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UAE expat beats deadly bacterial infection after battling for life for 54 days

An Indian expatriate has beaten a rare and deadly bacterial infection after struggling between life and death for 54 days in a private hospital in the United Arab Emirates.

Nitesh Sadanand Madgaocar, a 42-year-old driver from the Indian state of Goa, was diagnosed with cepacia syndrome – a bacterial infection with a high mortality rate of 75 percent.

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Cepacia syndrome is a fatal condition affecting the respiratory system combined with multiple organ failures.

Presented with critical COVID-19 symptoms

A resident of the UAE for 27 years, Nitesh had returned to Abu Dhabi after a vacation in the last week of August. He developed fever and weakness while quarantining in his room in Musaffah.

On August 28, two days after the onset of fever, his condition worsened. Nitesh called up his employer, who took him to Burjeel Medical City, a quaternary care hospital at Mohammed Bin Zayed City in Musaffah.

At the emergency department, Nitesh reported having high fever, fatigue, pain in the joints, shortness of breath, and loss of smell and appetite.

Upon medical evaluation, he was found to be diabetic and had pneumonia. His inflammatory markers were high, and he had tachycardia (faster heart rates) and crepitation (explosive sounds) in both lungs.

He was immediately admitted to ICU as his oxygen saturation level was critically low. Put on high flow nasal oxygen, he was administered intravenous antibiotics by the doctors to treat pneumonia.

Initially, Nitesh had responded well to medicines and started showing signs of recovery. It had been a week, and the doctors were to shift him to room when his condition worsened again.

Nitesh developed a high fever and tachycardia and had to continue in the ICU for few more days.

Diagnosis of cepacia syndrome

Nitesh was shifted to room care on the second week of September as his condition improved following the treatment. While he was recuperating in the ward, abscesses started surfacing on his skin and joints. The first abscess had developed on the medial portion of his left knee, from which the doctors drained 90 ml of fluid.

Later, abscesses surfaced on different parts of Nitesh’s body, and he developed effusion in the left knee. His health started to deteriorate, and the inflammatory markers went up again. He developed acute respiratory distress, and there were multiple cavitary lesions and septic emboli (blood clots) in the lungs. He also developed abscesses in the liver in both the lobes. He deteriorated considerably and had to be shifted to ICU again.

The culture reports from multiple abscesses found a rare bacterium, ‘Burkholderia cepacia’, and he was diagnosed to be having a rare cepacia syndrome.

In the ICU for a month

Shifted to the ICU, a multi-disciplinary team of doctors analyzed his reports and health condition. Dr. Niyas Khalid, Specialist Internal Medicine at Burjeel Medical City, led the team of doctors with Dr. Georgey Koshy, the Medical Director of the hospital.

“The team designed the treatment protocol and administered Nitesh double IV antibiotics, along with inhalational and antifungal antibiotics and steroids. It took four weeks for him to get better,” said Dr. Niyas, who diagnosed the case.

After a few days in the ICU, Nitesh’s reports showed that his health had improved. The lesions in the lungs and abscesses in the liver had disappeared.

Speaking on the case, Dr. Koshy said: “Nitesh’s was a highly complicated case. Any delay in diagnosing the case would have cost a life. God has been great and kind to all of us. Nitesh recovered completely, and he is healthy and fit.”

Thankful to doctors

It took 54 days for Nitesh to beat the rare and deadly bacterial infection.

“I am grateful to God and the doctors at Burjeel Medical City for this second life. When I fell ill, I had hardly thought that it was so serious. By the time I reached the hospital, my health had deteriorated considerably. I would not have come back to life if the doctors had not treated me well. They are like God to me. My family and I will always remember them in our prayers for our lifetime,” said Nitesh.

It was a tough time for his family in India also. Nitesh had informed about his condition only to his wife. “She was scared and praying all the time for my recovery. I had asked her not to share the news with my mother as she would panic. So, my wife has to bear the pain all by herself,” said Nitesh, who has a four-year-old daughter.

Rare in immunocompetent individuals

It is not sure how had Nitesh contracted the disease. Cepacia syndrome usually affects immunocompromised individuals like those having cystic fibrosis.

However, Nitesh was lucky as he was immunocompetent and was not on any immune suppressant drugs or therapy, said Dr. Niyas, adding that proper diagnosis and effective treatment have saved his life.

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Pakistan military raids suspected former Taliban stronghold, kills three militants


Pakistani troops raided a suspected militant hideout in a former Pakistani Taliban stronghold near the border with Afghanistan, triggering a shootout that killed three militants, the military said Tuesday.
A militant commander was among those killed in the shootout late on Monday in Khyber, a district of Khyber Pakhtunkhwa province, according to a military statement.
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The military did not provide any additional details, saying only the targeted militants had attacked Pakistani troops in the past.
The Pakistani Taliban, also known as Tehrik-e-Taliban Pakistan or TTP , are a separate group but allied with the Afghan Taliban, who two years ago seized Afghanistan as US and NATO troops were in the final stages of their pullout from the country after 20 years of war.
The Taliban takeover of Afghanistan has emboldened the Pakistani Taliban, who have stepped up attacks against police and troops.
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West’s failure to back Ukraine’s tactics risks handing Putin major advantage: Analyst


The West needs to fully support Ukraine’s battle strategies against Russia in the current counter-offensive and the ones to come next, because to do otherwise would hand Russia the gift of valuable time to regroup its forces, said an analyst at the Washington-based think tank Institute of Study of War (ISW).

“Ukrainian forces have adapted. Ukraine’s military decision-making is sound. Now is not the time for Western doubt but for the West to embrace Ukraine’s way of war and commit to sustaining Ukraine’s initiative on the battlefield,” wrote Nataliya Bugayova, non-resident Russia Fellow at ISW.

She highlighted that Ukraine recognized the realities of Russian defenses much faster than Western policymakers, who were expecting a rapid Ukrainian breakthrough.

Bugayova stressed that the US should wholeheartedly embrace its collaboration with a capable ally who takes the lead – Ukraine. In many instances, the US has been accustomed to working with partners who depend on it for leadership, whether it's the proxy forces it has trained or allies relying on its security assistance. Yet, in the case of Ukraine, the US finds itself in a partnership where Ukraine is leading on the frontlines. They possess an in-depth understanding of their operational environment, their adversaries, as well as their own strengths and weaknesses. Ukrainians have consistently demonstrated their grasp of the complexities of this conflict and their ability to adapt. Perhaps most crucially, Ukraine's unwavering determination to continue the fight remains undiminished.

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“Now is not the time for Western doubt. The West must reinforce its military and diplomatic commitments and lean in to help sustain Ukraine’s battlefield momentum. Ukraine is still facing an existential challenge from Russia, which requires Western aid to militarily defeat. Leaning in means embracing Ukraine’s campaign design. It means ensuring that the Western training of Ukrainian troops is done in conditions in which Ukraine fights at its best,” she wrote.

She added: “The West should also help shape strategic communications to set proper expectations around Ukraine’s progress. Ukraine can win this war militarily, but it will take more than one counteroffensive operation. It will take as many campaigns as it takes for Ukraine to liberate its territory and its people.”

“The West should be prepared to support them all because the fundamentals shaping this conflict have not changed: Ukraine can win this war, Russia can only be defeated on the battlefield, and what is at stake includes Ukraine’s existence and vital US interests.”

Bugayova wrote that the current objective of the Kremlin is obstruct and hinder Western and Ukrainian decision-making processes, as this stands as one of the few avenues through which Russian President Vladimir Putin can further his goals. Delays in Western decision-making, especially when it leads to sluggish deliveries of military aid, can offer Russia a respite from pressure. Granting Russia such respite, whether at the operational level or the strategic level, has proven to be disastrous.

She further elaborated that with additional time on their side, Russia has the opportunity to regroup and launch further attacks. However, Russia's Achilles' heel remains its incapacity to swiftly adapt when confronted with relentless pressure or a series of setbacks. Under sustained, unyielding pressure, the Russian forces are likely to begin to weaken. This is the desired outcome of Ukraine's present counteroffensive strategy, and it can only be realized if the West embraces Ukraine's approach to warfare for both the current phase and the future.

“Russia’s Achilles heel remains its inability to rapidly pivot when faced with relentless pressure or consecutive setbacks. Faced with constant pressure over time with no relief, the Russians will likely start to crack. This is the effect Ukraine’s current counteroffensive strategy is seeking to achieve, and it can only be realized if the West embraces Ukraine’s way of war for this phase of the counteroffensive and beyond,” she wrote.

Ukraine’s successes on the battlefronts

“Ukraine maintains the battlefield initiative and its forces are advancing in Zaporizhia Oblast and near Bakhmut. Ukraine continues to liberate its territory and people and is slowly but steadily breaking through an incredibly formidable Russian prepared defense — and the Russian forces are unable to stop the advance, which is now moving in two directions,” Bugayova wrote.

She added that Ukraine's military strategy has achieved notable victories against Russian forces. With backing from Western allies, Ukrainian troops have consistently thwarted Russian goals in various regions, including Kyiv, Kharkiv, Kharkiv Oblast, Kherson, and increasingly, in the southern part of the country. She stressed that Ukraine's efforts have prevented Russian forces from gaining complete control of the skies, while also challenging their naval dominance. This persistent resistance is gradually rendering the Russian military's presence in Crimea less sustainable, a development that was once considered improbable by many observers.

“Ukraine’s decision to keep pressure on Russian forces throughout the entire frontline instead of focusing all of Ukraine’s combat power on one line of attack in the direction of Melitopol, which some Western advisors preferred, was a good adaptation. Ukraine’s decision to hold and conduct counterattacks in Bakhmut allowed it to pin down a substantial portion of the combat power of Russia’s relatively elite airborne (VDV) forces and deny the creation of a strategic Russian reserve. The recent Ukrainian advances in Zaporizhia Oblast are likely forcing the Russians to laterally redeploy their units away from around Bakhmut, where Ukrainian forces are advancing too,” the Russia Fellow wrote.

Black Sea tactics

Bugayova highlighted Ukraine’s “asymmetrical tactics” in the Black Sea which she said are preventing the Black Sea Fleet from operating freely, “forcing Russia to reposition naval assets, and increasingly challenging Russian forces in Crimea — all operational developments of strategic significance.”

This is in light of Ukraine’s missile attack on the headquarters of Russia's Black Sea navy in the Crimean port of occupied Sevastopol on Saturday. The Special Operations Forces of the Armed Forces of Ukraine said on Monday that the strike killed 34 Russian officers, including the commander of the Russian Black Sea Fleet.

The Ukrainian Navy said on Tuesday that the Russians will face challenges in controlling their troops deployed in the Black Sea area after the Ukrainian strike on the headquarters of the Russian Black Sea Fleet killed their commander.

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China says it has not been notified about North Korea’s border reopening


China has not been notified through diplomatic channels about any re-opening of North Korea’s borders, a spokesperson at the Chinese foreign ministry said on Tuesday.

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On Monday, China’s national broadcaster CCTV reported that North Korea had allowed foreigners to enter, and that visitors would be subject to a two-day quarantine upon arrival.
North Korea has largely closed its international borders since early 2020 due to COVID-19.

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