Scientists discover mechanism that may prevent death of cells

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.

New delhi, Jun 22: As consumer sentiment runs high amid growing chorus for boycotting Chinese goods in the country, the fluid market situation offers new opportunities for various smartphone makers, especially the non-Chinese ones like Samsung, Apple, Nokia, Asus and others, to realign their strategies and regain the lost market share in the face of fierce Chinese competition.

The challenge here would be not to look "opportunistic" and leverage the current explosive situation on just riding on the anti-Chinese sentiment but to offer real challenges in the form of top-end devices with solid internals at affordable price points, feel industry experts.

"The current market conditions in India are fluid and open up new opportunities for smartphone original equipment manufacturers (OEMs) to focus and leverage," Prabhu Ram, Head-Industry Intelligence Group, CyberMedia Research (CMR), told IANS.

In the first quarter (January-March) this year, Samsung's shipments were driven by its upgraded A and M series (A51, A20s, A30s, and M30s).

According to Counterpoint Research, Samsung managed to hold third position in Q1 2020 due to launches across several price tiers, especially in the affordable premium segment (S10 Lite, Note 10 Lite).

The South Korean smartphone maker last week announced a Rs 4,000 price drop on its popular Galaxy Note10 Lite smartphone that will now cost Rs 37,999 (6GB variant).

Earlier this month, Samsung launched two new smartphones, Galaxy M11 and Galaxy M01, with powerful batteries under Rs 15,000 in India.

Galaxy M11 comes in two variants. The 3GB+32GB will be priced at Rs 10,999 while the higher 4GB+64GB variant will be available for Rs 12,999.

Samsung has also launched an affordable Galaxy A21s smartphone with quad-camera system and 5,000mAh battery at a starting price of Rs 16,499.

Also read: Boycott China? OnePlus 8 Pro sold out within minutes of going on sale

On the other hand, Apple grew a strong 78 per cent YoY driven by strong shipments of iPhone 11 and multiple discounts on platforms like Flipkart and Amazon in Q1, according to Counterpoint.

Apple has also brought its cheapest yet powerful new iPhone SE that costs Rs 38,900 (64GB) in India with a special offer from HDFC Bank. The new iPhone SE is powered by the Apple-designed A13 Bionic, the fastest chip in a smartphone and features the best single-camera system ever in an iPhone.

According to Tarun Pathak, Associate Director, Counterpoint Research, consumer sentiments are running high and a section of users will look for alternatives, benefitting global and Indian brands.

"However, we do not think non-Chinese brands will run aggressive campaigns based on the situation as it might look like being opportunistic," Pathak told media.

It may actually let brands of Chinese origin try to run aggressive campaigns on their presence and scale.

"Some of these Chinese brands have been active in scaling up local value addition, creating jobs and investing in research and development," Pathak noted.

On Saturday, market leader Xiaomi said that it is "more Indian" than any other smartphone brand.

The company's India head Manu Kumar Jain said that the company's mobile phone R&D centre and product team is in India, it employs 50,000 people in the country, the entire leadership team is Indian and that the company pays its taxes in India.

Earlier, Realme India CEO Madhav Sheth who is also very active on social media said that Realme is an Indian startup.

In his latest episode of Ask Madhav' series on YouTube, Sheth said: "I can proudly say Realme is an Indian startup, which is now a global MNC (multinational corporation)".

Citing the current dismal aviation scenario, Air India is terminating the services of trainee cabin crew and cabin crew by withdrawing the offer of employment of those who were under training.

As per sources, the new crew and trainee pilots might reduce contracts from five years to one year. Sources said Air India is terminating 1,200 crew and employees who are more than 55-yr-old including 190 trainee pilots.

In a letter reviewed by IANS, Air India has informed an applicant who had been selected as cabin crew in August 2019 subject to successful completion of training.

"On behalf of Air India we would like to thank you for the interest shown by you in joining our organization. However, in view of the current aviation scenario, it would not be possible for Air India to impart any further training to you for engaging your services," the company said.

"In view of the above reasons, which are beyond the control of the company, it has been decided to discontinue your training arrangements and dispense with the offer of engagement with immediate effect. The bank guarantee furnished by you at the time of joining is returned herewith," Air India told the cabin crew.

"Once again on behalf of Air India we thank you for your cooperation and trust that you will appreciate the circumstances under which we are constrained to discontinue the training arrangements," the carrier said.