Rivals clash as Mursi deputy seeks end to Egypt crisis

CAIRO (Reuters) - Islamists battled with protesters outside Egyptian President Mohamed Mursi's palace on Thursday, after his vice president suggested amendments could be agreed to the draft constitution that has divided the nation.

Fires burned in the streets near the palace perimeter where opponents and supporters of Mursi threw stones and petrol bombs. Riot police tried to separate the two sides, but failed to halt fighting that extended from Wednesday into the early morning.

Residents, frustrated that police had not calmed the streets, set up makeshift road blocks nearby to check passers-by, scenes reminiscent of the popular uprising that toppled Mursi's autocratic predecessor Hosni Mubarak.

Five people were killed and 350 injured in the clashes, according to a statement released by the Ministry of Health.

"No to dictatorship," Mursi's opponents chanted, while their rivals chanted: "Defending Mursi is defending Islam."

Mursi's opponents accused him of creating a new autocracy by awarding himself extraordinary powers in a decree on November 22 and were further angered when an Islamist-dominated assembly pushed through a draft constitution that opponents said did not properly represent the aspirations of the whole nation.

The United States, worried about the stability of a state that has a peace deal with Israel and to which it gives $1.3 billion in military aid each year, called for dialogue.

A presidential source said Mursi was expected to make a statement later on Thursday. His opponents had earlier called on him to address the nation to help calm the streets.

Bidding to end the worst crisis since Mursi took office less than six months ago, Vice President Mahmoud Mekky said amendments to disputed articles in the constitution could be agreed with the opposition. A written agreement could then go to parliament, to be elected after a referendum on the constitution on December 15.

"There must be consensus," he told a news conference inside the presidential palace as fighting raged outside on Wednesday evening, saying opposition demands had to be respected.

PROTESTS SPREAD

Prime Minister Hisham Kandil called for calm to "give the opportunity" for efforts underway to start a national dialogue.

Protests spread to other cities, and offices of the Muslim Brotherhood's political party in Ismailia and Suez were torched.

But Mursi has shown no sign of buckling under pressure from protestors, confident that the Islamists, who have dominated both elections since Mubarak was overthrown in February 2011, can win the referendum and parliamentary election to follow.

On top of the support of the Brotherhood, which backed him for the presidency in the June election, Mursi may also be able to rely on a popular yearning for stability and economic revival after almost two years of political turmoil.

Egypt's opposition coalition blamed Mursi for the violence and said it was ready for dialogue if the Islamist leader scrapped the decree that gave him wide powers and shielded his decisions from judicial review.

"Today what is happening in the Egyptian street, polarization and division, is something that could and is actually drawing us to violence and could draw us to something worse," opposition coordinator Mohamed ElBaradei said on Wednesday.

"We are ready for dialogue if the constitutional decree is cancelled ... and the referendum on this constitution is postponed," he told a news conference.

But liberals, leftists, Christians, ex-Mubarak followers and others opposed to Mursi have yet to generate a mass movement or a grassroots base to challenge the Brotherhood.

'REAL DANGER'

Opposition leaders have previously urged Mursi to retract the decree, defer the referendum and agree to revise the constitution, but have not echoed calls from street protesters for his overthrow and the "downfall of the regime".

Mursi has said his decree was needed to prevent courts still full of judges appointed by Mubarak from derailing a constitution vital for Egypt's political transition.

Mekky said street mobilization by both sides posed a "real danger" to Egypt. "If we do not put a stop to this phenomenon right away ... where are we headed? We must calm down."

U.S. Secretary of State Hillary Clinton weighed into Egypt's political debate, saying dialogue was urgently needed on the new constitution, which should "respect the rights of all citizens".

Clinton and Mursi worked together last month to broker a truce between Israel and Hamas Islamists in the Gaza Strip.

British Foreign Secretary William Hague called for restraint on all sides. He said Egypt's authorities had to make progress on the transition in an "inclusive manner" and urged dialogue.

Both Islamists and their opponents have staged big shows of strength on the streets since Mursi's decree, each bringing out tens of thousands of people.

State institutions, with the partial exception of the judiciary, have mostly fallen in behind Mursi.

The army, the muscle behind all previous Egyptian presidents in the republic's six-decade history, has gone back to barracks, having apparently lost its appetite to intervene in politics.

(Additional reporting by Yasmine Saleh and Marwa Awad; Writing by Edmund Blair; Editing by Will Waterman)

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Japan polls tip big win for opposition

TOKYO: Japan's main opposition party will comfortably win the general election this month, opinion polls showed Thursday, the first time surveys have indicated anything other than a fragile coalition.

The hawkish chief of the conservative Liberal Democratic Party (LDP) Shinzo Abe is also tipped to win back the premiership, an office he held for around a year until 2007, according to a telephone poll conducted by Kyodo news agency.

The LDP is on course to win up to 306 of the 480 seats in lower house of parliament on December 16, with the projected tally representing a huge jump from the 118 seats the party currently has.

The survey of 123,700 eligible voters showed Prime Minister Yoshihiko Noda's Democratic Party of Japan (DPJ) will see its number of seats plunge to between 57 and 82 from the 308 it swept to power with in 2009.

Around 1,500 candidates, fielded by 12 parties or standing as independents, are vying for the 480 seats -- 300 in single-seat constituencies and 180 allocated for proportional representation in 11 blocs.

Previous opinion polls have shown a much tighter race, with commentators expecting the election would leave Japan with a fragile coalition government.

Kyodo noted about half the voters said they had not yet decided on who to vote for.

Similar surveys by the mass-circulation Asahi and Yomiuri dailies, released Thursday, also showed the LDP was gaining momentum and was on course to win a single-party majority.

The Kyodo survey said the LDP's potential junior coalition partner New Komeito party is likely to win between 25 and 31 seats.

If the two parties joined forces they would have a two-thirds majority in the powerful lower house, giving them the right to overrule the DPJ-dominated upper house.

The Japan Restoration Party, an unwieldy coalition of followers of Osaka's outspoken mayor Toru Hashimoto and of the China-bashing former governor of Tokyo, Shintaro Ishihara, is likely to become a third-largest party, the polls showed.

The Tomorrow Party of Japan, a hastily cobbled-together grouping of DPJ malcontents and a left-leaning newcomers pledging to end Japan's nuclear power programme in 10 years, could have just 15 seats.

This month's vote is being seen as a verdict on the DPJ's three-year rule, which included the turbulent months after the nuclear disaster plunged the nation into its biggest crisis since World War II.

- AFP/ck

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Nasa releases satellite imagery of India on Diwali night

WASHINGTON: Nasa, the national space agency of the US, today released a black and white satellite imagery of India this Diwali night, cautioning people against the fake image in circulation on the social media.

"On November 12, 2012, the Visible Infrared Imaging Radiometer Suite (VIIRS) on the Suomi NPP satellite captured this nighttime view of southern Asia," Nasa said releasing a picture of India on this Diwali night.

"The image is based on data collected by the VIIRS 'day- night band', which detects light in a range of wavelengths from green to near-infrared. The image has been brightened to make the city lights easier to distinguish," it said.

Nasa said most of the bright areas in the imagery released by it are cities and towns in India, the country with the world's largest Hindu population.

"India is home to more than 1.2 billion people and has 30 cities with populations over 1 million. (For comparison, China has 62 cities with more than 1 million residents and the United States has 9)," it said.

Cities in Bangladesh, Nepal, and Pakistan are also visible near the edges of the image.

"An image that claims to show the region lit for Diwali has been circulating on social media websites and the Internet in recent years. In fact, it does not show what it claims. That image, based on data from the Operational Linescan System flown on US Defense Meteorological Satellite Program (DMSP) satellites, is a color-composite created in 2003 by NOAA scientist Chris Elvidge to highlight population growth over time," Nasa said.

"In that image, white areas show city lights that were visible prior to 1992, while blue, green, and red shades indicate city lights that became visible in 1992, 1998, and 2003 respectively," it said.

"In reality, any extra light produced during Diwali is so subtle that it is likely imperceptible when observed from space," Nasa said.

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Study could spur wider use of prenatal gene tests

A new study sets the stage for wider use of gene testing in early pregnancy. Scanning the genes of a fetus reveals far more about potential health risks than current prenatal testing does, say researchers who compared both methods in thousands of pregnancies nationwide.

A surprisingly high number — 6 percent — of certain fetuses declared normal by conventional testing were found to have genetic abnormalities by gene scans, the study found. The gene flaws can cause anything from minor defects such as a club foot to more serious ones such as mental retardation, heart problems and fatal diseases.

"This isn't done just so people can terminate pregnancies," because many choose to continue them even if a problem is found, said Dr. Ronald Wapner, reproductive genetics chief at Columbia University Medical Center in New York. "We're better able to give lots and lots of women more information about what's causing the problem and what the prognosis is and what special care their child might need."

He led the federally funded study, published in Thursday's New England Journal of Medicine.

A second study in the journal found that gene testing could reveal the cause of most stillbirths, many of which remain a mystery now. That gives key information to couples agonizing over whether to try again.

The prenatal study of 4,400 women has long been awaited in the field, and could make gene testing a standard of care in cases where initial screening with an ultrasound exam suggests a structural defect in how the baby is developing, said Dr. Susan Klugman, director of reproductive genetics at New York's Montefiore Medical Center, which enrolled 300 women into the study.

"We can never guarantee the perfect baby but if they want everything done, this is a test that can tell a lot more," she said.

Many pregnant women are offered screening with an ultrasound exam or a blood test that can flag some common abnormalities such as Down syndrome, but these are not conclusive.

The next step is diagnostic testing on cells from the fetus obtained through amniocentesis, which is like a needle biopsy through the belly, or chorionic villus sampling, which snips a bit of the placenta. Doctors look at the sample under a microscope for breaks or extra copies of chromosomes that cause a dozen or so abnormalities.

The new study compared this eyeball method to scanning with gene chips that can spot hundreds of abnormalities and far smaller defects than what can be seen with a microscope. This costs $1,200 to $1,800 versus $600 to $1,000 for the visual exam.

In the study, both methods were used on fetal samples from 4,400 women around the country. Half of the moms were at higher risk because they were over 35. One-fifth had screening tests suggesting Down syndrome. One-fourth had ultrasounds suggesting structural abnormalities. Others sought screening for other reasons.

"Some did it for anxiety — they just wanted more information about their child," Wapner said.

Of women whose ultrasounds showed a possible structural defect but whose fetuses were called normal by the visual chromosome exam, gene testing found problems in 6 percent — one out of 17.

"That's a lot. That's huge," Klugman said.

Gene tests also found abnormalities in nearly 2 percent of cases where the mom was older or ultrasounds suggested a problem other than a structural defect.

Dr. Lorraine Dugoff, a University of Pennsylvania high-risk pregnancy specialist, wrote in an editorial in the journal that gene testing should become the standard of care when a structural problem is suggested by ultrasound. But its value may be incremental in other cases and offset by the 1.5 percent of cases where a gene abnormality of unknown significance is found.

In those cases, "a lot of couples might not be happy that they ordered that test" because it can't give a clear answer, she said.

Ana Zeletz, a former pediatric nurse from Hoboken, N.J., had one of those results during the study. An ultrasound suggested possible Down syndrome; gene testing ruled that out but showed an abnormality that could indicate kidney problems — or nothing.

"They give you this list of all the things that could possibly be wrong," Zeletz said. Her daughter, Jillian, now 2, had some urinary and kidney abnormalities that seem to have resolved, and has low muscle tone that caused her to start walking later than usual.

"I am very glad about it," she said of the testing, because she knows to watch her daughter for possible complications like gout. Without the testing, "we wouldn't know anything, we wouldn't know to watch for things that might come up," she said.

The other study involved 532 stillbirths — deaths of a fetus in the womb before delivery. Gene testing revealed the cause in 87 percent of cases versus 70 percent of cases analyzed by the visual chromosome inspection method. It also gave more information on specific genetic abnormalities that couples could use to estimate the odds that future pregnancies would bring those risks.

The study was led by Dr. Uma Reddy of the National Institute of Child Health and Human Development.

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Online:

Medical journal: http://www.nejm.org

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Subway Push Murder Suspect Implicated Self: Police

A suspect believed to be responsible for throwing a man into the path of an oncoming New York City subway train who was taken into custody today has made statements implicating himself, police said.

According to Deputy Commissioner for Public Information Paul Browne, the suspect has been questioned by police since at least early afternoon and while the suspect is in police custody, he has not been officially charged.

Police are continuing to question the suspect and more lineups have been scheduled for tomorrow, Browne said.

Police have not released the suspect's name but began questioning him Tuesday afternoon about the death of Ki-Suck Han, 58, of Queens, N.Y.

Han was tossed onto the subway track at 49th Street and Seventh Avenue around 12:30 p.m. Monday after Han confronted a mumbling man who was alarming other passengers on the train platform. Han tried to scramble back onto the platform, but was crushed by an oncoming train.

The suspect fled the station, prompting a police dragnet for a man described by witnesses and see on surveillance video as a 6-foot-tall, 200-pound black man wearing dreadlocks in his hair.

Witnesses tried to revive the victim after he was hit and provided descriptions of the suspect to police.

Dr. Laura Kaplan, medical resident at Beth Israel Medical Center who was standing on the platform during the incident rushed to give Han aid after he was hit, she said in a statement released by her medical practice today.

New York Police Department

Bystanders Pull Mom, Son From Subway Tracks Watch Video

"A security guard and I performed 3-4 minutes of chest compressions. I hope the family may find some comfort in knowing about the kindness of these good Samaritans, as they endure this terrible loss," Kaplan said.

"I would like the family to know that many people in the station tried to help Mr. Han by alerting the subway personnel," she said.

Kaplan said she wanted to console the family of Han, who she called "a brave man trying to protect other passengers that he did not know."

The suspect had reportedly been mumbling to himself and disturbing other passengers, according to ABC News affiliate WABC. Police told WABC that the suspect could be mentally disturbed.

The suspect could be heard arguing with Han just moments before he hurled Han onto the track bed, according to surveillance video released by the police. The suspect is heard telling the victim to stand in line and "wait for the R train."

A freelance photographer for the New York Post was on the platform and said he ran towards the train flashing his camera hoping to alert the train to stop in time, but the train caught Han against the shoulder deep platform wall.

The photographer, R. Umar Abbasi, caught an eerie photo of Han with his head and arms above the platform and staring at the oncoming train.

Han was treated by EMS workers on the platform for traumatic arrest and rushed to Roosevelt Hospital, where he was pronounced dead, according to the Fire Department of New York.

"I just heard people yelling. The train came to an abrupt stop about three-quarters into the station and that's when I heard a man was hit by a train," Patrick Gomez told ABC News affiliate WABC.

Police set up a command post outside the train station Monday night searching nearby surveillance cameras to try and get a clear image of the suspect, reports WABC. They said Tuesday that the investigation is ongoing.

Anyone with information is asked to call Crime Stoppers at 1-800-577-TIPS (8477). The public can also submit tips by logging onto the Crime Stoppers website at www.nypdcrimestoppers.com or by texting their tips to 274637 (CRIMES) then enter TIP577. All calls are strictly confidential.

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NATO warns Syria not to use chemical weapons

BRUSSELS/BEIRUT (Reuters) - NATO told Syrian President Bashar al-Assad on Tuesday that any use of chemical weapons in his fight against encroaching rebel forces would be met by an immediate international response.

The warning from NATO Secretary-General Anders Fogh Rasmussen came as U.S. government sources said Washington had information that Syria was making what could be seen as preparations to use its chemical arsenal.

Syrian forces meanwhile bombarded rebel districts near Damascus in a sustained counter-attack to stem rebel gains around Assad's power base as the insurgency may be entering a decisive phase.

International concern over Syria's intentions has been heightened by reports that its chemical weapons have been moved and could be prepared for use.

"The possible use of chemical weapons would be completely unacceptable for the whole international community and if anybody resorts to these terrible weapons I would expect an immediate reaction from the international community," Rasmussen told reporters at the start of a meeting of alliance foreign ministers in Brussels.

The chemical threat made it urgent for the alliance to send Patriot anti-missile missiles to Turkey, Rasmussen said.

The French Foreign Ministry referred to "possible movements on military bases storing chemical weapons in Syria" and said the international community would react if they were used.

Britain has told the Syrian government that any use of chemical weapons would have "serious consequences", Foreign Secretary William Hague said.

U.S. President Barack Obama on Monday told Assad not to use chemical weapons, without saying how the United States might respond. The Foreign Ministry in Damascus said it would never use such weapons against Syrians.

CLASSIFIED INTELLIGENCE

The U.S. has collected what has been described as highly classified intelligence information demonstrating that Syria is making what could be construed as preparations to use elements of its extensive chemical weapons arsenal, two U.S. government sources briefed on the issue said.

One of the sources said that there was no question that the US "Intelligence community" had received information pointing to "preparations" under way in Syria related to chemical weapons. The source declined to specify what kind of preparations had been reported, or how close the intelligence indicated the Syrians were to deploying or even using the weapons.

Western military experts say Syria has four suspected chemical weapons sites, and it can produce chemical weapons agents including mustard gas and sarin, and possibly also VX nerve agent. The CIA has estimated that Syria possesses several hundred liters of chemical weapons and produces hundreds of tonnes of agents annually.

The fighting around Damascus has led foreign airlines to suspend flights and prompted the United Nations and European Union to reduce their presence in the capital, adding to a sense that the fight is closing in.

The army fightback came a day after the Syrian foreign ministry spokesman was reported to have defected in a potentially embarrassing blow to the government.

The Syrian Observatory for Human Rights said 200 people were killed across Syria on Monday, more than 60 of them around Damascus. Assad's forces bombarded districts to the south-east of the capital on Tuesday, near to the international airport, and in the rebel bastion of Daraya to the south-west.

Opposition footage posted on the Internet showed a multiple rocket launcher fire 20 rockets, which activists said was filmed at the Mezze military airport in Damascus.

Reuters could not independently verify the footage due to the government's severe reporting restrictions.

In central Damascus, shielded for many months from the full force of a civil war in which 40,000 people have been killed, one resident reported hearing several loud explosions.

"I have heard four or five thunderous blows. It could be barrel bombs," she said, referring to makeshift bombs which activists say Assad's forces have dropped from helicopters on rebel-dominated areas.

MORTAR ATTACK

The state news agency said that 28 students and a teacher were killed near the capital when rebels fired a mortar bomb on a school. Rebels have targeted government-held residential districts of the capital.

The mainly Sunni Muslim rebel forces have made advances in recent weeks, seizing military bases, including some close to Damascus, from forces loyal to Assad, who is from Syria's Alawite minority linked to Shi'ite Islam.

Faced with creeping rebel gains across the north and east of the country, and the growing challenge around the capital, Assad has increasingly resorted to air strikes against the insurgents.

A diplomat in the Middle East said Syrian Foreign Ministry spokesman Jihad Makdissi had left the country and defected, while the British-based Observatory said it had information that he flew from Beirut on Monday afternoon heading for London.

In Beirut, a diplomat said Lebanese officials had confirmed that Makdissi spent several days in Beirut before leaving on Monday, but could not confirm his destination.

"We're aware of reports that he has defected and may be coming to the UK. We're seeking clarification," a Foreign Office spokeswoman in London said.

Makdissi was the public face to the outside world of Assad's government as it battled the 20-month-old uprising. But he had barely appeared in public for several weeks before Monday's report of his defection.

He had little influence in a system largely run by the security apparatus and the military. But Assad's opponents will see the loss of such a high profile figure, if confirmed, as further evidence of a system crumbling from within.

The United Nations and European Union both said they were reducing their presence in Syria in response to the escalated violence around the capital.

A spokesman for U.N. humanitarian operations said the move would not stop aid deliveries to areas which remained accessible to relief convoys.

"U.N.-funded aid supplies delivered through SARC (Syrian Arab Red Crescent) and other charities are still moving daily where the roads are open," Jens Laerke told Reuters in Geneva.

"We have not suspended our operation, we are reducing the non-essential international staff."

Three remaining international staff at the European Union delegation, who stayed on in Damascus after the departure of most Western envoys, crossed the border into Lebanon on Tuesday after pulling out of the Syrian capital.

(Additional reporting by David Brunnstrom in Brussels, Khaled Yacoub Oweis in Cairo, Erika Solomon, Oliver Holmes and Ayat Basma in Beirut, Mark Hosenball, Mohammed Abbas and David Cutler in London, and Stephanie Nebehay in Geneva; Editing by Giles Elgood)

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N. Korea completes installing rocket

SEOUL: North Korea has completed installing a long-range rocket on its launch pad, ahead of its planned launch this month in defiance of widespread international condemnation, a report said Wednesday.

All three stages of the Unha-3 rocket have been placed on the pad at the North's Sohae satellite launch station, a South Korean government source told Yonhap news agency.

"Some workers are pulling out of the site," the source said.

Pyongyang announced on Saturday that it intends to launch the rocket between December 10 and 22.

The United States and its key Asian allies South Korea and Japan have condemned the move as a disguised ballistic missile test that violates UN resolutions triggered by Pyongyang's two nuclear tests in 2006 and 2009.

North Korea is now expected to install support equipment, such as radar and cameras, before fueling the carrier, Yonhap said.

US Secretary of State Hillary Clinton on Tuesday urged her NATO allies and Russia to press North Korea to call off the mission.

"The United States is deeply concerned about North Korea's recent announcement that it plans to carry out another rocket launch," Clinton told a meeting of the NATO-Russia council.

"We urge everyone here to publicly call upon North Korea to comply fully with its UN Security Council obligations."

Pyongyang insists the launch is a "peaceful" and purely scientific mission aimed at placing a satellite in orbit.

A previous attempt in April failed when the carrier exploded shortly after take-off.

China has expressed "concern" at the launch plan, with the foreign ministry urging "relevant parties (to) act in a way that is more conducive to the stability of the Korean peninsula".

Russia added its "regret" and noted that North Korea was obliged to abide by UN resolutions.

But analysts say the international community is running out of options for pressuring the impoverished but nuclear-armed North, which is already under layers of sanctions.

The six-party, aid-for-denuclearisation talks have been at a standstill since Pyongyang walked of the forum in April 2009. It staged its second nuclear test a month later.

- AFP/ck

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India urges Israel to speed up defence projects

NEW DELHI: India has asked Israel to speed up crucial bilateral defence projects, including the around Rs 13,000 crore development of two advanced surface-to-air missile (SAM) systems to arm Indian armed forces against hostile aircraft, drones and helicopters.

This came at the 10th joint working group on defence cooperation here, co-chaired by defence secretary Shashikant Sharma and Israeli defence ministry director-general Major-General Ehud Shani.

While the regional and global security situation, including the recent Israel-Hamas ceasefire, figured in the talks, the focus was on bilateral defence training programmes, exchanges, R&D projects and armament deals.

Israel is India's second largest defence supplier, second only to Russia, but the expansive ties are largely kept under wraps due to political sensitivities. Tel Aviv records military sales worth around $1 billion to New Delhi every year, ranging from Heron and Searcher UAVs, Harpy and Harop 'killer' drones to Barak anti-missile defence systems and Green Pine radars, Python and Derby air-to-air missiles.

Sources said India expressed "concern'' at the "two-year delay'' in completion of the long-range SAM (LR-SAM) project, sanctioned in December 2005 at a cost of Rs 2,606 crore to arm Indian warships.

There are "minor hitches'' even in the bigger Rs 10,076 crore medium-range SAM (MR-SAM) project, sanctioned in February 2009 for air defence squadrons of IAF.

Both the SAM systems, being developed by Israeli Aerospace Industries (IAI) in collaboration with DRDO, have the same missile with an interception range of 70-km. They are to be produced in bulk by defence PSU Bharat Dynamics (BDL) to plug the existing holes in India's air defence cover.

"While the multi-function surveillance and threat radars, weapon control systems with data links and the like of the LR-SAM have all been tested, there has been delay in the missiles being developed by IAI,'' said a source.

"But the Israelis said everything was sorted out now and they will try to make up for the delay. DRDO has already finished its work on the propulsion and other systems,'' he added. Incidentally, the LR-SAM project was to be completed by May this year.

Another major missile project, worth around $1 billion, that Israel could bag is the one to supply third-generation anti-tank guided missiles (ATGMs) to the 1.13-million strong Indian Army. The Army has already trial-evaluated the Israeli 'Spike' ATGM after the US offer of its 'Javelin' missiles was shelved due to Washington's reluctance to undertake "transfer of technology'' to ensure BDL can make them in large numbers, as reported by TOI earlier.

India is also in commercial negotiations for another two advanced Israeli Phalcon AWACS (airborne warning and control systems), capable of detecting hostile aircraft, cruise missiles and other incoming aerial threats far before ground-based radars, at a cost of over $800 million. The first three Phalcon AWACS were inducted by IAF in 2009-2010 under the $1.1 billion tripartite agreement between India, Israel and Russia.

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Study: Drug coverage to vary under health law

WASHINGTON (AP) — A new study says basic prescription drug coverage could vary dramatically from state to state under President Barack Obama's health care overhaul.

That's because states get to set benefits for private health plans that will be offered starting in 2014 through new insurance exchanges.

The study out Tuesday from the market analysis firm Avalere Health found that some states will require coverage of virtually all FDA-approved drugs, while others will only require coverage of about half of medications.

Consumers will still have access to essential medications, but some may not have as much choice.

Connecticut, Virginia and Arizona will be among the states with the most generous coverage, while California, Minnesota and North Carolina will be among states with the most limited.

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Avalere Health: http://tinyurl.com/d3b3hfv

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Kate's Illness Sometimes Linked to Twins

Hyperemesis gravidarum, the reason newly pregnant Kate Middleton is in the hospital, is a rare but acute morning sickness that results in weight loss and accounts for about 2 percent of all morning sickness, doctors say.

The condition is sometimes associated with women having twins, experts said.

Women diagnosed with hyperemesis gravidarum have lost 5 percent of their pre-pregnancy weight, or 10 pounds, said Dr. Ashley Roman, a professor and OB/GYN at New York University Langone Medical Center.

It poses little danger to the tiny heir, doctors said.

"It's traditionally thought that nausea and vomiting is a sign of a healthy pregnancy," Roman said

Dr. Nancy Cossler, an OB/GYN at University Hospitals in Ohio said the condition does not cause loss of pregnancy or birth defects, but it can be a torture to endure.

"The biggest problem with this is how it interferes with your life," Cossler said. "Constantly feeling sick and puking is difficult."

Click here to read about other women with hyperemesis gravidarum.

Hyperemesis gravidarum is thought to be caused by higher levels of the pregnancy hormone, hCG, or human chorionic gonadotropin, Cossler said. Extra hCG can often be brought on by carrying more than one fetus, she said.

Chris Jackson/AFP/Getty Images

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In other words, it could be a sign that Middleton is carrying twins. Although there's very little data on twins and hyperemesis gravidarum, one study showed that women carrying twins had a 7.5 percent higher risk of experiencing the acute morning sickness, Roman said.

The extreme morning sickness is usually diagnosed about nine weeks into the pregnancy, and in most cases resolves itself by 16 or 20 weeks, Roman said. In rare cases, it can last the whole pregnancy.

"As the pregnancy is in its very early stages, Her Royal Highness is expected to stay in hospital for several days and will require a period of rest thereafter," a statement from St. James Palace said. Prince William is at the hospital with Middleton, according to the Britain's Press Association.

Click here for photos of Kate through the years.

Roman said doctors prescribe vitamins and ginger capsules at first. If that doesn't stop the vomiting, they will prescribe antihistamines and stronger anti-nausea medications.

Women with hyperemesis gravidarum are also treated with fluids, said Dr. Jessica Young, an OB/GYN at Vanderbilt University. But if left untreated, a pregnant woman who is severely dehydrated for a long period of time could die, "just like any person," Young said.

In extreme cases in which the woman is losing weight and unable to eat, doctors will treat her with intravenous nutrition, Young said.

Hospital stays can vary, and women will often have to be admitted more than once before the condition passes, doctors said.

Hyperemesis gravidarum is somewhat mysterious because some expectant mothers have acute morning sickness during only one of their pregnancies, but have no morning sickness for subsequent pregnancies.

There is a chance that higher levels of hCG, which likely caused Middleton's nausea, could be a sign of a molar pregnancy instead of twins, Cossler said. This would mean Middleton is carrying only a benign growth in her uterus instead of a fetus, or she is carrying a fetus with abnormal DNA and a benign growth. Neither is considered a viable pregnancy.

However, Cossler said molar pregnancies become apparent early on, and doctors would already know whether Middleton had one.

"They would not have released this information," Cossler said of the birth announcement. "I'm certain that they have already eliminated both of those [types of molar pregnancies]."

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