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Patna, Feb 21: The country is paying the price for failure to send Muslims to Pakistan and bring Hindus to India after the Islamic state came into being at the time of Independence, Union minister Giriraj Singh has said, triggering a fresh controversy.

The BJP leader made the remark in Purnea district in the Seemanchal region of Bihar which has a sizeable Muslim population and where the Begusarai MP was canvassing in favor of the Citizenship (Amendment) Act.

Highlighting the need for such a legislation, he told reporters late Thursday "when our forefathers were fighting for Independence from British rule, Jinnah was pushing for the creation of an Islamic state".

"Our forefathers, however, committed a mistake. Had they ensured that all our Muslim brothers were sent to Pakistan and Hindus brought here, the need for such a move (CAA) would not have arisen. This did not happen and we have paid a heavy price for it," the outspoken BJP leader said.

The CAA, which seeks to fast-track granting citizenship to non-Muslim refugees from Pakistan, Bangladesh and Afghanistan who might have fled their home countries because of religious persecution, has become a major bone of contention since it is feared that a country-wide National Register for Citizens (NRC) may follow.

The Narendra Modi government, which had formerly hinted that a country-wide NRC was on the anvil, seems to have put it on the backburner though a section of citizens across the country, especially Muslims, have been organizing protests out of fear that, if implemented, the NRC may result in a large number of people becoming stateless.

Singh has often been in the crosshairs of the opposition for placing his foot in the mouth. This time, however, his words were frowned upon even by NDA ally Lok Janshakti Party, founded by his cabinet colleague Ram Vilas Paswan and now headed by his son Chirag Paswan.

The young LJP chief, who kicked off a state-wide "Bihar First-Bihari First" yatra here Friday morning, to project the NDAs progressive face ahead of the assembly polls due later this year, expressed strong disapproval of Singh's utterance and noted the coalition had to suffer in the Delhi polls because of "divisive" remarks by BJP leaders.

"We are an NDA constituent but many times our coalition partners say things which the LJP does not at all agree with. This one (Giriraj Singhs statement) is such an example. Had a person of my party spoken in this fashion, I would have taken responsibility and acted," Paswan said.

He said he had placed his view repeatedly on record that the coalition had to suffer on account of divisive remarks, Paswan said in apparent reference to inflammatory speeches by BJP leaders like Union minister Anurag Thakur and BJP MP Parvesh Verma, among others.

"The people of Delhi voted on the basis of performance. We wish they do so again in Bihar and real issues don't get drowned in political cacophony.

"The Nitish Kumar government has accomplished a lot, though much more needs to be achieved. We wish to reach out to people with our vision for the future, said Paswan, before he embarked on the yatra on a customized bus decorated like a chariot in front of which he offered prayers and smashed a coconut.

Meanwhile, Giriraj Singh who loves to wear his Hindu nationalism on the sleeves was busy joining issue with Asaduddin Owaisi's AIMIM which has been under attack for controversial remarks by its leader Waris Pathan.

Sharing video of an old speech by Owaisis brother Akbaruddin which had landed him in jail, besides Pathan's recent remark, Singh asked the opposition RJD-Congress combine in Bihar and the "tukde tukde gang" whether they wanted to "convert India into Pakistan".

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.