Powerful quake sparks panic in Indonesia

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, Mar 4: The UK government has reiterated its concern over the potential impact of the Citizenship Amendment Act (CAA) and said it is continuing to follow the events in India closely.

In response to an urgent question on “Recent Violence in India” tabled by Pakistani-origin Opposition Labour Party MP Khalid Mahmood in the House of Commons on Tuesday, UK’s Minister of State in the Foreign and Commonwealth Office (FCO) Nigel Adams said the UK engages with India at all levels, including on human rights, and also referred to the country's "proud history" of inclusive government and religious tolerance.

"The UK government also have concerns about the potential impact of the legislation (CAA),” said Adams, the Minister for Asia who was standing in for UK Foreign Secretary Dominic Raab, who is on a visit to Turkey.

"It is because of our close relationship with the government of India that we are able to discuss difficult issues with them and make clear our concerns where we have them, including on the rights of minorities. We will continue to follow events closely and to raise our concerns when we have with them,” said the minister.

While Mahmood, who had tabled the urgent question for an FCO statement, described the government response as “facile”, another Pakistani-origin MP Nusrat Ghani called on the government to relay the UK Parliament's concerns to the Indian authorities.

British Sikh Labour MP Tanmanjeet Singh Dhesi said the violence had brought back “painful personal memories” from the 1984 Sikh riots while he was studying in India and fellow Sikh MP Preet Kaur Gill also referenced 1984 in her intervention.

Other MPs sought to highlight the steps taken by the Indian authorities to restore “peace and tranquillity” in Delhi.

“He will be aware that it is not just Muslims who have been killed; Hindus have also been killed as part of the riots,” said Conservative Party MP Bob Blackman.

Scottish National Party (SNP) MP Alyn Smith sought the UK government’s intervention to share best practice around countering the online disinformation campaign being used in India to “inflame tensions”.

“We are in constant contact on these issues, and we know how important this is to Members of Parliament and their constituents, who may have family in the area,” said Adams, in his response.

Jaipur, Jul 14: Sachin Pilot has been removed as Deputy Chief Minister and Rajasthan PCC Chief, announced Congress leader Randeep Singh Surjewala on Tuesday.

"Sachin Pilot, Vishvendra Singh and Ramesh Meena have been removed from the posts of Deputy Chief Minister and Ministerial posts respectively. Sachin Pilot has also been removed as the Rajasthan PCC Chief," said Surjewala.

Govind Singh Dotasra has been appointed as the new PCC chief, he added.

"Sachin Pilot, few Congress Ministers and MLAs got involved in the conspiracy to topple the Congress government by getting entangled within the trap of BJP," he added.

The decision was taken after a Congress Legislature Party (CLP) meeting at the Fairmont Hotel in Jaipur, Rajasthan earlier today.

The Rajasthan Congress is in turmoil over the past few days. While Chief Minister Ashok Gehlot has blamed the BJP for attempting to destabilise the State government by poaching MLAs, Deputy Chief Minister Sachin Pilot has been camping in Delhi.

A controversy broke out in Rajasthan after Special Operation Group (SOG) sent a notice to Pilot to record his statement in the case registered by SOG in the alleged poaching of Congress MLAs in the State.