In U-Turn on Seizing Jaish Headquarters, Pakistan Calls It a "Seminary"

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."

Kanpur, Jul 10: Kanpur encounter main accused Vikas Dubey, who was injured in an encounter with the police, died on Friday, the police said.

"Gangster Vikas Dubey arrested for killing eight policemen is dead," confirmed the police.

According to SP Kanpur West Anil Kumar, gangster Vikas Dubey attempted to flee after the car overturned. Dubey attempted to flee by snatching pistol of the injured policemen. However, he was shot in the retaliatory firing.

"Vikas Dubey attempted to flee by snatching pistol of the injured policemen after the car overturned. Police tried to make him surrender, during which he fired at the policemen. He was injured in retaliatory firing by police. He was later rushed to the hospital," SP Kanpur West told reporters here.

Dubey, the main accused in the Kanpur encounter was arrested by the police in Ujjain on Thursday morning. He was on the run for the last six days and had come to Ujjain to offer prayers at Temple, where he was identified by a security guard at the shrine.

The gangster is the main accused in the encounter that took place in Bikru village in Chaubeypur area of Kanpur last week, in which a group of assailants allegedly opened fire on a police team, which had gone to arrest Dubey. Eight police personnel were killed in the encounter.

Dubey managed to escape after the killing.  The Uttar Pradesh police launched a hunt for him and raised the bounty on him to Rs 5 lakh.

Bahua Dubey and Prabhat Mishra, close aides of the main accused, were killed in separate encounters in Etawah and Kanpur respectively, on Thursday.

The main accused's other aide Shyamu Bajpai was arrested by the Chaubeypur police following an encounter. He carried a reward of Rs 25,000, the police informed on Wednesday. Earlier the same day, Uttar Pradesh's Special Task Force (STF) gunned down Vikas Dubey's close aide Amar Dubey in Hamirpur district.

Seoul, Apr 26: A train presumed to belong to North Korean's Kim Jong-un has been spotted at a station in the state's eastern coastal town of Wonsan amid speculation about the leader's health, a US monitor said on Sunday, citing commercial satellite imagery on the region, Yonhap news agency reported.

According to 38 North-- a website devoted to analysis about North Korea, the imagery showed a train "probably belonging to Kim Jong Un parked at the Leadership Railway Station servicing his Wonsan compound since at least April 21."

"The approximately 250-metre long train, although partially covered by the station's roof, can be seen at a railway station reserved for use by the Kim family. It was not present on April 15 but was present on both April 21 and 23," it said.

"The train's presence does not prove the whereabouts of the North Korean leader or indicate anything about his health, but it does lend weight to reports that Kim is staying at an elite area on the country's eastern coast," it added.

The report came as rumours about his health have spread as Kim apparently skipped an important annual visit to the Kumsusan Palace of the Sun on the occasion of the April 15 birthday of late state founder and his grandfather, Kim Il-sung.

CNN intensified the speculation by reporting earlier last week that the United States is looking into intelligence that Kim is "in grave danger" after surgery.

Seoul officials have disputed recent media reports about Kim, saying there have been no unusual signs from the North. Some said that Kim is presumed to be staying in Wonsan for unspecified reasons.

Washington has also dismissed the reports, with US President Donald Trump calling such reports "incorrect" in a press briefing late last week.

On Saturday, other media reports stated that China has dispatched a team of medical doctors and officials to North Korea "to advise on" Kim, citing multiple unnamed people familiar with the situation.

North Korea's state media, however, has not made any mention of Kim's public activity for two weeks since he was last seen in April 11 presiding over a major party meeting, though it has reported on his handling of routine state affairs, such as sending diplomatic letters.
But not all speculation has proven to be false.

When he was absent from public for about a month in 2014, speculation arose about his health and a political crisis in the secretive state. He later reemerged with a cane and a limp reportedly after having a cyst removed from his ankle.

The 36-year-old leader is known to have various health problems apparently caused by obesity and heavy smoking. He took office as leader of the communist state after his father, Kim Jong-il, died of a heart attack in late 2011.