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Mumbai, Jan 28: Flag carrier Air India has kept one of its 423-seater jumbo planes ready in Mumbai for the evacuation of Indian citizens from Wuhan in China in the wake of the coronavirus outbreak in that country, an official source said on Tuesday.

The airline is awaiting necessary approvals from the ministries of external affairs and health to operate the special flight, the source said. The health ministry's nod is required because the operating crew has to fly in a virus outbreak territory.

"We have kept a Boeing 747-400 ready in Mumbai to operate an evacuation flight to China whenever we get a go ahead from the government," the source said.

Some 250 Indians are to be evacuated.

At a meeting of top secretaries called by the cabinet secretary on Monday, the government decided to be prepared for possible evacuation of Indian nationals in Wuhan.

Accordingly, Ministry of External Affairs will make a request to the Chinese authorities for evacuation of Indian nationals, mostly students, stuck in Wuhan city. The Ministry of Civil Aviation and Ministry of Health will make arrangements for transport and quarantine facilities respectively, an official release said on Monday.

Wuhan along 12 other cities have been completely sealed by the Chinese authorities to stop the virus from spreading. The death toll climbed to 80 with 2,744 confirmed cases.

New Delhi, Feb 17: Two alleged criminals were killed in an exchange of fire with the Special Cell of Delhi Police at Pul Pehlad Pur area in New Delhi on Monday morning, officials said.

The encounter took place around 5 am, they said.

Raja Qureshi and Ramesh Bahadur, who were injured during the encounter, were rushed to a nearby hospital, where they were declared brought dead by doctors, Deputy Commissioner of Police (Special Cell) P S Kushwah said.

According to police, the two men were involved in multiple cases of murder and robbery.

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.