A transplant that won a Pakistani heart

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.

Pune, Jul 24: Agile and dexterous, 85-year-old Shantabai Pawar wields sticks with absolute ease as she displays 'lathi-kathi' on the streets of Pune.

A video of her, displaying her skills in the Indian martial art form for livelihood, has gone viral on social media.

Pawar told media persons that she learnt the art form when she was only eight and has been practising it since then. The ancient martial art s believed to be linked to Dombari community, a nomadic tribe in Maharashtra.

"I have been pursuing the art of lathi-kathi since I was eight. I have never left it. It is part of me and it is an honour to practice it. My father taught me this. He taught me to work hard," Pawar told media persons.

In the video, the sari-clad octogenarian takes a warrior-like stride and effortlessly rotates a stick several times in a second in her hand and around her head and then does it with two sticks together with a smile on her face. She also tosses a stick in the air and catches it with ease.

The assembled gathering is impressed and enthused.

"People come and say, 'Well done Daadi!' I practice it to earn money for my children and grandchildren," she said.

Pawar leaves her home in the morning in the conditions created by coronavirus and performs the art form on roads and streets.

"I go to various areas to perform the art form and people give money," she said.

The artiste also uses thali and stick to gather the attention of people as most of them are indoors due to conditions created by COVID-19.

Senior citizens have been advised against venturing out due to their greater susceptibility to coronavirus but Pawar said she is not afraid to step out.

"People do advise me to not go out due to fear of COVID-19 but I am not scared. Whenever I step out, I pray to my God and he has kept me safe so far," she said.

Aishwarya Kale, a dancer and the person who uploaded the video on social media, said that it is "only an artist who can understand what help another artist needs".

"I was in that area shopping for some items and it was then I saw her performing and thought that I should film her and upload her video on social media. But I never thought that the video would go viral and she would receive financial help not just from people in the country but overseas as well," Kale told media persons.

"She is now getting honour for her craft that she couldn't get in the last 85 years. I feel good that through my small video, her art form has become viral," she added. 

Feb 27: With the window to submit comments on India's proposed personal data protection law closing on Tuesday, a period of anxious wait for final version of the Bill started for social media firms.

This comes even as global Internet companies have called on the government for improved transparency related to intermediary Guidelines (Amendment) Rules and allay fears about the prospect of increased surveillance and prompting a fragmentation of the Internet in India that would harm users.

As per the proposed amendments, an intermediary having over 50 lakh users in the country will have to be incorporated in India with a permanent registered office and address.

When required by lawful order, the intermediary shall, within 72 hours of communication, provide such information or assistance as asked for by any government agency or assistance concerning security of the state or cybersecurity.

This means that the government could pull down information provided by platforms such as Wikipedia, potentially hampering its functioning in India.

In the open letter to IT Minister Ravi Shankar Prasad, leading browser and software development platform like Mozilla, Microsoft-owned GitHub and Cloudflare earlier called for improved transparency by allowing the public an opportunity to see a final version of these amendments prior to their enactment.

According to a Business Insider report, Indian users may lose access to Wikipedia if the new intermediary rules for internet and social media companies are approved.

Since the rules would require the website to take down content deemed illegal by the government, it would require Wikipedia to show different content for different countries.

Anusha Alikhan, senior communications director for Wikimedia told Business Insider that the platform is built though languages and not geographies. Therefore, removing content from one country, while it is still visible to other country users may not work for the company’s model.

India is one of Wikipedia’s largest markets. Over 771 million Indian users accessed the site in just November 2019.

Also read: Explained: What is the Personal Data Protection Bill and why you should care

The Personal Data Protection Bill, 2019, which was introduced in Lok Sabha in the winter session last year, was referred to a Joint Parliamentary Committee (JPC) of both the Houses.

The government last month decided to seek views and suggestions on the Bill from individuals and associations and bodies concerned and the last date for submitting the comments was on Tuesday.

Prasad, while introducing the Personal Data Protection Bill, 2019, in the Lok Sabha on December 11, announced that the draft Bill empowers the government to ask companies including Facebook, Google and others for anonymised personal data and non-personal data.

There was a buzz when the Bill's latest version was introduced in the Lok Sabha, especially the provision seeking to allow the use of personal and non-personal data of users in some cases, especially when national security is involved.

Several legal experts red-flagged the issue and said the provision will give the government unaccounted access to personal data of users in the country.

In their submission to the JPC, several organisations also flagged that the power to collect non-personal and anonymised data by the government without notice and consent should not form part of the Bill because of issues regarding effective anonymisation and potential abuse.

"Clauses 35 and 36 of the Bill provide unbridled access to personal data to the Central Government by giving it powers to exempt its agencies from the application of the Bill on the basis of various broad worded grounds," SFLC.in, a New Delhi-based not-for-profit legal services organisation, commented.

The Software Alliance, also known as BSA, a trade group which includes tech giants such as Microsoft, IBM and Adobe, among others said that the current version of the privacy bill pose substantial challenges, including the sweeping new powers for the government to acquire non-personal data, restrictions on data transfers, and local storage requirements.

"We urge the Joint Parliamentary Committee, as it considers revisions to the Bill, to eliminate provisions concerning non-personal data from the Personal Data Protection Bill and to remove the data localisation requirements and restrictions on international data flows," said Venkatesh Krishnamoorthy, Country Manager-India, BSA.

The Personal Data Protection (PDP) Bill, 2019 draws its origins from the Justice B.N. Srikrishna Committee on data privacy, which produced a draft of legislation that was made public in 2018 ("the Srikrishna Bill").

The mandatory requirement for storing a mirror copy of all personal data in India as per Section 40 of the Srikrishna Bill has been done away with in the PDP Bill, 2019, meaning that companies like Facebook and Twitter would be able to store data of Indian users abroad if they so wish.

But the bill prohibits processing of sensitive personal data and critical personal data outside India.

What is more, what constitutes critical data has not been clearly defined.

As per the proposals, social media companies will have to modify their application as they are required to have a system in place by which a user can verify themselves.

So legal experts believe that some system to upload identification documents should be there and something like the Twitter blue tick mark should be there to identify verified accounts.

"The 2019 Bill introduces a new category of data fiduciaries called social media intermediaries ('SMIs'). SMIs are a subcategory of significant data fiduciaries ('SDFs') and will be notified by the Central government after due consultation with the DPA, or the Data Protection Authority. Clause 26(4) of the Bill defines SMIs as intermediaries who primarily or solely enable online interaction between two or more users," SFLC.in said.

"On a plain reading of the definition, online platforms like Facebook, Twitter, YouTube, TikTok, ShareChat and WhatsApp are likely to be notified as SMIs under the Bill," it added.