Rx OD Risks: Grapefruit-Meds Warning Expanded


Nov 26, 2012 5:48pm







gty grapefruit juice medication ll 121126 wblog Grapefruit, Medicine Interaction Warning Expanded

Image credit: Johner/Getty Images


ABC News’ Ben Maas reports:


It has long been known that grapefruit juice can pose dangerous — and even deadly — risks when taken along with certain medications. Now, experts warn the list of medications that can result in these interactions is longer than many may have believed.


Check below to see whether your medication appears on the list.


In a new report released Monday in the Canadian Medical Association Journal, researchers at the University of Western Ontario said that while 17 drugs were identified in 2008 as having the potential to cause serious problems when taken with grapefruit, this number has now grown to 43.


“The frequency of these reactions may be small, but the risks are not worth it, especially for drugs which could cause sudden death,” said lead study author David Bailey, a professor of pharmacology and one of the first to report the interactions between grapefruit juice and certain medications 20 years ago. “Physicians need to know that this affects a number of new drugs and apply this information to their practice and patients.”


So how does a common breakfast fruit cause these problems? Grapefruits contain chemicals called furanocoumarins that interfere with how your body breaks down drugs before they enter the bloodstream. By preventing this normal breakdown of a drug, these chemicals in grapefruit can effectively cause a drug overdose and more severe side-effects.


Among the side effects sometimes seen with grapefruit-induced overdoses are heart rhythm problems, kidney failure, muscle breakdown, difficulty with breathing and blood clots. Atorvastatin — commonly known by the brand name Lipitor and taken by millions of Americans — is one of the drugs that have been linked to serious cases of drug toxicity when combined with grapefruit products. Other common heart medications — including verapamil and amiodarone — have also led to serious interactions when consumed with grapefruit or grapefruit juice.


While there have been many reported cases of serious side effects attributable to this problem, the total number of Americans who have been affected is not known.


As little as one grapefruit or one 8-ounce glass of grapefruit juice can cause an effect that may last more than 24 hours.  Other fruits including Seville oranges, limes, and pomelos can have the same effect, although sweet orange varieties do not produce this interaction.



“People know that drugs react with drugs, but fewer are aware of drug-food interactions,” said Professor Paul Doering of the University of Florida Pharmacy Department. “Health professionals need to learn as much as they can about this.  Undetected there are very serious adverse effects.”


For consumers, the best advice may be to ask a doctor or pharmacist when they are prescribed a new drug whether there are foods or other medicines that they should avoid.



A-C
Alfentanil (oral)
Amiodarone
Apixaban
Atorvastatin
Buspirone
Clopidogrel
Crizotinib
Cyclosporine


D-F
Darifenacin
Dasatinib
Dextromethorphan
Domperidone
Dronedarone
Eplerenone
Erlotinib
Erythromycin
Everolimus
Felodipine
Fentanyl (oral)
Fesoterodine


H-P
Halofantrine
Ketamine (oral)
Latatinib
Lovastatin
Lurasidone
Maraviroc
Nifedipine
Nilotinib
Oxycodone


P-Z
Pazopanib
Pimozide
Primaquine
Quinine
Quetiapine
Quinidine
Rilpivirine
Rivaroxaban
Silodosin
Simvastatin
Sirolimus
Solifenacin
Sunitinib
Tacrolimus
Tamsulosin
Ticagrelor
Triazolam
Vandetanib
Venurafenib


Verapamil
Ziprasidone



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Euro zone, IMF reach deal to cut long-term Greek debt

BRUSSELS (Reuters) - Euro zone finance ministers and the International Monetary Fund clinched agreement on reducing Greece's debt on Monday in a breakthrough to release urgently needed loans to keep the near-bankrupt economy afloat.


After 12 hours of talks at their third meeting in as many weeks, Greece's international lenders agreed on a package of measures to reduce Greek debt by 40 billion euros, cutting it to 124 percent of gross domestic product by 2020.


In a significant new pledge, ministers committed themselves to take further steps to lower Greece's debt to "significantly below 110 percent" in 2022 -- the most explicit recognition so far that some write-off of loans may be necessary from 2016, the point when Greece is forecast to reach a primary budget surplus.


"When Greece has achieved, or is about to achieve, a primary surplus and fulfilled all of its conditions, we will, if need be, consider further measures for the reduction of the total debt," German Finance Minister Wolfgang Schaeuble said.


Eurogroup Chairman Jean-Claude Juncker said ministers would formally approve the release of a major aid installment needed to recapitalize Greece's teetering banks and enable the government to pay wages, pensions and suppliers on December 13.


Greece will receive up to 43.7 billion euros in stages as it fulfills the conditions. The December installment will comprise 23.8 billion for banks and 10.6 billion in budget assistance.


The IMF's share, less than a third of the total, will only be paid out once a buy-back of Greek debt has occurred in the coming weeks, but IMF Managing Director Christine Lagarde said the Fund had no intention of pulling out of the program.


To reduce Greece's debt pile, ministers agreed to cut the interest rate on official loans, extend their maturity by 15 years to 30 years, and grant Athens a 10-year interest repayment deferral.


They promised to hand back 11 billion euros in profits accruing to their national central banks from European Central Bank purchases of discounted Greek government bonds in the secondary market.


They also agreed to finance Greece to buy back its own bonds from private investors at what officials said was a target cost of around 35 cents in the euro.


European Central Bank President Mario Draghi said on leaving the talks: "I very much welcome the decisions taken by the ministers of finance. They will certainly reduce the uncertainty and strengthen confidence in Europe and in Greece."


BETTER FUTURE


The euro strengthened against the dollar after news of the deal was first reported by Reuters.


Juncker said the accord opened new hope for Greeks.


"This is not just about money. This is the promise of a better future for the Greek people and for the euro area as a whole, a break from the era of missed targets and loose implementation towards a new paradigm of steadfast reform momentum, declining debt ratios and a return to growth," he told a 2 a.m. news conference.


Greek Finance Minister Yannis Stournaras said earlier that Athens had fulfilled its part of the deal by enacting tough austerity measures and economic reforms, and it was now up to the lenders to do their part.


Greece, where the euro zone's debt crisis erupted in late 2009, is the currency area's most heavily indebted country, despite a big "haircut" this year on privately-held bonds. Its economy has shrunk by nearly 25 percent in five years.


Negotiations had been stalled over how Greece's debt, forecast to peak at 190-200 percent of GDP in the coming two years, could be cut to a more sustainable 120 percent by 2020.


The agreed figure fell slightly short of that goal, and the IMF was still insisting that euro zone ministers should make a firm commitment to further steps to reduce the debt stock if Athens implements its adjustment program faithfully.


The key question remains whether Greek debt can become sustainable without euro zone governments having to write off some of the loans they have made to Athens.


Germany and its northern European allies have hitherto rejected any idea of forgiving official loans to Athens, but EU officials believe that line may soften after next year's German general election.


DEBT RELIEF "NOT ON TABLE"


Schaeuble told reporters earlier that debt forgiveness was legally impossible, not just for Germany but for other euro zone countries, if it was linked to a new guarantee of loans.


"You cannot guarantee something if you're cutting debt at the same time," he said. That did not preclude possible debt relief at a later stage if Greece completed its adjustment program and no longer needs new loans.


At Germany's insistence, earmarked revenue and aid payments will go into a strengthened "segregated account" to ensure that Greece services its debts.


A source familiar with IMF thinking said a loan write-off once Greece has fulfilled its adjustment program would be the simplest way to make its debt viable, but other methods such as forgoing interest payments, or lending at below market rates and extending maturities could all help.


The German banking association (BDB) said a fresh "haircut" or forced reduction in the value of Greek sovereign debt, must only happen as a last resort.


The ministers agreed to reduce interest on already extended bilateral loans from the current 150 basis points above financing costs to 50 bps.


No figures were announced for the debt buy-back in an effort to avoid triggering a rise in market prices in anticipation of a buyer. But before the meetings, officials had spoken of a 10 billion euro buy-back, that would achieve a net reduction of about 20 billion euros in the debt stock.


German central bank governor Jens Weidmann has suggested that Greece could "earn" a reduction in debt it owes to euro zone governments in a few years if it diligently implements all the agreed reforms. The European Commission backs that view.


An opinion poll published on Monday showed Greece's anti-bailout SYRIZA party with a four-percent lead over the Conservatives who won election in June, adding to uncertainty over the future of reforms.


(Additional reporting by Robert-Jan Bartunek, Ethan Bilby, Luke Baker in Brussels, Reinhardt Becker in Berlin; Writing by Paul Taylor; Editing by Luke Baker)


Read More..

Asian markets rise on Greece deal






HONG KONG: Asian markets rose in early trade Tuesday after the eurozone and the IMF agreed to unlock 43.7 billion euros ($56 billion) in loans to Greece and grant significant debt relief for decades to come.

Tokyo shares rose 0.38 per cent by the break, Hong Kong was up 0.25 per cent and Sydney gained 0.68 per cent.

Seoul opened flat but Shanghai was down 0.76 per cent on concerns over the strength of recovery in the domestic economy.

The Eurogroup of currency partners penned the Greek deal at its third late-night meeting in two weeks, agreeing to release, in December, the funds after months in which Greece was starved of bailout financing.

Greece, struggling to stay afloat despite a series of unpopular austerity measures, has been waiting impatiently for an injection of international loans for several weeks to avoid defaulting on its upcoming debt repayments.

Greece's public creditors agreed to take measures to bring down the country's debt-to-GDP ratio from an estimated 144 per cent to 124 per cent within eight years, in exchange for the bailout funds.

Finance ministers, the IMF and the European Central Bank said the money would be paid in four instalments from December 13 through until the end of March.

Greek Prime Minister Antonis Samaras said the agreement represented a fresh start for his beleaguered country.

"Everything has gone well," Samaras told local media in Athens. "All Greeks have fought (for this decision) and tomorrow is a new day for every Greek person."

ECB President Mario Draghi said: "The decision will certainly reduce the uncertainty and strengthen confidence in Europe and in Greece."

US markets were feeble in the first session after a slow Thanksgiving holiday week, with the jury still out over how strong the crucial Black Friday holiday sales were for retailers.

The Dow Jones Industrial Average finished down 42.31 points (0.33 per cent) at 12,967.37.

The broad-market S&P 500 lost 2.86 (0.20 per cent) at 1,406.29, while the Nasdaq Composite rose 9.93 (0.33 per cent) to 2,976.78.

On currency markets the euro was stronger in Asian trade as investors breathed a sigh of relief over the deal for Greece.

The 17-nation currency bought $1.2980 and 106.46 yen in Tokyo morning trade after briefly topping $1.30 for the first time in about a month.

That was up from $1.2971 and 106.38 yen in New York trade late Monday, although the euro eased slightly after the Greece announcement.

The dollar was flat at 82 yen.

On oil markets, New York's main contract, West Texas Intermediate (WTI) for January delivery, bounced 30 cents to $88.04 a barrel and Brent North Sea crude, also for January, jumped 29 cents to $111.21.

Gold was at $1,749.50 at 0310 GMT compared with $1,734.47 late Monday.

- AFP/ck



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Green tax on diesel cars: Auto sector slams cess proposal

NEW DELHI: The automobile industry has come out against any proposal to impose an additional tax on diesel cars over environmental issues.

"Diesel is not as polluting as it is made out to be. How can you tax a technology that is very clean and more fuel efficient?" said Vishnu Mathur, DG of industry lobby group, Society of Indian Automobile Manufacturers. While diesel is not a big polluter, there are other industries that need to be checked into, he said, adding, "What about power producers, the industry and gensets?" P Balendran, VP at General Motors India, also countered the stand that diesel is more polluting. "It is energy saving and is more fuel efficient than petrol," he said.

Mayank Parek, COO at Maruti Suzuki, said that while pollution levels certainly need to be controlled, taxing diesel cars is not an answer. "It is not only cars that pollute. In fact, their contribution to pollution is very low when compared to other industries."

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Bounce houses a party hit but kids' injuries soar

CHICAGO (AP) — They may be a big hit at kids' birthday parties, but inflatable bounce houses can be dangerous, with the number of injuries soaring in recent years, a nationwide study found.

Kids often crowd into bounce houses, and jumping up and down can send other children flying into the air, too.

The numbers suggest 30 U.S. children a day are treated in emergency rooms for broken bones, sprains, cuts and concussions from bounce house accidents. Most involve children falling inside or out of the inflated playthings, and many children get hurt when they collide with other bouncing kids.

The number of children aged 17 and younger who got emergency-room treatment for bounce house injuries has climbed along with the popularity of bounce houses — from fewer than 1,000 in 1995 to nearly 11,000 in 2010. That's a 15-fold increase, and a doubling just since 2008.

"I was surprised by the number, especially by the rapid increase in the number of injuries," said lead author Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.

Amusement parks and fairs have bounce houses, and the playthings can also be rented or purchased for home use.

Smith and colleagues analyzed national surveillance data on ER treatment for nonfatal injuries linked with bounce houses, maintained by the U.S. Consumer Product Safety Commission. Their study was published online Monday in the journal Pediatrics.

Only about 3 percent of children were hospitalized, mostly for broken bones.

More than one-third of the injuries were in children aged 5 and younger. The safety commission recommends against letting children younger than 6 use full-size trampolines, and Smith said barring kids that young from even smaller, home-use bounce houses would make sense.

"There is no evidence that the size or location of an inflatable bouncer affects the injury risk," he said.

Other recommendations, often listed in manufacturers' instruction pamphlets, include not overloading bounce houses with too many kids and not allowing young children to bounce with much older, heavier kids or adults, said Laura Woodburn, a spokeswoman for the National Association of Amusement Ride Safety Officials.

The study didn't include deaths, but some accidents are fatal. Separate data from the product safety commission show four bounce house deaths from 2003 to 2007, all involving children striking their heads on a hard surface.

Several nonfatal accidents occurred last year when bounce houses collapsed or were lifted by high winds.

A group that issues voluntary industry standards says bounce houses should be supervised by trained operators and recommends that bouncers be prohibited from doing flips and purposefully colliding with others, the study authors noted.

Bounce house injuries are similar to those linked with trampolines, and the American Academy of Pediatrics has recommended against using trampolines at home. Policymakers should consider whether bounce houses warrant similar precautions, the authors said.

___

Online:

Pediatrics: http://www.pediatrics.org

Trade group: http://www.naarso.com

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Fire Kills 112 Workers Making Clothes for US Brands













The 100-plus workers who died in a fire late Saturday at a high-rise garment factory in Bangladesh were working overtime making clothes for major American retailers, including Wal-Mart, according to workers' rights groups.


Officials in Bangladesh said the flames at the Tazreen Fashions factory outside Dhaka spread rapidly on the ground floor, trapping those on the higher floors of the nine-story building. There were no exterior fire escapes, according to officials, and many died after jumping from upper floors to escape the flames.


As firemen continued to remove bodies Sunday, officials said at least 112 people had died but that the number of fatalities could go higher.


The Tazreen fire is the latest in a series of deadly blazes at garment factories in Bangladesh, where more than 700 workers, many making clothes for U.S. consumers, have died in factory fires in the past five years. As previously reported by ABC News, Bangladesh has some of the cheapest labor in the world and some of the most deplorable working conditions.


READ the original ABC News report.








More Than 100 Dead in Bangladesh Garment Factory Fire Watch Video











Worker Deaths at Factory for Hilfiger Clothes Watch Video





"The industry and parent brands in the U.S. have been warned again and again about the extreme danger to workers in Bangladesh and they have not taken action," said Scott Nova, executive director of the Worker Rights Consortium, an American group working to improve conditions at factories abroad that make clothes for U.S. companies. Nova said the fire was the most deadly in the history of the Bangladesh apparel industry, and "one of the worst in any country."


WATCH the 'Nightline' report on deadly factories.


Workers' activists went into the burned-out remains today to document which major retailers were using the Tazreen factory.


They say they found labels for Faded Glory, a Wal-Mart private label, along with labels they said traced back to Sears and a clothing company owned by music impresario Sean "Diddy" Combs.


"There's no question that Wal-Mart and the other customers at this factory bear some blame for what happened in this factory," Nova said.


Nova also said that Wal-Mart "knew exactly what's going on at these facilities. They have staff on site in Bangladesh."


Wal-Mart actually warned of dangerous conditions at the Tazreen factory last year, in a letter posted online by the factory owner.


Wal-Mart told ABC News that the company has not yet been able to confirm that it was still making clothes at the factory.


In a statement, Wal-Mart told ABC News, "Our thoughts are with the families of the victims of this tragedy. ... [F]ire safety is a critically important area of Wal-Mart's factory audit program and we have been working across the apparel industry to improve fire safety education and training in Bangladesh.


"As part of this effort, we partnered with several independent organizations to develop and roll out fire safety training tools for factory management and workers. Continued engagement is critical to ensure that reliable, proactive measures are in place to reduce the chance of factory fires. "


Spokespeople for Combs and Sears did not immediately respond to requests for comment.



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Egypt's Mursi to meet judges over power grab

CAIRO (Reuters) - Egyptian President Mohamed Mursi will meet senior judges on Monday to try to ease a crisis over his seizure of new powers which has set off violent protests reminiscent of last year's revolution which brought him to power.


Egypt's stock market plunged on Sunday in its first day open since Mursi issued a decree late on Thursday temporarily widening his powers and shielding his decisions from judicial review, drawing accusations he was behaving like a new dictator.


More than 500 people have been injured in clashes between police and protesters worried Mursi's Muslim Brotherhood aims to dominate the post-Hosni Mubarak era after winning Egypt's first democratic parliamentary and presidential elections this year.


One Muslim Brotherhood member was killed and 60 people were hurt on Sunday in an attack on the main office of the Brotherhood in the Egyptian Nile Delta town of Damanhour, the website of the Brotherhood's Freedom and Justice Party said.


Egypt's highest judicial authority hinted at compromise to avert a further escalation, though Mursi's opponents want nothing less than the complete cancellation of a decree they see as a danger to democracy.


The Supreme Judicial Council said Mursi's decree should apply only to "sovereign matters", suggesting it did not reject the declaration outright, and called on judges and prosecutors, some of whom began a strike on Sunday, to return to work.


Mursi would meet the council on Monday, state media said.


Mursi's office repeated assurances that the measures would be temporary, and said he wanted dialogue with political groups to find "common ground" over what should go in Egypt's constitution, one of the issues at the heart of the crisis.


Hassan Nafaa, a professor of political science at Cairo University, saw an effort by the presidency and judiciary to resolve the crisis, but added their statements were "vague". "The situation is heading towards more trouble," he said.


Sunday's stock market fall of nearly 10 percent - halted only by automatic curbs - was the worst since the uprising that toppled Mubarak in February, 2011.


Images of protesters clashing with riot police and tear gas wafting through Cairo's Tahrir Square were an unsettling reminder of that uprising. Activists were camped in the square for a third day, blocking traffic with makeshift barricades. Nearby, riot police and protesters clashed intermittently.


"BACK TO SQUARE ONE"


Mursi's supporters and opponents plan big demonstrations on Tuesday that could be a trigger for more street violence.


"We are back to square one, politically, socially," said Mohamed Radwan of Pharos Securities, an Egyptian brokerage firm.


Mursi's decree marks an effort to consolidate his influence after he successfully sidelined Mubarak-era generals in August. It reflects his suspicions of a judiciary little reformed since the Mubarak era.


Issued just a day after Mursi received glowing tributes from Washington for his work brokering a deal to end eight days of violence between Israel and Hamas, the decree drew warnings from the West to uphold democracy. Washington has leverage because of billions of dollars it sends in annual military aid.


"The United States should be saying this is unacceptable," former presidential nominee John McCain, leading Republican on the Senate Armed Services Committee, said on Fox News.


"We thank Mr. Mursi for his efforts in brokering the ceasefire with Hamas ... But this is not what the United States of America's taxpayers expect. Our dollars will be directly related to progress toward democracy."


The Mursi administration has defended his decree as an effort to speed up reforms that will complete Egypt's democratic transformation. Yet leftists, liberals, socialists and others say it has exposed the autocratic impulses of a man once jailed by Mubarak.


"There is no room for dialogue when a dictator imposes the most oppressive, abhorrent measures and then says 'let us split the difference'," prominent opposition leader Mohamed ElBaradei said on Saturday.


WARNINGS FROM WEST


Investors had grown more confident in recent months that a legitimately elected government would help Egypt put its economic and political problems behind it. The stock market's main index had risen 35 percent since Mursi's victory. It closed on Sunday at its lowest level since July 31.


Political turmoil also raised the cost of government borrowing at a treasury bill auction on Sunday.


"Investors know that Mursi's decisions will not be accepted and that there will be clashes on the street," said Osama Mourad of Arab Financial Brokerage.


Just last week, investor confidence was helped by a preliminary agreement with the International Monetary Fund over a $4.8 billion loan needed to shore up state finances.


Mursi's decree removes judicial review of decisions he takes until a new parliament is elected, expected early next year.


It also shields the Islamist-dominated assembly writing Egypt's new constitution from a raft of legal challenges that have threatened it with dissolution, and offers the same protection to the Islamist-controlled upper house of parliament.


"I am really afraid that the two camps are paving the way for violence," said Nafaa. "Mursi has misjudged this, very much so. But forcing him again to relinquish what he has done will appear a defeat."


Many of Mursi's political opponents share the view that Egypt's judiciary needs reform, though they disagree with his methods. Mursi's new powers allowed him to sack the prosecutor general who took his job during the Mubarak era and is unpopular among reformists of all stripes.


(Additional reporting by Yasmine Saleh and Marwa Awad in Cairo and Philip Barbara in Washington; Editing by Peter Graff and Philippa Fletcher)


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80% of customers satisfied with their property agents: survey






SINGAPORE: The first Public Perception Survey by the Council for Estate Agencies (CEA) has found that most consumers are satisfied with their property agents.

Eight out of 10 said they were satisfied with the conduct and services provided.

Seven out of 10 planned to recommend their agents to others.

Top of the list was service excellence with agents being contactable, responsive to queries and courteous at all times.

Bottom of the list was knowledge and expertise about the real estate industry.

Consumers felt that the agents should improve their knowledge so that they can advise customers on property transactions.

These include financial matters and accurate and up-to-date information related to the property.

Most consumers, more than 70 per cent, were also aware of key industry practices and regulations.

The awareness level among potential consumers came in lower, averaging about 60 per cent.

The survey also looked at feedback from the industry.

Most were supportive of the initiatives implemented by CEA to enhance professionalism in the sector.

Eighty per cent indicated that the regulatory measures and enforcement of minimum eligibility criteria for agents has helped raise the professionalism of the industry.

More than 90 per cent of agents found that the training that they received in the last 12 months, was effective in raising their professionalism.

The majority of them also indicated that they would require additional training on government rules and regulations and market information.

The survey was conducted between March and July this year.

Face-to-face interviews were conducted with more than 2,200 consumers and potential consumers.

An online survey was conducted with more than 1,700 property agents and key executive officers.

The findings will set the baseline for CEA to measure the progress of the industry in delivering professional service to consumers.

- CNA/ck



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26/11 anniversary: Experts doubt netas’ claim of safe Mumbai

MUMBAI: Senior police officers and politicians declared on Sunday that Mumbai is prepared to repel any attack of the magnitude of 26/11 but their words were met with disbelief and scepticism.

On the eve of the fourth anniversary of the bloody assault, home minister R R Patil admitted that law-enforcement agencies were unequipped to fend off the 10 Pakistani terrorists who landed in Mumbai by sea on November 26, 2008, and wreaked terror on the city.

"We have learnt our lessons. In the past four years, we have stepped up security not only in Mumbai but also in entire Maharashtra. We now have state-of-the-art weapons and adequate manpower. I am confident that we are prepared to take on terror attacks of any magnitude," claimed the home minister.

Patil argued that the Democratic Front government had implemented in letter and spirit the recommendations of the Ram Pradhan committee, which was set up in the wake of the 26/11 attack to examine the preparedness of Mumbai police.

Anti-terrorism squad chief Rakesh Maria echoed Patil: "In November 2008, we were taken aback owing to the magnitude of the attack. We were not prepared at all. In the last four years, we have redrafted our strategy. We now have a standard operation procedure in place. Everyone from a constable to the DG today knows his task in the event of an attack."

Mumbai police commissioner Satyapal Singh too said the force had learnt from the past. "I do not say that there is no threat. But the force is prepared and confident," added Singh.

The contentions were, however, decried by a former DGP who asserted that Mumbai police was still grossly unprepared. "A large number of the Pradhan committee recommendations, particularly on manpower deployment, weapons and coordination, have not been implemented," he told TOI on condition of anonymity. "Even today, police personnel do not have adequate ammunition for training and practice." The former DGP's declaration, other ex-policemen said, was borne out by evidence on the ground.

The state government's ambitious Rs 800-crore plan to install 6,000 CCTV cameras around Mumbai was still in tendering stage after a sputtering start. The city's coastal security was still wanting: patrol boats and amphibian vehicles were either out of order or without fuel; policemen required to protect the coastline did not even know how to swim.

Furthermore, the state's elite Force One, which was created along the lines of the National Security Guard, did not have a home of its own in the city for training.

Still, Patil said the only matter of concern was the delay in the installation of the CCTV camera network. "We were in the final stages of allotting the contract but it had to be cancelled after a member of the chosen consortium was found to have been blacklisted earlier. As a result, we initiated the entire process afresh. I am sure that in the next one year, we will have a CCTV network for the metropolis," Patil said.

(With inputs from V Narayan)

26/11 claims and the reality

While the ATS chief and home minister claim the city is prepared for another terror attack, the evidence on the ground suggests otherwise. For example, the plan to install CCTV cameras is yet to be implemented, coastal security is in tatters and disaster management is beset by poor cooperation.

Intelligence sharing and coordination

As Ajmal Kasab and his cohorts went on the rampage, several security agencies came together and worked as a team to terminate the carnage . The result was the death of nine terrorists and Kasab's arrest . But that was in 2008. Since then, ignoring national interest, most security agencies have scrapped with each other to bag credit for passing victories against terror groups. The dearth of intelligence-sharing and coordination was evidenced by the escape of terror principal Yasin Bhatkal earlier this year. Although Delhi police's Special Cell was on his tail, it did not inform Maharashtra ATS, which was working on the same case. In the confusion, Bhatkal slipped away. Similarly, reports said, Special Cell did not keep the ATS in the loop when getting 26/11 co-conspirator Abu Jundal extradited from Saudi Arabia. Meanwhile, efforts to bolster intelligence gathering too have only just edged forward. The Maharashtra government set up an intelligence academy to recruit and train specialists. But, of the 200 recruits, 75 soon left for better opportunities in the private sector.

Bulletproof jackets

Joint police commissioner Hemant Karkare's death in 26/11 raised alarming questions about the quality of the bulletproof jacket he wore during the attack. It was said that the jackets the state had acquired were of poor standard . Had Karkare's jacket been better, many argued, perhaps his life could have been saved. The widespread ire aimed at the state prompted it to begin the process of procuring high-quality bulletproof jackets a week after the attack. However, because of technical reservations, no company was awarded the contract for three years. Finally, the state got the right jackets from the agencies that supply such protective wear to the NSG and CRPF. In the last one year, it has procured over 3,000 bulletproof jackets.

Coastal security

The ease with which 26/11 gunmen landed by sea in Mumbai exposed a glaring chink in the city's armour. Eager to be seen as rectifying the fault, the state vowed to beef up coastal security. Yet, its promises scarcely translated into lasting work. Set up to protect the coastline, Sagari police station even today operates from rooms in governmental quarters at Mahim. It still cannot register an FIR, for which it has to depend on the Yellow Gate police station. Together, the two stations are reportedly short of 1,180 policemen. Five of their 14 amphibian vehicles and 13 of their 27 patrol boats are in repair yards. Lacking a jetty, Sagari police park boats at Malad or near the Gateway of India. Worst of all, most personnel at the two stations neither have the expertise to run the patrol boats nor basic swimming skills.

Medical care

Every time a disaster rocks Mumbai, causing mass casualties, the inadequacies of trauma care facilities at public hospitals get highlighted. During 26/11, most victims were rushed to the state-run St George and GT hospitals but soon they had to be shifted to bigger centres like JJ Hospital. Four years on, no lessons have been learnt. Sion Hospital till date is the only civic-run facility to have a dedicated trauma care centre. Hospitals such as JJ and KEM have the capacity to care for 500 casualty patients, but, as JJ Hospital dean Dr T P Lahane points out, it is not the same as having a hub where doctors from neurosurgery, orthopaedics, surgery and anaesthesia are available round-the-clock .

State of surveillance

The state's ambitious Rs 800 crore plan to install 6,000 CCTV cameras around Mumbai has sputtered forward ever since 26/11. To give the plan a boost, home minister R R Patil set up a high-level committee and led a delegation to the UK to study the CCTV surveillance grid there. But just as the contract was to be granted, it turned out that one of the firms in the chosen consortium had been blacklisted earlier . As a result, a fresh tendering process was initiated. Till now, only Raj Bhavan, CM residence Varsha and Patil's residence Chitrakut are guarded by CCTV networks. The city will likely have to wait for at least another year for its surveillance system.

Arms & ammo

Mumbai police received sophisticated arms, ammunition and communication gadgets in the wake of the 2008 attack. While rifles are still used for local policing, police now have AK-47 s and MP5 submachine guns to ward off an assault as big as 26/11. In addition, each office of regional police commissioner is equipped with a bulletproof vehicle.

Bomb suits

In the last four years, there has been no dearth of alert citizens calling the bomb detection and disposal squad, alerting it of suspicious objects on the city's streets. What has been lacking is bomb-disposal suits and sniffer dogs. The squad urgently needs more suits, but the procedure has been held up on account of an alleged scam. The economic offences wing this August arrested a businessman for allegedly cheating the state out of Rs 6.25 crore by providing low-quality bomb disposal suits.

Railway security

Post-26 /11, electronic surveillance was made a priority for securing railway stations. According to the Government Railway Police, there are about 1,500 closed-circuit television cameras at 90 of the 136 stations on the suburban network. The Integrated Security System—to be implemented on CR—will bring in advanced CCTVs, vehicle scanners and baggage scanners. The GRP has also stepped up visibility on stations and introduced random checking of passengers and baggage on platforms, foot overbridges and subways. Armed riot control policemen are deployed at stations like CST and Dadar to handle any situation. Furthermore, city police are frequently roped in for anti-sabotage checks. More AK47s and SLRs with ammunition have been procured.

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AP PHOTOS: Simple surgery heals blind Indonesians

PADANG SIDEMPUAN, Indonesia (AP) — They came from the remotest parts of Indonesia, taking crowded overnight ferries and riding for hours in cars or buses — all in the hope that a simple, and free, surgical procedure would restore their eyesight.

Many patients were elderly and needed help to reach two hospitals in Sumatra where mass eye camps were held earlier this month by Nepalese surgeon Dr. Sanduk Ruit. During eight days, more than 1,400 cataracts were removed.

The patients camped out, sleeping side-by-side on military cots, eating donated food while fire trucks supplied water for showers and toilets. Many who had given up hope of seeing again left smiling after their bandages were removed.

"I've been blind for three years, and it's really bad," said Arlita Tobing, 65, whose sight was restored after the surgery. "I worked on someone's farm, but I couldn't work anymore."

Indonesia has one of the highest rates of blindness in the world, making it a target country for Ruit who travels throughout the developing world holding free mass eye camps while training doctors to perform the simple, stitch-free procedure he pioneered. He often visits hard-to-reach remote areas where health care is scarce and patients are poor. He believes that by teaching doctors how to perform his method of cataract removal, the rate of blindness can be reduced worldwide.

Cataracts are the leading cause of blindness globally, affecting about 20 million people who mostly live in poor countries, according to the World Health Organization.

"We get only one life, and that life is very short. I am blessed by God to have this opportunity," said Ruit, who runs the Tilganga Eye Center in Katmandu, Nepal. "The most important of that is training, taking the idea to other people."

During the recent camps, Ruit trained six doctors from Indonesia, Thailand and Singapore.

Here, in images, are scenes from the mobile eye camps:

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