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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Agencies
June 10,2020

US dictionary Merriam-Webster will update the meaning of the word "racism" after being contacted by a Missouri black woman, who claimed the current definition fell short of including the systematic oppression of people of colour, according to media reports.

"A revision to the entry for racism is now being drafted to be added to the dictionary soon, and we are also planning to revise the entries of other words that are related to racism or have racial connotations," according to a statement of the 189-year-old dictionary shared by Kennedy Mitchum, a recent graduate of Drake University in Iowa, on her Facebook.

Mitchum, 22, emailed the dictionary last month, following the death of African American George Floyd in the custody of four Minneapolis police officers, Xinhua news agency reported.

"I kept having to tell them that definition is not representative of what is actually happening in the world," Mitchum told CNN. "The way that racism occurs in real life is not just prejudice, it's the systemic racism that is happening for a lot of black Americans."

Merriam-Webster's first definition of racism is "a belief that race is the primary determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race."

"It's not just disliking someone because of their race," Mitchum wrote in a Facebook post on Friday. "This current fight we are in is evidence of that, lives are at stake because of the systems of oppression that go hand-in-hand with racism."

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News Network
January 17,2020

New Delhi, Jan 17: E-commerce major Amazon on Friday said it plans to create one million new jobs in India over the next five years through investments in technology, infrastructure and its logistics network.

These jobs are in addition to the seven lakh jobs Amazon's investments have enabled over the last six years in the country.

"Amazon plans to create one million new jobs in India by 2025," the company said in a statement, adding that the jobs - created both directly and indirectly - will be across industries, including information technology, skill development, content creation, retail, logistics, and manufacturing.

Amazon.com Inc chief Jeff Bezos had on Wednesday announced USD 1 billion (over Rs 7,000 crore) investment in India to help bring small and medium businesses online and committed to exporting USD 10 billion worth of India-made goods by 2025.

"We are investing to create a million new jobs here in India over the next five years," Bezos said.

"We’ve seen huge contributions from our employees, extraordinary creativity from the small businesses we've partnered with, and great enthusiasm from the customers who shop with us—and we’re excited about what lies ahead," Bezos added.

India has prioritised job creation and skilling initiatives – including the training of more than 400 million people by 2022 – in rural and urban areas.

"Amazon’s job creation commitment and investment in traders and micro, small and medium enterprises (MSMEs) complement this social inclusion and social mobility efforts by creating more opportunities for people in India to find employment, build skills, and expand entrepreneurship opportunities," the statement said.

The new investments will help to hire talent to fill roles across Amazon in India, including software development engineering, cloud computing, content creation, and customer support.

Since 2014, Amazon has grown its employee base more than four times, and last year inaugurated its new campus building in Hyderabad – Amazon’s first fully-owned campus outside the United States and the largest building globally in terms of employees (15,000) and space (9.5 acres).

The investments will also help in expanding growth opportunities for the more than 5,50,000 traders and micro, small, and medium-sized businesses – including local shops – through programs like Saheli, Karigar, and “I Have Space”.

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