fatalities followed by Haryana with five deaths, Jharkhand, Bihar and Odisha reported four each, Assam and Puducherry have registered three each, Chhattisgarh and Goa reported two each while Kerala and Uttarakhand have registered a fatality each.

Of the total 26,273 deaths reported so far, Maharashtra accounted for the highest 11,452 fatalities followed by Delhi with 3,571 deaths, Tamil Nadu 2,315, Gujarat 2,106, Karnataka 1,147, Uttar Pradesh 1,084, West Bengal 1,049, Madhya Pradesh 697 and Rajasthan 546.

So far 534 people have died of COVID-19 in Andhra Pradesh, 403 in Telangana, 327 in Haryana, 239 in Punjab, 231 in Jammu and Kashmir, 201 in Bihar, 83 in Odisha, 51 in Uttarakhand and Assam each, 46 in Jharkhand and 38 in Kerala.

Puducherry has registered 25 deaths, Chhattisgarh 23, Goa 21, Himachal Pradesh and Chandigarh 11 each, Arunachal Pradesh and Tripura three each, Meghalaya and Dadra and Nagar Haveli and Daman and Diu two each while Ladakh has reported one fatality.

The Health Ministry stressed that more than 70 per cent of the deaths occurred due to comorbidities.

Maharashtra has reported the highest number of cases at 2,92,589 followed by Tamil Nadu at 1,60,907, Delhi at 1,20,107, Karnataka at 55,115, Gujarat at 46,430, Uttar Pradesh at 45,163 and Telangana at 42,496.

The number of Covid-19 cases has gone up to 40,646 in Andhra Pradesh, 38,011 in West Bengal, 27,789 in Rajasthan, 24,797 in Haryana, 23,589 in Bihar and 21,081 in Madhya Pradesh.

Assam has instances of 20,646 infections, Odisha 16,110 and Jammu and Kashmir 12,757 cases. Kerala has reported 11,066 novel coronavirus infections so far, while Punjab has 9,442 cases.

A total of 4,964 have been infected by the virus in Chhattisgarh, 4,921 in Jharkhand, 4,102 in Uttarakhand, 3,304 in Goa, 2,366 in Tripura, 1,832 in Puducherry, 1,800 in Manipur, 1,417 in Himachal Pradesh and 1,151 in Ladakh.

Nagaland has recorded 956 Covid-19 cases, Chandigarh 660, Arunachal Pradesh 609 and Dadra and Nagar Haveli and Daman and Diu together have reported 585 cases.

Meghalaya has reported 403 cases, Mizoram 282, Sikkim has registered 266 infections so far, while Andaman and Nicobar Islands has recorded 194 cases.

"Our figures are being reconciled with the ICMR," the ministry said, adding that 163 cases are being reassigned to states.

State-wise distribution is subject to further verification and reconciliation, it added.