A transplant that won a Pakistani heart

[email protected] (The Hindu)
May 24, 2013

Chennai, May 24: When Moulana Mohammed Zubair Ashmi's heart grew large, literally, and failed him, it was another large heart that replaced it. If hearts have nationalities, then the first was Pakistani, and the second, Indian.

The 51-year-old Pakistani religious teacher was diagnosed with a condition calleddilated cardiomyopathy' where the heart is enlarged, becomes weakened and is unable to function well. Doctors had told him that his only option was a heart transplant.

“There is no facility for a transplant back home,” he says over video, still not completely up to hobnobbing with media persons. His folks did a search and contacted K.R.Balakrishnan, director, Cardiac Sciences, Fortis Malar Hospital, here.

Pakistani_heartHe was critically ill even as he was flown to Chennai via Dubai from Lahore.To make matters worse, he was Hepatitis C positive.

Though he spent about two months in the ICU at the hospital, Ashmi's condition continued to deteriorate. Doctors had to find a donor heart for him or put him on an artificial implant device. It turns out a donor became available in March. The family of a 37-year-old man who had met with a road accident and been declared brain dead, came forward to donate the organs.

“Even if there had been a delay of two days, we would have lost him,” says Suresh Rao, chief, Cardiac Anaesthesia and Critical Care, Fortis Malar. He goes on to explain that though the donor and recipient were of two different blood groups, the tissue mapping showed a good and viable match.

Pre- and post-transplant, Ashmi's Hepatitis C viral load had to be brought down, the kidney damage managed, and immuno suppressant therapy had to be modified to suit the patient, Dr. Rao explains.

Traditional immuno suppressants affect the liver, and with an existing hepatitis C infection, extra care had to be paid to that, Dr. Balakrishnan adds.

“It is good government policy in Tamil Nadu that has facilitated a man from Pakistan to get a heart from Chennai. Goes to show that good policies have a major impact on promoting good health, not only locally, but globally too,” he says, further.

Maulana Ashmi is weak, but has gone back to talking at length. He would like to go home, to his family (his wife could not accompany him as she was denied a visa) and back to teaching in his mosque.

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Agencies
July 15,2020

New Delhi, Jul 15: The employees union of state-run telecom operator BSNL will stage protests across the country on Thursday on a host of issues including the cancellation of its 4G tender and non-payment of salaries.

All major unions are organising ‘lunch-hour black-flag' demonstrations throughout the country under the banner of All Unions and Association of BSNL (AUAB), said a statement by AUAB. These demonstrations will be organised, by maintaining social distancing and by taking other precautions, like wearing of masks. The BSNL employees will also wear black-badges the whole day on July 16.

The employees body would demand that BSNL should immediately be allowed to roll out its 4G services and the tender should be issued immediately. Further, they want that in the matter of procuring new equipment and upgradation, there should not be any discrimination between BSNL and other private telecom service providers.

Recently, the Centre cancelled the 4G upgradation tender for BSNL as it had decided to come up with fresh specifications for the upgrade process, in a move to keep Chinese technology companies at bay as the border tussle escalated with the northern neighbour.

The Department of Telecommunications (DoT) would issue a fresh tender for the same, and people in the know said that Chinese companies may not be allowed to participate.

"The agitational programme is being organised to express the deep anguish and resentment of the employees against cancellation of BSNL's 4G tender, cancellation of BSNL's proposal for upgradation of its 49,300 BTSs to 4G, abnormal delay in issuing ‘Add on Order' for 4G equipments, inordinate delay in the implementation of BSNL's Revival Package and against the non-settlement of the burning problems of the employees," said the statement.

The umbrella body of BSNL's employees' unions noted that rolling out of 4G services is the backbone for the revival of this telecom PSU, but the recent cancellation of the tender floated by BSNL for procuring 4G equipment at a cost of Rs 9,300 crore, has brought the company back to square one.

It said that BSNL is already having 49,300 base transceiver stations (BTS), which are 4G compatible and through minor upgradation, all these equipment can be converted into 4G BTSs with an investment of about Rs 1,500 crore.

In addition to this, BSNL could have added another 15,000 BTSs, by placing an Add on Order to the existing mobile tender, it added.

Noting that in October 2019, the PSU could have rolled out pan-India 4G services, AUAB said: "Being the sole owner of the company, the Government of India also cannot shirk its responsibility in this matter."

"Adding insult to injury, the tender floated by BSNL to procure 4G equipment, has been cancelled by the government, based on a complaint from the Telecom Equipments and Services Promotional Council (TEPC)," it said.

AUAB said that BSNL is already lagging four years behind the private operators, in terms of 4G and the cancellation of the tender is going to inordinately delay the company's 4G launch.

Saying that TEPC's contention has been to bar foreign companies from participating in BSNL's tender, AUAB statement pointed out that when private operators are procuring equipment from multinationals, "why BSNL alone should be compelled to procure 4G equipments from domestic vendors, whose 4G technology is not tested or proven so far."

It alleged a conspiracy to destabilise BSNL by disrupting its rolling out of 4G services.

AUAB further said that even after the lapse of nine months, the implementation of the much publicised BSNL's Revival Package is moving at a snail's pace.

"Except the swift retrenchment of 79,000 BSNL employees under VRS, all other assurances given in BSNL's Revival Package have been put in cold storage."

The management should ensure that the salary payment of the employees is made on the last working day of every month. Deductions made from employees' salary, on account of "society dues", should immediately be remitted, it said.

Regarding the monetisation of the company's assets under the revival package, the organisation said that the land asset should not be handed over to corporates, at "throwaway" prices.

"These lands should be sold in a transparent manner and at the prevailing market rates. They should not be sold at book value or at circle rates. The AUAB will strictly monitor these dealings," it said.

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News Network
May 30,2020

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.

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Agencies
January 3,2020

Giving each and every app access to personal information stored on Android smartphones such as your contacts, call history, SMS and photos may put you in trouble as bad actors can easily use these access to spy on you, send spam messages and make calls anywhere at your expense or even sign you up for a premium "service", researchers from cybersecurity firm Kaspersky have warned.

But one can restrict access to such information as Android lets you configure app permissions. 

Giving an app any of these permissions generally means that from now on it can obtain information of this type and upload it to the Cloud without asking your explicit consent for whatever it intends to do with your data.

Therefore, security researchers recommend one should think twice before granting permissions to apps, especially if they are not needed for the app to work. 

For example, most games have no need to access your contacts or camera, messengers do not really need to know your location, and some trendy filter for the camera can probably survive without your call history, Kaspersky said. 

While decision to give permission is yours, the fewer access you hand out, the more intact your data will be.

Here's what you should know to protect your data.

SMS: An app with permission to send and receive SMS, MMS, and WAP (Wireless Application Protocol) push messages, as well as view messages in the smartphone memory will be able to read all of your SMS correspondence, including messages with one-time codes for online banking and confirming transactions.

Using this permission, the app can also send spam messages in your name (and at your expense) to all your friends. Or sign you up for a premium "service." You can see and conrol which apps have these rights by going to the settings of your phone.

Calendar: With permission to view, delete, modify, and add events in the calendar, prying eyes can find out what you have done and what you are doing today and in the future. Spyware loves this permission.

Camera: Permission to access the camera is necessary for the app to take photos and record video. But apps with this permission can take a photo or record a video at any moment and without warning. Attackers armed with embarrassing images and other dirt on you can make life a misery, according to Kaspersky.

Contacts: With permission to read, change, and add contacts in your address book, and access the list of accounts registered in the smartphone, an app can send your entire address book to its server. Even legitimate services have been found to abuse this permission, never mind scammers and spammers, for whom it is a windfall.

This permission also grants access to the list of app accounts on the device, including Google, Facebook, and many other services.

Phone: Giving access to your phone means permission to view and modify call history, obtain your phone number, cellular network data, and the status of outgoing calls, add voicemail, access IP telephony services, view numbers being called with the ability to end the call or redirect it to another number and call any number.

This permission basically lets the app do anything it likes with voice communication. It can find out who you called and when or prevent you from making calls (to a particular number or in general) by constantly terminating calls. 

It can eavesdrop on your conversations or, of course, make calls anywhere at your expense, including to pay-through-the-nose numbers, Kaspersky warned.

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