IMF calls for 'urgent' action by India amid slowdown

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."

London, May 14: Fugitive liquor baron Vijay Mallya on Thursday urged the Central government to accept his offer to repay 100 per cent of his loan dues and close the case against him.

While congratulating the Centre for introducing Rs 20 lakh crore relief package to boost the economy amid the coronavirus lockdown, Mallya, lamented that his repeated attempts to pay back his dues have been ignored by the Indian government.

"Congratulations to the Government for a Covid 19 relief package. They can print as much currency as they want BUT should a small contributor like me who offers 100% payback of State-owned Bank loans be constantly ignored? Please take my money unconditionally and close," he tweeted.

Earlier this month, Mallya had sought permission to appeal against a ruling ordering his extradition to India in Britain's highest court the UK Supreme Court.

The application comes two weeks after the High Court in London - the UK's second-highest court - dismissed Mallya's appeal against a lower court ruling that he be sent to India to face charges of defrauding a consortium of Indian banks of more than Rs 9,000 crores relating to the collapse of Kingfisher Airlines in 2012.

Dirbrugarh, Feb 4: Three persons, including two BJP activists, have been arrested for allegedly attacking the residence of Union minister Rameswar Teli during anti-CAA protests in Assam, police said on Monday.

The house of Teli, Union Minister of State for Food Processing, in Upper Assam's Duliajan town was attacked on December 11 during the statewide stir against the contentious Citizenship (Amendment) Act, 2019.

"Based on CCTV footages, Debajit Hazarika, Vicky Sonar and Arup Kahar were arrested. We had picked them up on Sunday," Dibrugarh Superintendent of Police, Sreejith T told PTI.

A total of 18 persons have been arrested so far for allegedly attacking Teli's house, he said.

"These three persons were also involved in pelting stones on a police party during protests in Duliajan," Sreejith said.

A BJP source confirmed that Debajit Hazarika and Vicky Sonar are party activists.

Family members of the accused have given statements to the police on the arrested persons' alleged role in violence and attacking Teli's house, sources said.

When contacted, Teli said, "I do not know for what reasons they were apprehended. But if police arrested them after proper investigation, then there must be some truth. The trio stays near my house. They always attended my programmes with their families."

A total of 88 people have been arrested so far from Dibrugarh district for their alleged involvement in violence during protests against the Act.