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May 30: Patients undergoing surgery after contracting the novel coronavirus are at an increased risk of postoperative death, according to a new study published in The Lancet journal which may lead to better treatment guidelines for COVID-19.

In the study, the scientists, including those from the University of Birmingham in the UK, examined data from 1,128 patients from 235 hospitals from a total of 24 countries.

Among COVID-19 patients who underwent surgery, they said the death rates approach those of the sickest patients admitted to intensive care after contracting the virus.

The scientists noted that SARS-CoV-2 infected patients who undergo surgery, experience substantially worse postoperative outcomes than would be expected for similar patients who do not have the infection.

According to the study, the 30-day mortality among these patients was nearly 24 per cent.

The researchers noted that mortality was disproportionately high across all subgroups, including those who underwent elective surgery (18.9 per cent), and emergency surgery (25.6 per cent).

Those who underwent minor surgery, such as appendicectomy or hernia repair (16.3 per cent), and major surgery such as hip surgery or for colon cancer also had higher mortality rates (26.9 per cent), the study said.

According to the study, the mortality rates were higher in men versus women, and in patients aged 70 years or over versus those aged under 70 years.

The scientists said in addition to age and sex, risk factors for postoperative death also included having severe pre-existing medical problems, undergoing cancer surgery, undergoing major procedures, and undergoing emergency surgery.

"We would normally expect mortality for patients having minor or elective surgery to be under 1 per cent, but our study suggests that in SARS-CoV-2 patients these mortality rates are much higher in both minor surgery (16.3%) and elective surgery (18.9%)," said study co-author Aneel Bhangu from the University of Birmingham.

Bhangu said these mortality rates are greater than those reported for even the highest-risk patients before the pandemic.

Citing an example from the 2019 UK National Emergency Laparotomy Audit report, he said the 30-day mortality was 16.9 per cent in the highest-risk patients.

Based on an earlier study across 58 countries, Bhangu said the 30-day mortality was 14.9 per cent in patients undergoing high-risk emergency surgery.

"We recommend that thresholds for surgery during the SARS-CoV-2 pandemic should be raised compared to normal practice," he said.

"For example, men aged 70 years and over undergoing emergency surgery are at particularly high risk of mortality, so these patients may benefit from their procedures being postponed," Bhangu added.

The study also noted that patients undergoing surgery are a vulnerable group at risk of SARS-CoV-2 exposure in hospital.

It noted that the patients may also be particularly susceptible to subsequent pulmonary complications, due to inflammatory and immunosuppressive responses to surgery and mechanical ventilation.

The scientists found that overall in the 30 days following surgery 51 per cent of patients developed a pneumonia, acute respiratory distress syndrome, or required unexpected ventilation.

Nearly 82 per cent of the patients who died had experienced pulmonary complications, the researchers said.

"Worldwide an estimated 28.4 million elective operations were cancelled due to disruption caused by COVID-19," said co-author Dmitri Nepogodiev from the University of Birmingham.

"Our data suggests that it was the right decision to postpone operations at a time when patients were at risk of being infected with SARS-CoV-2 in hospital," Nepogodiev said.

According to the researchers, there's now an urgent need for investment by governments and health providers in to measures which ensure that as surgery restarts patient safety is prioritised.

They said this includes the provision of adequate personal protective equipment (PPE), establishment of pathways for rapid preoperative SARS-CoV-2 testing, and consideration of the role of dedicated 'cold' surgical centres.

London, Feb 21: Scientists have discovered a new species of land snail, and have named it Craspedotropis Greta Thunberg in honour of the Swedish activist Greta Thunberg for her efforts to raise awareness about climate change.

According to the study, published in the Biodiversity Data Journal, the newly discovered species belongs to the so-called caenogastropods -- a group of land snails known to be sensitive to drought, temperature extremes, and forest degradation.

The scientists, including evolutionary ecologist Menno Schilthuizen from Naturalis Biodiversity Center in the Netherlands, said the snails were found very close to the research field station at Kuala Belalong Field Studies Centre in Brunei.

They added that the snails were discovered at the foot of a steep hill-slope, next to a river bank, foraging at night on the green leaves of understorey plants.

The effort aided by amateur scientist J.P. Lim, who found the first individual of the snail said, "Naming this snail after Greta Thunberg is our way of acknowledging that her generation will be responsible for fixing problems that they did not create."

"And it's a promise that people from all generations will join her to help," Lim said.

The researchers said they approached Thunberg who said that she would be "delighted" to have this species named after her.

The study work including, fieldwork, morphological study, and classification of identified specimen was carried out in a field centre with basic equipment and no internet access, the scientists said.

According to the study, the work was done by untrained ‘citizen scientists’ guided by experts, on a 10-day taxon expedition.

"While we are aware that this way of working has its limitations in terms of the quality of the output (for example, we were unable to perform dissections or to do extensive literature searches), the benefits include rapid species discovery and on-site processing of materials," the researchers wrote in the study.

Mumbai, Jun 12: Following an overwhelming response for the mega rights issue of Mukesh Ambani-owned Reliance Industries, the partly paid-up rights shares are set to debut on stock exchanges on June 15.

The biggest ever Rs 53,124 crore rights issue was subscribed 1.59 times and received bids worth Rs 84,000 crore on June 3.

Reliance said the rights issue saw a huge investor interest, including from lakhs of small investors and thousands of institutional investors, both Indian and foreign.

In 2019, Ambani said in the Reliance's annual general meeting that the company will be net zero debt by March 2021. The company is on course to achieve its target ahead of the deadline.

"In spite of the COVID-19 crisis and the lockdowns, the due-diligence by Saudi Aramco for the planned investment in the O2C business is on track as both the parties are committed and actively engaged," he said recently.

"With a strong visibility to these equity infusions, Reliance is set to achieve net zero debt status ahead of its own aggressive timeline. We believe rights issue was a part of the company's strategy of deleveraging its balance sheet," said Ambani.