19 people killed in explosion at Tehran medical facility

New Delhi, Jan 3: US aviation regulator Federal Aviation Administration on Thursday warned America's airlines and their pilots that there is risk involved in operating flights in Pakistan airspace due to "extremist or militant activity", according to an official document.

"Exercise caution during flight operations. There is a risk to US civil aviation operating in the territory and airspace of Pakistan due to extremist/militant activity," said the US Federal Aviation Administration (FAA) in a notice to airmen (NOTAM) dated December 30, 2019.

The NOTAM is applicable to all US-based airlines and US-based pilots.

The US regulator said in its NOTAM that there continues to be a risk to US civil aviation sector from attacks against airports and aircraft in Pakistan, particularly for aircraft on the ground and aircraft operating at low altitudes, including during the arrival and departure phases of flights.

"The ongoing presence of extremist/militant elements operating in Pakistan poses a continued risk to US civil aviation from small-arms fire, complex attacks against airports, indirect weapons fire, and anti-aircraft fire, any of which could occur with little or no warning," it said.

The FAA said that while, to date, there have been no reports of man-portable air defense systems or Manpads being used against the civil aviation sector in Pakistan, some extremist or terrorist groups operating there are suspected of having access to these Manpads.

"As a result, there is potential risk for extremists/militants to target civil aviation in Pakistan with Manpads," it said.

The regulator added that pilots or airlines must report safety or security incidents - which may happen in Pakistan - to the FAA.

Pakistan on July 16 last year opened its airspace for India after about five months of restrictions imposed in the wake of a standoff with New Delhi.

Following the Balakot airstrikes by the Indian Air Force, Pakistan had closed its airspace on February 26 last year.

Pakistan in October last year had denied India's request to allow Prime Minister Narendra Modi's VVIP flight to use its airspace for his visit to Saudi Arabia over the Jammu and Kashmir issue.

Doha, Feb 29: The United States signed a landmark deal with the Taliban on Saturday, laying out a timetable for a full troop withdrawal from Afghanistan within 14 months as it seeks an exit from its longest-ever war.

President Donald Trump urged the Afghan people to embrace the chance for a new future, saying the deal held out the possibility of ending the 18-year conflict.

"If the Taliban and the government of Afghanistan live up to these commitments, we will have a powerful path forward to end the war in Afghanistan and bring our troops home," he said on the eve of the event in Doha.

Secretary of State Mike Pompeo arrived in the Qatari capital to witness the signing of the accord, while Defence Secretary Mark Esper was in Kabul for a separate joint declaration with the Afghan government.

The agreement is expected to lead to a dialogue between the Kabul government and the Taliban that, if successful, could ultimately see the Afghan war wind down.

But the position of the Afghan government, which has been excluded from direct US-Taliban talks, remains unclear and the country is gripped by a fresh political crisis amid contested election results.

The United States and its allies will withdraw all their forces from Afghanistan within 14 months if the Taliban abide by the Doha agreement, Washington and Kabul said in a joint statement.

After an initial reduction of troops to 8,600 within 135 days of Saturday's signing, the US and its partners "will complete the withdrawal of their remaining forces from Afghanistan within 14 months... and will withdraw all their forces from remaining bases", the declaration stated.

The Doha accord was drafted over a tempestuous year of dialogue marked by the abrupt cancellation of the effort by Trump in September.

The signing comes after a week-long, partial truce that has mostly held across Afghanistan, aimed at building confidence between the warring parties and showing the Taliban can control their forces.

NATO Secretary General Jens Stoltenberg heralded the agreement as a "first step to lasting peace".

"The way to peace is long and hard. We have to be prepared for setbacks, spoilers, there is no easy way to peace but this is an important first step," the Norwegian former prime minister told reporters in Kabul.

Since the US-led invasion that ousted the Taliban after the September 11, 2001 attacks, America has spent more than $1 trillion in fighting and rebuilding in Afghanistan.

About 2,400 US soldiers have been killed, along with unknown tens of thousands of Afghan troops, Taliban fighters and Afghan civilians.

The insurgents said they had halted all hostilities Saturday in honour of the agreement.

"Since the deal is being signed today, and our people are happy and celebrating it, we have halted all our military operations across the country," Taliban spokesman Zabihullah Mujahid told AFP.

Close to 30 nations were represented at Saturday's signing in the Qatari capital.

While Kabul will not be represented at the Doha ceremony, set for 1245 GMT, it will send a six-person taskforce to the Qatari capital to make initial contact with the Taliban political office, established in 2013.

Any insurgent pledge to guarantee Afghanistan is never again used by jihadist movements such as Al-Qaeda and the Islamic State group to plot attacks abroad will be key to the deal's viability.

The Taliban's sheltering of Al-Qaeda was the main reason for the US invasion following the 9/11 attacks.

The group, which had risen to power in the 1990s in the chaos of civil war, suffered a swift defeat at the hands of the US and its allies. They retreated before re-emerging to lead a deadly insurgency against the new government in Kabul.

After the NATO combat mission ended in December 2014, the bulk of Western forces withdrew from the country, leaving it in an increasingly precarious position.

While Afghans are eager to see an end to the violence, experts say any prospective peace will depend on the outcome of talks between the Taliban and the Kabul government.

But with President Ashraf Ghani and rival Abdullah Abdullah at loggerheads over contested election results, few expect the pair to present a united front, unlike the Taliban, who would then be in a position to take the upper hand in negotiations.

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."