Indra Nooyi inducted into US' National Portrait Gallery

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."

New Delhi, Jun 16: Jet fuel or ATF price on Tuesday was hiked by 16.3 per cent while petrol price was increased by 47 paise per litre and that of diesel by a record 93 paise on the back of firming international oil rates.

Aviation turbine fuel (ATF) price was hiked by ₹5,494.5 per kilolitre (kl), or 16.3 per cent, to ₹39,069.87 per kl in the national capital, according to a price notification by state-owned oil marketing companies.

This is the second straight increase in ATF price this month. Rates were hiked by a record 56.5 per cent (₹12,126.75 per kl) on June 1.

Simultaneously, petrol and diesel prices were hiked for the 10th day in a row.

Petrol price in Delhi was hiked to ₹76.73 per litre from ₹76.26, while diesel rates were increased to ₹75.19 a litre from ₹74.26, the price notification said.

In 10 hikes, petrol price has gone up by ₹5.47 per litre and diesel by Rs 5.8 a litre.

Rates have been increased across the country and vary from state to state depending on the incidence of local sales tax or VAT.

The hike in diesel rates is the highest daily increase since the state-owned fuel retailers started daily revision in rates in May 2017.

Hike for 10th consecutive day

Tuesday’s increase in petrol and diesel price marks the 10th straight day of rise in rates since oil companies on June 7 restarted revising prices in line with costs, after ending an 82-day hiatus.

The freeze in rates was imposed in mid-March soon after the government hiked excise duty on petrol and diesel to shore up additional finances.

Oil PSUs Indian Oil Corp (IOC), Bharat Petroleum Corp Ltd (BPCL) and Hindustan Petroleum Corp Ltd (HPCL) instead of passing on the excise duty hikes to customers adjusted them against the fall in the retail rates that was warranted because of fall in international oil prices.

The June 1 hike in jet fuel price had come after seven consecutive reductions in rates since February. ATF price in Delhi before the reduction cycle began in February was ₹64,323.76 per kilolitre, which got reduced to ₹21,448.62 last month.

Industry officials said the hike was necessitated because benchmark international rates have bounced back from a two-decade low.

While ATF prices are revised on 1st and 16th of every month, petrol and diesel prices are revised on a daily basis.

Oil companies used to revise ATF prices on the first of every month, but adopted fortnightly revisions on March 21 to pass on the benefit of falling international oil prices to airlines.

Feb 14: India will never forget the martyrdom of the security personnel killed in last year's Pulwama attack, Prime Minister Narendra Modi said on Friday.

He termed the slain security personnel were "exceptional individuals" who devoted their lives to serving and protecting the nation.

On February 14 last year, a convoy of vehicles carrying security personnel on the Jammu-Srinagar National Highway was attacked by a vehicle-borne suicide bomber at Lethpora in Pulwama district of Jammu and Kashmir. Forty Central Reserve Police Force (CRPF) personnel were killed in the attack.

"Tributes to the brave martyrs who lost their lives in the gruesome Pulwama Attack last year. They were exceptional individuals who devoted their lives to serving and protecting our nation. India will never forget their martyrdom," tweets PM Modi one year since the Pulwama attack.

"I pay homage to the martyrs of Pulwama Attack. India will forever be grateful of our bravehearts and their families who made supreme sacrifice for the sovereignty and integrity of our motherland," tweets Union Home Minister Amit Shah.