NEW DELHI, July 23: Blood clots have been reported as one of the AEFIs (Adverse Event Following Immunisation) of viral vector vaccines for covid such as Oxford-AstraZeneca (uses non-human vector), Russian Sputnik and Johnson & Johnson's Janssen in some countries. The CDC too had earlier warned of a rare risk of blood clots with low platelets after receiving Janssen. The condition is called Thrombotic Thrombocytopenic Syndrome (TTS). The clots can form in small blood vessels anywhere in the body. They block the flow of blood, and thereby oxygen, to various organs like brain, kidneys and heart and lead to serious medical problems.

Now, how does Thrombotic Thrombocytopenic Syndrome or blood clots occur post inoculation of viral vector vaccines. There have been debates in the recent times how does it happen. And different views have emerged.

When vaccine enters blood stream, and not the muscle

The vaccinators sometimes accidentally hit your blood vessels, especially when the skin is pinched up, and the needle is not going deep enough to enter the muscles targeted. (There is a network of blood vessels between the skin and the muscle, in the subcutaneous area.) With the result, some of the vaccine enters the blood stream, instead of the muscle tissues. The vaccination therefore will be less effective too, but what is more serious is the response it creates in the blood, even though the vaccine dose is very little. However, the incident is very rare: A one-in-a-thousadnd chance! This clotting event is reportedly occurring in the case of the three adenovirus viral vector vaccines.

Earlier in the month of March German and Norwegian researchers had found that a rare autoimmune reaction is behind several cases of brain blood clotting following AstraZeneca vaccination.

How does this autoimmune reaction take place. Reactions can occur in the bloodstream due to adenovirus particles, whether human or non-human. Receptor interaction between adenovirus particles and platelets has also been reported. The violent immune response that hits randomly results in a cytokine storm leading to coagulation problems, inducing thrombocytopenia, in unpredictable parts.

In England, the vaccinators have to indicate in a form whether blood was seen after the injection!

Pulling the plunger

In the established practice of aspirating the plunger, the needle must be changed and a new dose used if there is blood drawn to the syringe.

The vaccinators, newly recruited on a large scale and possibly less experienced, may not be following the time-tested norm of aspirating the plunger. And, practically, it is not possible to have enough skilled vaccinators to immunise the whole world in a short period. Secondly, in the current exigency when the production of the vaccines for the new pandemic is yet to reach a momentum to provide sufficient quantities, wasting the dose and changing the needle in case the needle hits blood vessels may not be thought to be prudent.

Moreover, the social purpose of vaccinating everybody overrides the minuscule episodes of AEFIs. So let us go ahead and take the jab! Do we stop driving because the rate of road accidents are quite high.

Non-AEFI blood clot

Unlike AEFIs, non-AEFI kind of blood clot episodes are not uncommon, especially among those who sit or lie in one position for long like in air travel or in certain office jobs or patients bedridden etc. There are several types of clots: DVT, PE, Cerebral Thrombosis that can cause haemorrhage, (stroke) etc. In Deep Vein Thrombosis (DVT), blood clots (thrombus) form in the deep veins in the body, usually in the legs. It may cause leg pain or swelling and sometimes there are no symptoms. The clots can travel up. When a blood clot is lodged in an artery in the lung, blocking blood flow, it is called Pulmonary Embolism (PE). In PE there can be a stabbing chest pain, cough and breathlessness. In Cerebral Thrombosis, the impact may be sudden, leading to cerebral infarction in the thrombosed brain - a rare episode, mostly seen among those in the 30s. Headache, blurred vision, seizures, paralysis are the symptoms.

There are modern medicines available today to treat blood clots and blood tests are there to determine if there had been any clots, like D-Dimer protein test and ultrasound/CT scan.

Treatment for non-AEFI DVT and PE

1. Doctors may prescribe blood thinners called anti-coagulants in minor cases and in more serious cases clot busters called thrombolytics are administered.
2. Compression stockings may also be advised.
3. Exercises do help.

Prevention

1. Raise your legs above heart level several times a day
2. Wear loose-fitting clothes
3. Wear compression stockings, if advised
4. Change position frequently while travelling

The new offer will enable H-1B speciality occupation visa holders in the US to apply for a Canadian work permit, while also offering study and work permit opportunities for their family members accompanying them.

The selected applicants will be granted an unrestricted work permit for a maximum period of three years. The IRCC will entertain 10,000 applications. The window is open for one year.

However, drinking alcohol in the trains and metro premises is strictly prohibited. Violators can be booked under the provisions of the Excise Act and the Indian Penal Code.

• Curfew was clamped on areas in Paris on Thursday lasting till Monday. The police apprehend an escalation of volence in the coming days. There will be "actions targeted at the forces of order and the symbols of the State", they said.
• Under present law, the police have brute powers to deal with traffic violators. Young Nahel was shot point-blank by a cop for purported traffic violation and an anticipated crime.

Way back when on June 20 EST after searches were launched, India Travel Times had, on an analysis of the data available, indicated the probability of Titan undergoing a sudden and massive implosion (inward collapse) at great depths. (SEE: Titanic expedition goes missing: A ray of hope from sounds of bang) Now videos taken by a Canadian robot that reached the floor on Thursday evening, June 22, has confirmed it. The fragments are lying scattered. Horizon Arctic's ROV robot found the debris 1600 ft from Titanic bow.

The submersible imploded at 500 metres above sea bed, if we go by our calculations. The water pressure it had to withstand at that point was 2,345 kg per sq inch. The hull was not built to take that, as per the court cases fought by concerned people at the time of building the sub and going by the details revealed in the cancellation of booking by at least one ocean expert.

Sources said some people shifted places on the decks of the boat crammed with over 500 migrants and that tilted the vessel, while others said engine failure. It sank about 75 km from Pylos peninsular jetty on the Greek coast in the Ionian Sea bay in the international waters of the Mediterranean Sea on the intervening night of Tuesday-Wednesday.

ChatGPT has 'duped' a New York lawyer of a federal court. A first-time user, Schwartz asked the bot to do the laborious research work on his behalf and bring out cases similar to the suit he was filing against Avianca airline. About six non-existing cases the chatbot "hallucinated" and Schwartz promptly submitted them. The judge could not find these "legal gibberish" in records and the lawyer stands thoroughly discredited and humiliated. What was all the excitement about ChatGPT? When we approach ChatGPT does it introduce itself as what it is and what it is not?

After reaching New York, the Cessna made a hairpin turn and flew back over Washington DC for inexplicable reasons. But why was the pilot unresponsive to air traffic controllers FAA for two hours in the air and the fighters' flares later? It is said the plane, flying at 34,000 feet, likely lost cabin pressure, the pilot slumping due to hypoxia that sets in in about 20 to 30 seconds! Did the auto pilot take over till fuel lasted? Why did it make a 360 deg turn? The moot point is, how secure is the White House!

• Angered over President Tsai Ing-wen's visit to the US last week, China has launched a three-day military drill to intimidate Taiwan and as a warning to the US. The patrol also has a standby nuclear-armed ballistic missile submarine (see pix below).
• Meanwhile, Tsai's meeting with Kevin McCarthy indicates a bipartisan move in the US, probably a Biden plan for legislation to end the ambiguity over official relations with Taiwan.
• And, next year's election in Taiwan will be fought by the US and China by proxy.
• The US seeks to check the growing Chinese military presence in the Pacific with new alliances.

ANALYSIS: The underlying crime that defendant ex-President Donald Trump, is said to have concealed by falsification of business records - which only will make the whole thing a felony and stand up in the court - is not specified in the indictment which is sketchy: may be because prosecutors can withhold details at this stage. Yet, the hush-money payment being federal election law violations, it cannot come under the jurisdiction and scope of State prosecutors. Deprived of substantial documentary evidence, how will the veteran District Attorney Alwin Bragg navigate through this complexity and prove the intent is to be seen. He will have an option to invoke State tax laws, where violation is serious crime. But that is another case. The trial will drag on for years, anyway!

What next: His fingerprints and mugshot will be taken like any defendant in criminal cases. Arrest is unlikely (Florida Governor can block any warrant, complicating matters). Trump's attorney Tacopina said Trump will turn himself in.

Can Trump contest presidential election? Yes. There is no existing US law to bar him. He can even serve as President from prison.

The loophole: The Grand Jury has no documentary evidence as the NDA was not signed either by Trump or Cohen (Trump's attorney who turned hostile) on his behalf. It is depending on the testimony of Cohen and Daniels.

Where do Republicans stand: At any rate, the 'stormy petrel' has cooked Donald Trump's presidential goose, although he thinks otherwise. The Republicans are a divided lot.

• The shooter, a former student of the school., entered through a side door, after breaking the glass door. She was shot dead by the police, but only after six lives were lost.
• Every time a shooting takes place in the US, every time the White House makes a statement: “Enough is enough.” It's funny, painful and cruel!. Mostly the mass shootings take place in the schools.

In a related development, the USCIS issued a clarification that those who have lost jobs in the ongoing layoffs in the tech sector can apply for a change of non-immigrant status or for a "compelling circumstances" employment authorization document and stay back. This followed an appeal to Biden by thousands of Indians who have been affected by the layoffs.

"Enough!" - In a sheer lack of sense of proportion, President Biden had reacted to yet another boy, just of 15 years, shooting dead five people in North Carolina some time ago, besides sounding like he is going to put an end to American gun violence instantly! After the latest LA episode, he is yet to react! Biden presents a brilliant comparison to Indian Chief Ministers for their stupid reactions in similar circumstances of recent months!

For sure, gun violence will continue as long as the gun is there! Primarily meant for self-defence, how many times - or what percentage of all firings - it has successfully defended the carriers and saved lives and how? Has there been a survey?

Cricketer Rishabh Pant had an attack of sleep at the wheel. The situation of a sudden attack of sleep during travel is not a sleep disorder like narcolepsy but a common occurrence when one does not get enough rest and, surely, is not preventable. Because no driver really knows the moment when sleep attack will come over, says a US study. The consequence can be disastrous, especially in long distance driving.

Darkness has descended on most of the US from the Great Lakes to Mexican border and from the Appalachian mountains in the east to the Rockies mountains in the west without power, and large swathes have gone under the snow. Several thousands of flights have been cancelled due to the howling blizzards and zero-visibility in the past few days and medical services are unable to operate sans accessibility. A fast-moving Guv Kathy Hochul has already declared emergency in New York and closed vulnerable airports. Christmas is washed out.

The story is no different in Canada, coming nearer to the pole where the cold vortex cycle has been blasted off (Arctic blast) by the hot winds from an Atlantic, warmed up due to climate change.

The life-threatening situation will continue for several days more. Too taxing for the hypothalamus!

A half-baked British media report has laid the 'blame' at the Indian High Commission's door for the assumed losses of the British tourists, who have en masse cancelled India trips for want of visas. In the first place, why one must book tour package and then look for visa in a busy season? Because that has been the practice with the tour operators and nothing new. They refund money if visa is not comimg. However, the article is silent on this and implicates the mission alleging it changed the visa rules, while that is contrary to the fact. The UK report, duplicated in India mindlessly, has defamed the Indian High Commission. However, there are some missing links!

A million visitors are queuing up to attend the longest-reigning Queen Elizabeth II Lying-in-State, making history; while a galaxy of world leaders land in London for the State funeral at Westminster Abbey at 11 am (3:30 pm IST) on Monday. It will be a huge gathering of world leaders never seen before. King Charles III hosted a reception at Buckingham Palace for them on Sunday evening. There were 500 dignitaries.

The queue from Southwark Park touches Tower bridge, London bridge, Southwark bridge, Millennium bridge, Blackfriars bridge, Waterloo bridge and Westminster bridge before crossing the Lambeth bridge to enter a zig-zag near the entrance.

The BBC gave a calculation of the length of the queue. The distance from Westminster to Southwark Park, the starting point of the queue, is 11 km. Then there is the zig-zag section of nearly 5 km to rough in. So the queue is meandering slowly up towards Westminster for a total of 16 km! (which in theory becomes a constant). Although, 16 km is quite a lot for standing and moving without any chance to cool your legs for a moment. "Very little opportunity to sit down as the queue will be continuously moving” - the Government itself cautioned a swelling stream of mourners pouring into London from across the kingdom day and night. The time taken can easily be 14 hours! Yet the determination keeps everyone fit as a fiddle.

The calculation doesn't take into account a queue to join the queue that has come up and the last-minute doubling of the official queue into a double lane.

The masses in the queues looked extremely solemn and serious too and displayed an amazing natural discipline that illustrated a national character evolved partly from a thousand years of democratic tradition.

The spectacle was an engineering marvel that took India to the world club of demolitions, even as in less than ten seconds it created a gap up in the sky incomprehensible for the layman. Where has it gone!

WHAT TO DO, WHEN... : IndiaTravelTimes does not guarantee the authenticity of the video (above) of the episode of the flight turbulence at Durgapur airport on May 1, yet this is being put out with a view to familiarising the ordinary fliers with such probabilities lest they are caught unawares and fail to react rationally to handle such terrible situations. The 'eternity' can last up to 15 minutes. Tighten your belts, believe in your pilot and shift your thoughts to reduce disabling anxieties! Rest assured, the aircraft can rock and fall but not more than a hundred feet anyway.