Our prophet and our duty...

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.

New Delhi, Jan 22: "Don't get into a trap. Your security is in your hands," the Border Security Force (BSF) has said issuing its social media rules for its officers and men. It has directed them not to use 42 mobile applications and show caution while using Facebook, Twitter and WhatsApp.

"Be cautious while using social media," said the BSF in a circular issued recently.

"Before using WhatsApp, Facebook, Twitter and other social media platforms, one needs to keep in mind that you are border guarding force and Central Civil Services (Conduct) Rules rule duly are applicable," it said.

It further pointed out that by commenting/writing about or forwarding unverified reports and rumours one violates laws of land.

"Several times unverified reports would be presented in way that they are absolutely true and start believing it. Seeing such post always use your commonsense and never get into the trap (sic.)," it state adding that the anti-national elements uses social media to propagate their agenda to cause unrest in India.

A picture clicked by Border Security Force personnel and posted on a social media platform remains there for always. Therefore, one should use officially approved pictures about any incident or untoward incidents related to Border Security Force, stated the circular. It pointed that unauthorised persons should not engage into taking pictures of the incidents.

It also highlighted how through social media, a few BSF personnel have fallen into trap of espionage racket carried out by enemy countries.

"Our security and respect is in our hands. Always think twice whether you are doing correct by accepting friendship requests from unknown persons, especially women and girls," it cautioned the troopers and officers.

It also highlighted that while going on leave and joining back the force, always follow the rules and regulations laid out for safety and security. "This is for your own safety," it stressed in the end.

The BSF has also issued a list of 42 mobile applications that needs to be completely avoided by serving BSF officers and jawans.

They are MI store, Weibo, Wechat, Shareit, Truecaller, UC News, UC Browser, Beautyplus, NewsDog, Viva Video - QU video Inc, Parallel Space, Apus Browser, Perfect Corp, Virus Cleaner - HI Security Lab, CM browser, MI Community, DU recorder, Vault Hide - No mobile Security, Youcam Makeup, Cachecleaner DU Apps Studio, DU battery saver, DU privacy, 360 security, DU Browser,Clean master - Cheeta Mobile, Baidu Translate, Wonder Camera - Bindu Inc, ES Ifle Explorer, Photo Wonder, QQ international , QQ music, QQ Mail, AA player, QQ News Feed, Wesync, QQ security Center, Selfie City, Mail Master, Mi Video Call -Xaomi and QQ launcher.

Thiruvananthapuram, Mar 12: In the wake of COVID-19 outbreak, Internet service providers in Kerala have agreed to step up the network capacity by 30 to 40 per cent of the present capacity to meet the demand, especially in view of the spurt in work-at-home mode.

"The decision was made at a meeting of representatives of various telecom service providers in Kerala circle and officials of the Telecommunication Department convened by the Secretary, Electronics and IT, following a direction by Chief Minister Pinarayi Vijayan to look into the issue," said a press release by the IT Department.

The decision will be beneficial for those working in IT institutions. The government has come out with a set of suggestions to avoid social gatherings at public places in view of coronavirus spread. Telecom service providers have assured the government that they are well equipped to face the current situation.

The major part of Internet consumption in Kerala is made available through local servers. Moreover, global Internet traffic is very low as compared to the overall consumption. So, increasing the capacity won't be difficult, service providers informed.

"Complaints regarding the low availability of the Internet due to the spurt in consumption of the Internet can be made to the service providers to their complaint redressal number or inform state government call centre (155300). But complaints regarding the insufficiency in the current network infrastructure should be strictly avoided," said the release.

The IT Department will also demand daily reports from various telecom service providers. By analysing these reports, steps for remedies will be taken after bringing the sudden increase in consumption to the service providers.