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.
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.
Xi's visit to Moscow – long touted by the Kremlin as a show of support from its most powerful friend – featured plenty of demonstrative bonhomie. The two leaders referred to each other as dear friends, promised economic cooperation and described their countries' relations as the best they have ever been.
A joint statement included familiar accusations against the West – that Washington was undermining global stability and NATO barging into the Asia-Pacific region.
On Ukraine, Putin praised Xi for a peace plan he proposed last month, and blamed Kyiv and the West for rejecting it.
“We believe that many of the provisions of the peace plan put forward by China are consonant with Russian approaches and can be taken as the basis for a peaceful settlement when they are ready for that in the West and in Kyiv. However, so far we see no such readiness from their side,” Putin said.
But Xi barely mentioned the conflict at all, saying that China had an “impartial position” on it.
The summit, Putin's biggest display of diplomacy since he ordered his invasion of Ukraine a year ago, was partly upstaged in Kyiv, where Japan's Prime Minister Fumio Kishida made a surprise visit and met President Volodymyr Zelenskyy.
The latest world leader to make the gruelling overland journey to show solidarity with Ukraine, Kishida toured Bucha on the capital's outskirts, left littered with dead last year by fleeing Russian troops. He lay a wreath by a church before observing a moment of silence and bowing.
“The world was astonished to see innocent civilians in Bucha killed one year ago. I really feel great anger at the atrocity upon visiting that very place here,” Kishida said. “Japan will keep aiding Ukraine with the greatest effort to regain peace.”
Diplomatic cover
Washington denounced the timing of Xi's visit to Moscow, just three days after the International Criminal Court in the Hague issued a warrant for Putin's arrest on war crime charges of illegally deporting Ukrainian children.
US Secretary of State Antony Blinken said visiting at such a time amounted to giving Putin “diplomatic cover” for atrocities. Moscow denies illegally deporting children, saying it has taken in orphans to protect them, and has opened its own criminal case into the ICC prosecutor and judges.
Putin and Xi signed a “no limits” partnership agreement last year just weeks before Russia invaded Ukraine. Beijing has since declined to blame Moscow for the war and criticised the West for imposing sanctions on Russia, even as China has profited by securing a deep discount for purchases of oil and gas that Russia can no longer export to Europe.
The West has largely dismissed Xi's peace plan for Ukraine as at best too vague to make a difference, and at worst a ploy to buy time for Putin to rebuild his forces and tighten his grip on occupied land.
But Kyiv, perhaps hoping to keep China neutral, has been more circumspect, cautiously welcoming the plan when China unveiled it last month. Zelenskyy has repeatedly called on Xi to speak to him.
Ukrainian officials hinted that a phone call could be in the works: “We are waiting for confirmation,” Ukraine's Deputy Prime Minister Iryna Vereshchuk told Italian newspaper Corriere della Sera. “That would be an important move. They have things to say to each other.”
Kyiv says firmly there can be no peace talks with Russia unless it withdraws its troops. Moscow says Kyiv must accept territorial “realities” – a reference to its claim to have annexed nearly a fifth of Ukraine.
Washington has said over the past month that it is worried that Beijing could arm Russia, which China denies.
Explosion in Crimea
On the ground, Ukraine's Defence Ministry said an explosion in Dzhankoi city in Crimea overnight destroyed Russian Kalibr-KN cruise missiles as they were being transported by rail for use by Russia's Black Sea Fleet to attack Ukraine.
Russian-installed officials in Crimea, controlled by Moscow since 2014, said the blast was caused by drones laced with shrapnel and explosives, and targeted civilian sites. One person was injured, they said.
Kyiv never discusses responsibility for attacks in Crimea. Dzhankoi is Crimea's main railway hub, linking routes to Russia proper with naval bases on the peninsula and Russian-occupied territory in mainland Ukraine.
Mick Ryan, a retired Australian major general and military analyst, said Ukraine apparently being able to hit the cargo “forces the Russians to rethink their force posture and defensive deployments in Crimea and beyond”.
“Strikes like this are not war winning silver bullets. But, their impact is cumulative on the degradation of Russian morale and war fighting capability,” he tweeted.
Kyiv recaptured swathes of territory in the second half of 2022, but its forces have largely kept to the defensive in recent months. Moscow, meanwhile, has launched a massive winter offensive using hundreds of thousands of freshly called-up reservists and convicts recruited as mercenaries from jail.
Despite the bloodiest fighting of the war, which both sides describe as a meatgrinder, the front line has barely moved for four months.
The one exception has been around the small eastern city of Bakhmut, where Russian forces made gains in January and February. Kyiv has decided this month not to pull its forces out of the city.
In the town of Chasiv Yar, just west of Bakhmut, bursts of incoming and outgoing artillery fire could be heard. Between apartment blocks, mainly elderly residents queued for water and food delivered by a team from the State Emergency Service.
Oleksii Stepanov said he had been in Bakhmut until five days ago but was evacuated when his house was destroyed by a missile.
“We were in the kitchen and the missile came through the roof. The kitchen was all that was left standing,” said the 54-year-old.
US ‘extremely troubled’ by Israeli parliament vote to legitimize settlements
The United States said Tuesday it was “extremely troubled” by the Israeli parliament's vote legitimizing some settlements, calling the move "provocative" and in violation of promises to ally Washington.
“The United States is extremely troubled that the Israeli Knesset has passed legislation rescinding important parts of the 2005 disengagement law,” State Department spokesman Vedant Patel told reporters.
End of truce: Colombia kills two cartel members, captures one
The Colombian army said Tuesday it had killed two members of the infamous Gulf Clan drug cartel and captured one of its bosses as operations resumed after the government called off a ceasefire.
On New Year’s Eve, the government of new President Gustavo Petro had declared a bilateral ceasefire with armed groups including the Clan, National Liberation Army (ELN) rebels and dissidents of the disarmed former Revolutionary Armed Forces of Colombia (FARC) guerrilla group.
It was a first step in leftist Petro’s “total peace” plan to end decades of armed conflict through negotiation.
But on Sunday, Petro suspended the truce with the Gulf Clan, accusing it of being behind attacks on civilians.
The government said the group had been supporting attacks by illegal gold miners since March 2 in the country’s northwestern Antioquia department.
Workers in illegal mines have been protesting the government’s destruction of the heavy machinery they use to dredge up soil to find gold.
Miners have shut down roads, and attacked a town hall and a bank in the Caucasia district.
On Monday, the army said, it had captured the alleged “coordinator of the hired killers… of this illegal group,” a man known as “Andres,” in the Antioquia region.
According to Defense Minister Ivan Velasquez, some 10,000 policemen and soldiers were deployed to the area.
And in a video sent to the media, the military said a “confrontation” in the neighboring Bolivar department “caused the deaths of two members of the Clan.”
The troops will “continue military operations,” added Colonel Luis Cifuentes, in charge of operations against the Clan.
Criminal groups in Colombia make almost as much money from illegal mining as they do from trafficking cocaine, authorities say.
According to official estimates, the Gulf Clan – Colombia’s biggest cartel – is behind between 30 and 60 percent of the drugs exported from Colombia, the world’s largest cocaine producer.