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
February 29,2020

Ahmedabad, Feb 29: The presence of two feral pigeons onboard a GoAir flight at the airport in Ahmedabad in Gujarat created a flutter among the amused passengers, even though the avian surprise did not lead to any untoward incident or delay in the flight.

The incident took place on Friday when the passengers were boarding the Ahmedabad-Jaipur flight.

"Two pigeons had found their way inside the flight G8 702 while the passengers were boarding," an airline statement said on Saturday.

"The crew immediately shooed away the birds. The flight took off at its scheduled time at 5 p.m.," it added.

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News Network
April 28,2020

Los Angeles, Apr 28: People who experience loss of smell as one of the COVID-19 symptoms are likely to have a mild to moderate clinical course of the disease, according to a study which may help health care providers determine which patients require hospitalisation.

The findings, published in the journal International Forum of Allergy & Rhinology, follows an earlier study that validated the loss of smell and taste as indicators of infection with the novel coronavirus, SARS-CoV-2.

According to the scientists from the University of California (UC) San Diego Health in the US, patients who reported loss of smell were 10 times less likely to be hospitalised for COVID-19 compared to those without the symptom.

"One of the immediate challenges for health care providers is to determine how to best treat persons infected by the novel coronavirus," said Carol Yan, first author of the current study and rhinologist from the UC San Diego Health.

"If they display no or mild symptoms, can they return home to self-quarantine or will they likely require hospitalisation? These are crucial questions for hospitals trying to efficiently and effectively allocate finite medical resources," Yan said.

The findings, according to the researchers, suggest that loss of smell may be predictive of a milder clinical course of COVID-19.

"What's notable in the new findings is that it appears that loss of smell may be a predictor that a SARS-CoV-2 infection will not be as severe, and less likely to require hospitalisation," Yan said.

"If an infected person loses that sense, it seems more likely they will experience milder symptoms, barring other underlying risk factors," she added.

Risk factors for COVID-19 previously reported by other studies include age, and underlying medical conditions, such as chronic lung disease, serious heart conditions, diabetes, and obesity.

In the current study, the scientists made a retrospective analysis between March 3 and April 8 including 169 patients who tested positive for COVID-19 at UC San Diego Health.

They assessed olfactory and gustatory data for 128 of the 169 patients, 26 of whom required hospitalisation.

According to the researchers, patients who were hospitalised for COVID-19 treatment were significantly less likely to report anosmia or loss of smell -- 26.9 per cent compared to 66.7 per cent for COVID-19-infected persons treated as outpatients.

Similar percentages were found for loss of taste, known as dysgeusia, they said.

"Patients who reported loss of smell were 10 times less likely to be admitted for COVID-19 compared to those without loss of smell," said study co-author Adam S. DeConde.

"Moreover, anosmia was not associated with any other measures typically related to the decision to admit, suggesting that it's truly an independent factor and may serve as a marker for milder manifestations of Covid-19," DeConde said.

The researchers suspect that the findings hint at some of the physiological characteristics of the infection.

"The site and dosage of the initial viral burden, along with the effectiveness of the host immune response, are all potentially important variables in determining the spread of the virus within a person and, ultimately, the clinical course of the infection," DeConde said.

If the SARS-CoV-2 virus initially concentrates in the nose and upper airway, where it impacts olfactory function, that may result in an infection that is less severe and sudden in onset, decreasing the risk of overwhelming the host immune response, respiratory failure, and hospitalisation, the scientists added.

"This is a hypothesis, but it's also similar to the concept underlying live vaccinations," DeConde explained.

"At low dosage and at a distant site of inoculation, the host can generate an immune response without severe infection," he added.

Loss of smell, according to the study, might also indicate a robust immune response which has been localised to the nasal passages, limiting effects elsewhere in the body.

Citing the limitations of the study, the scientists said they relied upon self-reporting of anosmia from participants, which posed a greater chance of recall bias among patients once they had been diagnosed with COVID-19.

They added that patients with more severe respiratory disease requiring hospitalisation may not be as likely to recognise or recall the loss of smell.

So the researchers said more expansive studies are needed for validating the results.

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Agencies
January 26,2020

New Delhi, Jan 26: Google on Sunday marked India's 71st Republic Day by dedicating a doodle illustrating the country's rich cultural heritage that permeates and unites the diverse nation.

From its world-famous landmarks like the Taj Mahal and India Gate, to the wide array of fauna such as its national bird (the Indian peafowl), to classical arts, textiles, and dances, the doodle, designed by Singapore-based artist Meroo Seth, brings together the rich cultural heritage of the country.

Republic Day marks the completion of India's transition towards becoming an independent republic after its constitution came into effect. The governing document had taken nearly three years of careful deliberation to finalise, and its eventual enactment was joyfully celebrated across the country.

While the Constitution was adopted by the Indian Constituent Assembly on 26 November 1949, it came into effect on January 26 -- a day when Declaration of Indian Independence (Purna Swaraj) was proclaimed by the Indian National Congress back in 1929, as opposed to the Dominion status offered by the British Regime.

Festivities embody the essence of diversity found in one of the world's most populous nations, celebrated over a three-day period with cultural events displaying national pride.

Last year's doodle on Republic Day, designed by artist Reshidev RK, had featured Rashtrapati Bhavan in the background along with a display of the country's iconic monuments and heritage.

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