A transplant that won a Pakistani heart

[email protected] (The Hindu)
May 24, 2013

Chennai, May 24: When Moulana Mohammed Zubair Ashmi's heart grew large, literally, and failed him, it was another large heart that replaced it. If hearts have nationalities, then the first was Pakistani, and the second, Indian.

The 51-year-old Pakistani religious teacher was diagnosed with a condition calleddilated cardiomyopathy' where the heart is enlarged, becomes weakened and is unable to function well. Doctors had told him that his only option was a heart transplant.

“There is no facility for a transplant back home,” he says over video, still not completely up to hobnobbing with media persons. His folks did a search and contacted K.R.Balakrishnan, director, Cardiac Sciences, Fortis Malar Hospital, here.

Pakistani_heartHe was critically ill even as he was flown to Chennai via Dubai from Lahore.To make matters worse, he was Hepatitis C positive.

Though he spent about two months in the ICU at the hospital, Ashmi's condition continued to deteriorate. Doctors had to find a donor heart for him or put him on an artificial implant device. It turns out a donor became available in March. The family of a 37-year-old man who had met with a road accident and been declared brain dead, came forward to donate the organs.

“Even if there had been a delay of two days, we would have lost him,” says Suresh Rao, chief, Cardiac Anaesthesia and Critical Care, Fortis Malar. He goes on to explain that though the donor and recipient were of two different blood groups, the tissue mapping showed a good and viable match.

Pre- and post-transplant, Ashmi's Hepatitis C viral load had to be brought down, the kidney damage managed, and immuno suppressant therapy had to be modified to suit the patient, Dr. Rao explains.

Traditional immuno suppressants affect the liver, and with an existing hepatitis C infection, extra care had to be paid to that, Dr. Balakrishnan adds.

“It is good government policy in Tamil Nadu that has facilitated a man from Pakistan to get a heart from Chennai. Goes to show that good policies have a major impact on promoting good health, not only locally, but globally too,” he says, further.

Maulana Ashmi is weak, but has gone back to talking at length. He would like to go home, to his family (his wife could not accompany him as she was denied a visa) and back to teaching in his mosque.

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News Network
June 18,2020

Beijing, Jun 18:  Besides washing hands and wearing masks, it is also important to close the toilet lid before flushing to contain the spread of COVID-19, as per a new study.

According to a new study cited by The Washington Post, scientists who simulated toilet water and airflows, have found that flushing a toilet can generate a plume of virus-containing aerosol particles that is widespread and can linger in the air long enough to be inhaled by others. The novel coronavirus has been found in the faeces of COVID-19 patients, but it remains unknown whether such clouds could contain enough virus to infect a person.

"Flushing will lift the virus up from the toilet bowl," co-author Ji-Xiang Wang, who researches fluids at Yangzhou University in Yangzhou, China, said in an email. Wang stressed that bathroom users "need to close the lid first and then trigger the flushing process" and wash hands properly if the closure is not possible. As one flushes the toilet with the lids open, bits of faecal matter swish around so violently that they can be propelled into the air, become aerosolised and then settle on the surroundings.

Experts call it the "toilet plume".Age-old studies have been made to understand the potential for airborne transmission of infectious disease via sewage, and the toilet plume's role. Scientists who have seeded toilet bowls with bacteria and viruses have found contamination of seats, flush handles, bathroom floors and nearby surfaces. This is one reason we are told to wash our hands after visiting the toilet. Public bathrooms are well known to contribute to the spread of viruses that transmit via ingestion, such as the noroviruses that haunt cruise ships. However, their role in the transmission of respiratory viruses has not been established, said Charles P Gerba, a microbiologist at the University of Arizona."The risk is not zero, but how great a risk it is, we do not know. The big unknown is how much virus is infectious in the toilet when you flush it ... and how much virus does it take to cause an infection," said Gerba, who has studied the intersection of toilets and infectious disease for 45 years.

A study published in March in the journal Gastroenterology found significant amounts of coronavirus in the stool of patients and determined that viral RNA lasted in faeces even after the virus cleared from the patients` respiratory tracts. While another study in the journal Lancet found coronavirus in faeces up to a month after the illness had passed.

Scientists around the world are now studying sewage to track the spread of the virus. According to the researchers, the presence of the virus in excrement and the gastrointestinal tract raises the prospect of transmission via toilets, because many COVID-19 patients experience diarrhoea or vomiting.

A study of air samples in two hospitals in Wuhan, China found that although coronavirus aerosols in isolation wards and ventilated patient rooms were very low, "it was higher in the toilet areas used by the patients".The Centers for Disease Control and Prevention (CDC) says it remains "unclear whether the virus found in faeces may be capable of causing COVID-19," and "there has not been any confirmed report of the virus spreading from faeces to a person".For now, the CDC characterises the risk as low based on observations from previous outbreaks of other coronaviruses such as severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). Wang decided to use computer models to simulate toilet plumes while isolating at home, as per Chinese government orders and thinking about how a fluids researcher "could contribute to the global fight against the virus".

Published in the journal Physics of Fluids, the study found that flushing of both single-inlet toilets, which push water into the bowl from one port, and annular-inlet toilets, which pour water into the bowl from the rim's surrounding edge with even greater energy, results in "massive upward transport of virus".

Particles can reach heights of more than three feet and float in the air for more than a minute, it found. The paper recommends not just lid-closing and hand-washing, it urges manufacturers to produce toilets that close and self-clean automatically. It also suggests that toilet-users should wipe down the seat. Gerba, however, said seats should not be a major concern.

Research has found that public and household toilet seats are typically the cleanest surfaces in restrooms, he said, probably because so many people already wipe them off before using them. Also, he said of SARS-CoV-2, the virus that causes COVID-19, "I don't think it's butt-borne, so I don`t think you have to worry."Gerba, who has been studying coronavirus transmission for two decades to investigate the role of a toilet flushing in a SARS outbreak stresses "flush and run" when using a public toilet without a lid. Gerba also said that people should wash hands well post-flushing and use hand sanitiser after leaving the restroom. "Choose well-ventilated bathrooms if possible and do not hang around the restroom in any case," added Gerba.

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News Network
February 5,2020

Feb 5: Tesla is making Elon Musk a lot richer without paying him a dime.

A blistering stock rally has bolstered the value of CEO Musk's 19% stake in the electric car maker by $16 billion since the start of 2020, to $30 billion.

Tuesday's steep climb in the share price could sweeten Musk's payday under his record-breaking compensation package, which is built on stock options that rely on market value targets. Two milestones have now been achieved that could see Musk unlock options worth $1.8 billion.

The controversial chief executive, who is also the majority owner and CEO of rocket maker SpaceX, recently testified that he did not have a lot of cash as he successfully defended himself in a defamation lawsuit. He previously has taken loans using his Tesla shares as collateral.

Musk does not take a salary, choosing instead a risky options package that envisions the stock market value of Tesla rising to $650 billion over 10 years, a prospect that was derided by some investors when the deal was announced in 2018.

That target now looks less crazy. Shares of Tesla have rallied over 50% since the company posted its second consecutive quarterly profit last Wednesday, which was viewed as a major accomplishment for a company competing against established automotive heavyweights including General Motors Co  and BMW.

Tesla shares have climbed about 400% since early June, helped by the company's better-than-expected financial results and ramped-up production at its new car factory in Shanghai.

On Tuesday, Tesla surged as much as 24% before falling back in the final minutes of the trading session to end the day up 13.7%. That put its market capitalization at $160 billion, almost twice the combined value of Ford Motor and General Motors.

The shares had also rallied on Monday, partly fueled by Panasonic Corp's 6752.T saying its automotive battery venture with Tesla was profitable for the first time.

The options Musk was awarded in 2018 vest incrementally based on targets for Tesla's stock market value and its financial performance. The market capitalization would have to sustainably rise by $50 billion increments over the agreement's 10-year period, with the full package payout reached if the market cap reaches $650 billion, as well as the company's meeting revenue and profit targets.

Musk is on his way to seeing his first two tranches of options vest. He achieved operational targets on revenue and adjusted earnings last year.

The rise in Tesla's market capitalization last month to a target of $100 billion opened the way for Musk's first tranche of options to vest. With Tuesday's surging share price, the market capitalization blew past the second target of $150 billion, opening the way for the second tranche to vest. Tesla's market capitalization must stay at or above each target level for one- and six-month averages for each set of options to vest.

Tesla was valued at about $52 billion when shareholders approved the pay package in March 2018, a time when the company faced a cash crunch, production delays and increasing competition from rivals.

A full payoff for Musk would surpass anything previously granted to U.S. executives, according to Institutional Shareholder Services, a proxy advisor that recommended investors reject the pay package deal at the time.

Musk currently owns about 34 million Tesla shares, and his compensation package would let him buy another 20.3 million shares if all his options tranches vest.

When Tesla unveiled Musk’s package, it said he could in theory reap as much as $55.8 billion if no new shares were issued. However, Tesla has since awarded stock to employees and last year sold $2.7 billion in shares and convertible bonds, diluting the value of the stock.

Musk has transformed Tesla from a niche car maker with production problems into the global leader in electric vehicles, with U.S. and Chinese factories. So far it has stayed ahead of more established rivals including BMW and Volkswagen.

Many investors remain skeptical that Tesla can consistently deliver profit, cash flow and growth. More Wall Street analysts rate Tesla "sell" than "buy," and the company's stock is the most shorted on Wall Street.

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Agencies
June 5,2020

With the scrapping of Mitron and Remove China Apps from its Play Store gaining a lot of attention in India, Google on Thursday said that it removed a video app "for a number of technical policy violations", while adding that it also does not allow an app that "encourages or incentivizes users into removing or disabling third-party apps".

Both the apps became immensely popular in India within a short span of time due to the prevailing anti-China sentiment amid border tensions between India and China in Ladakh and calls by Indian activists to boycott Chinese products.

Reports suggested that the Mitron app is a repackaged version of TicTic, which is a TikTok clone.

The Remove China Apps was designed to help users identify applications of Chinese origin.

Without naming the apps, Google hinted that the Mitron app may make a comeback on the Play Store once it fixes some technical issues, but the chances of the Remove China Apps are thin.

"We have an established process of working with developers to help them fix issues and resubmit their apps. We've given this developer (of the video app) some guidance and once they've addressed the issue the app can go back up on Play," Sameer Samat, Vice President, Android and Google Play, said in a statement.

Google said that its Android app store was designed to provide a safe and secure experience for the consumers while also giving developers the platform and tools they need to build sustainable businesses.

Samat said that Google Play recently suspended a number of apps for violating the policy that it does not allow an app that "encourages or incentivizes users into removing or disabling third-party apps or modifying device settings or features unless it is part of a verifiable security service".

"This is a longstanding rule designed to ensure a healthy, competitive environment where developers can succeed based upon design and innovation. When apps are allowed to specifically target other apps, it can lead to behaviour that we believe is not in the best interest of our community of developers and consumers," Samat said.

"We've enforced this policy against other apps in many countries consistently in the past - just as we did here," he added.

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