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How to prevent adverse events of blood clots in AstraZeneca vaccination

Can we ask the vaccinator, "Do you pull back the plunger and then push the vaccine? Do you Aspirate?" When the vaccination for covid started there were reports of worrisome incidents of adverse events post immunisation, the serious complaints being non-specific blood clots. These related to viral vector vaccines of human and non-human source: AstraZeneca and Janssen. How did it happen. There are various views. But here is a suggestion how simply it can be prevented.

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

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The much-touted 'one-nation, one-election' argument was purportedly to prevent wasteful expenditure of the people's money, manpower and deceleration of development, but the committee report when implemented will end up paving the way for holding more elections than currently being held. Because of the logistics and democratic limitations involved, the committee was not expected by commonsense to be out of a loose end either! Those who are alive at that time, and further for ten more years thereafter, can count the rounds and compare with the present numbers. Therefore, either the agenda is different or the 8-volume presentation is faulty/made-up!!!

The manager has defended himself saying that dry ice got mixed with mouth freshener by the negligence of the staff...After taking the mouth freshener the customers felt a burning sensation and started vomiting blood. Five of them were hospitalised. Two are in critical condition.

Harmful effects of dry ice: Ingested, dry ice can burn your mouth, esophagus and stomach as it sublimates on contact with the moisture of the organs and turns into CO2, apart from other damaging physical and chemical changes it induces. The pressure building up in the stomach due to sublimation can also rupture the stomach muscles. It turns lethal. In normal direct handling it leads to frostbite due to the cold temperature.

One of them is seen in CCTV being shot at close range. The motive is suspected to be personal enmity.

TAILPIECE: Almost every other day we hear of shootings in one place or other in the country. India will very soon replace the US as the world's No 1 in the incidence of mass shooting. It will eclipse terrorism as a source of concern. Who can help? At least, has it occurred to anyone's mind?

'This Moment' of Shakti fusion won the Best Global Music Album at the Grammys. Zakir Hussain has won two other awards too. In a great victory for Indians, five of them have won the Grammys this time. In other sections, Taylor Swift got her fourth Album of the Year award and Miley Cyrus got an award for the first time.

The Government scheme provides ₹ 51,000 per wedding of which ₹ 35,000 goes to the girl, ₹ 10,000 for wedding materials and ₹ 6,000 towards expenses for the ceremony.

“Two activists from the environmental movement ‘Riposte Alimentaire’ sprayed pumpkin soup on the armoured glass protecting the Mona Lisa, this Sunday, January 28, 2024, around 10 am (4aET),” a statement from the museum said.

It is not understood how undesirable elements are allowed to get so close to her and play havoc with the artwork. Several times over this has happened in the past, deranged minds masquerading as tourists and cultists venting their frustration.

A Spicejet passenger had a harrowing experience inside a tiny claustrophobic lavatory aboard a Mumbai-Bengaluru flight when he found to his bewilderment that the door was not opening.

Two days earlier, in a similar incident in the area, a domestic help was bitten by a pet dog in the lift when she was going for work.

Tailpiece: Sometimes appearing to outnumnber men and women on the streets, the stray dogs are turning more and more daring with sections of anti-social elements out there to feed and protect them in order to find a window for their unfulfilled love! There is an all-pervading feeling of lack of authority.

Ankit Tiwari had told the employee that “instructions had been received from the Prime Minister’s Office to conduct an enquiry” and reopen the “already disposed of” case and asked him to appear before the ED office at Madurai on October 30, DVAC said. The doctor was allegedly threatened with arrest and told to pay a bribe of Rs 3 cr to avoid the ED probe, which was later negotiated down to Rs 50 lakh.

Tailpiece: We are made to believe RBI, CBI, ED, Judiciary as sacrosanct and all others like railways, transport, revenue, education, PWD departments are composed of us the mortals, absolutely corrupt! As if in the sacrosanct places the angels descend from the heavens to work in the night and fly away before day-break! Let's be true to ourselves, we are all cut from the same cloth.

Apart from cash, Gill had also taken three planes as bribe and two of them were leased out to Redbird Aviation Academy. With the result, flying schools compromised on safety requirements and trainers met with accidents several times.

Five people were arrested from a banquet hall in Sector 51 Noida on Thursday where they were called to hold a rave party in a trap laid by the animal rights group, PFA. They named Yadav but he was not present.

Betting through Dubai-based Mahadev Book in India is conducted through a countrywide network. Probes reveal that the online gambling is worth several millions and top politicians, officials and celebs have been beneficiaries.

TAILPIECE: Polling dates for some States are round the corner. Top politicians have begun their acrimonious debate who looted more, even as Mahadev is washing their dirty laundry in the open ghat. Come what may, one needs to seize power to amass "thy wretched pelf!" One simple question is, why else one should spend lakhs or crores to get elected! A question every Indian should ask to oneself at least once a day!

His inaction amounts to defeating the rights of the people of the State to welfare measures sought to be implemented through the Bills, the Kerala Government's petition submitted, while the State of Tamil Nadu remarked that its "Governor is acting as a political rival."

Tailpiece: Coming up back to back, the petitions in their totality seem to question the provision of Raj Bhavan, and not motives of a Governor as a person.

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The pilots struggled with Emerson to thwart a shut-off as he reached for the T-handles (see pix). Later he admitted to police he had taken psychedelic mushrooms and had a "nervous breakdown."

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The killing of a teacher in France by an Islamic radical last Friday is linked to the Israel-Hamas war in West Asia, say authorities.

Shocking news from the UK: Leading grocers have started bribing policemen with free food and drinks to persuade them to take action against shoplifters.

Shoplifting has risen by about 27 per cent in 10 major cities across the UK this year. The cost of retail crime last year was $2.15 billion. Besides, “We are seeing organised gangs threatening staff with weapons and emptying stores," Helen Dickinson, chief executive of the British Retail Consortium, said. Data shows that the police failed to respond to 73 per cent of serious retail crimes that included assault and abuse of workers, apart from shoplifting.

Isar Mohammad allegedly picked up a banana offered to Ganesh idol on Chaturthi at a makeshift temple in Delhi and consumed it.

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