Taliban love triangle: Woman gunned down for affair with commander

Washington, Apr 28: After nearly three weeks in an intensive care unit in Los Angeles, doctors treating 41-year-old Broadway actor Nick Cordero for COVID-19 were forced to amputate his right leg.

The flow of blood had been impeded by a blood clot: yet another dangerous complication of the disease that has been bubbling up in frontline reports from China, Europe and the United States.

To be sure, so-called "thrombotic events" occur for a variety of reasons among intensive care patients, but the rates among COVID-19 patients are far higher than would be otherwise expected.

"I have had 40-year-olds in my ICU who have clots in their fingers that look like they'll lose the finger, but there's no other reason to lose the finger than the virus," Shari Brosnahan, a critical care doctor at NYU Langone said.

One of these patients is suffering from a lack of blood flow to both feet and both hands, and she predicts an amputation may be necessary, or the blood vessels may get so damaged that an extremity could drop off by itself.

Blood clots aren't just dangerous for our limbs, but can make their way to the lungs, heart or brain, where they may cause lethal pulmonary embolisms, heart attacks, and strokes.

A recent paper from the Netherlands in the journal Thrombosis Research found that 31 percent of 184 patients suffered thrombotic complications, a figure that the researchers called "remarkably high" -- even if extreme consequences like amputation are rare.

Behnood Bikdeli, a doctor at New York-Presbyterian Hospital, assembled an international consortium of experts to study the issue. Their findings were published in the Journal of The American College of Cardiology.

The experts found the risks were so great that COVID-19 patients "may need to receive blood thinners, preventively, prophylactically," even before imaging tests are ordered, said Bikdeli.

What exactly is causing it? The reasons aren't fully understood, but he offered several possible explanations.

People with severe forms of COVID-19 often have underlying medical conditions like heart or lung disease -- which are themselves linked to higher rates of clotting.

Next, being in intensive care makes a person likelier to develop a clot because they are staying still for so long. That's why for example people are encouraged to stretch and move around on long haul flights.

It's also now clear the COVID-19 illness is associated with an abnormal immune reaction called "cytokine storm" -- and some research has indicated this too is linked to higher rates of clotting.

There could also be something about the virus itself that is causing coagulation, which has some precedent in other viral illnesses.

A paper in the journal The Lancet last week showed that the virus can infect the inner cell layer of organs and of blood vessels, called the endothelium. This, in theory, could interfere with the clotting process.

According to Brosnahan, while thinners like Heparin are effective in some patients, they don't work for all patients because the clots are at times too small.

"There are too many microclots," she said. "We're not sure exactly where they are."

Autopsies have in fact shown some people's lungs filled with hundreds of microclots.

The arrival of a new mystery however helps solve a slightly older one.

Cecilia Mirant-Borde, an intensive care doctor at a military veterans hospital in Manhattan, told AFP that lungs filled with microclots helped explain why ventilators work poorly for patients with low blood oxygen.

Earlier in the pandemic doctors were treating these patients according to protocols developed for acute respiratory distress syndrome, sometimes known as "wet lung."

But in some cases, "it's not because the lungs are occupied with water" -- rather, it's that the microclotting is blocking circulation and blood is leaving the lungs with less oxygen than it should.

It has just been a little under five months since the virus emerged in Wuhan, China, and researchers are learning more about its impact every day.

"While we react surprised, we shouldn't be as surprised as we were. Viruses tend to do weird things," said Brosnahan.

While the dizzying array of complications may seem daunting, "it's possible there'll be one or a couple of unifying mechanisms that describe how this damage happens," she said.

"It's possible it's all the same thing, and that there'll be the same solution."

Islamabad/Dhaka, May 25: The coronavirus pandemic and lockdowns coupled with travel restrictions and social distancing norms have muted the Eid celebrations in Pakistan and Bangladesh as worshippers in the two Muslim-majority countries marked the end of Ramzan in strictly-regulated prayer congregations.

A large number of people in the two countries were forced to stay indoors on the occasion of Eid al-Fitr, marking the end of the fasting month of Ramzan, due to the fears of contracting the novel coronavirus which has killed nearly 3.5 lakh people and infected over 5.4 million across the world.

In Pakistan, the government has issued strict instructions to observe social distancing while offering Eid prayers and asked people to avoid visiting relatives and hosting parties.

As the railways remained closed, many people could not travel to their hometowns for the most important festival.

Eid congregations were held at open places, mosques and Eidgahs in all major cities and towns while following strict standard operating procedures (SOPs) of social distancing and other precautionary measures. But in some areas, the people did not adhere to the SOPs and were seen thronging to their favourite shops to celebrate Eid.

Pakistan Prime Minister's Special Assistant on Health Zafar Mirza on Friday said the deadly infection would continue to multiply if precautions are not taken.

Earlier this month, the government announced the lifting of the countrywide lockdown imposed to curb the spread of the COVID-19 in phases, even as infections continued to rise in the country.

Pakistan's coronavirus cases on Monday reached 56,349 with 1,748 new patients while the death toll climbed to 1,167 after 34 people lost their lives in the last 24 hours.

The trajectory showed that the number was steadily going up with authorities fearing a rise in cases in the wake of the easing of lockdown before Eid.

But Prime Minister Imran Khan cited the economic havoc the virus restrictions had wreaked on citizens as the reason behind the decision to ease the restrictions.

He urged Pakistanis to forgo the traditional Eid festivity in view of the hundreds of fatalities caused by the coronavirus and the lives lost in Friday's plane crash in Karachi.

Ninety-seven people, including nine children, were killed and two passengers miraculously survived a fiery crash when a Pakistan International Airlines plane with 99 travellers on board plunged into a densely populated residential area near the Jinnah International Airport.

Most of the victims were travelling home to celebrate Eid.

In Bangladesh, millions of Muslims joined the strictly-regulated prayer congregations across the country.

Thousands of worshippers attended the prayer services at the Baitul Mukarram National Mosque in Dhaka while following the health and social distancing protocols to limit the spread of the coronavirus, bdnews24.com reported.

Despite the government directive for children and senior citizens not to participate in Eid prayers, many children and people aged over 60 attended the Eid prayers. Although social distancing rules were maintained to a large extent, people were seen flouting the norms, the report said.

As per the government order, no Eid congregation will be held in an open space, but people can perform the Eid prayers in mosques. However, everyone coming to the mosques for prayer must wear a mask, follow social distancing and other hygiene rules, said Islamic Foundation Secretary Kazi Nurul Islam.

On Sunday, Bangladesh reported 28 new fatalities, the highest single-day increase, bringing the death toll to 480.

The number of coronavirus cases in the country rose to 33,610 after 1,532 people tested positive on Sunday.

Beijing, Jun 11: Floods and mudslides in south China have uprooted hundreds of thousands of people and left dozens dead or missing, state media reported Thursday.

The bad weather has wreaked havoc on popular tourist areas that had already been battered by months of travel restrictions during the coronavirus outbreak.

Torrential downpours unleashed floods and mudslides that caused nearly 230,000 people to be relocated and destroyed more than 1,300 houses, official state news agency Xinhua reported, citing the Ministry of Emergency Management.

In southern Guangxi Zhuang Autonomous Region, six people were reported dead and one missing, Xinhua said.

Streets were waterlogged in popular tourist destination Yangshuo, forcing residents and visitors to evacuate on bamboo rafts.

The local government said more than 1,000 hotels had been flooded and more than 30 tourist sites damaged.

One owner of a family-run hotel told Xinhua that the guest rooms were submerged in one metre (three feet) of rainwater.

The extreme weather has dealt a hefty blow to the region's tourism sector, which is still reeling from the COVID-19 epidemic.

The emergency management ministry said there were direct economic losses of over 4 billion yuan (more than $550 million) from the flooding, Xinhua reported.

In Hunan Province, at least 13 people were killed in rain-triggered disasters, and another eight people are missing or killed in southwestern Guizhou province, according to the local emergency response departments, Xinhua said.

The heavy downpours began at the beginning of June and have led to "dangerously high water levels" in 110 rivers, Xinhua reported.

Further rainstorms are expected in the next few days across the south.