Clinton's blood clot an uncommon complication

The kind of blood clot in the skull that doctors say Hillary Rodham Clinton has is relatively uncommon but can occur after an injury like the fall and concussion the secretary of state was diagnosed with earlier this month.

Doctors said Monday that an MRI scan revealed a clot in a vein in the space between the brain and the skull behind Clinton's right ear.

The clot did not lead to a stroke or neurological damage and is being treated with blood thinners, and she will be released once the proper dose is worked out, her doctors said in a statement.

Clinton has been at New York-Presbyterian Hospital since Sunday, when the clot was diagnosed during what the doctors called a routine follow-up exam. At the time, her spokesman would not say where the clot was located, leading to speculation it was another leg clot like the one she suffered behind her right knee in 1998.

Clinton had been diagnosed with a concussion Dec. 13 after a fall in her home that was blamed on a stomach virus that left her weak and dehydrated.

The type of clot she developed, a sinus venous thrombosis, "certainly isn't the most common thing to happen after a concussion" and is one of the few types of blood clots in the skull or head that are treated with blood thinners, said neurologist Dr. Larry Goldstein. He is director of Duke University's stroke center and has no role in Clinton's care or personal knowledge of it.

The area where Clinton's clot developed is "a drainage channel, the equivalent of a big vein inside the skull — it's how the blood gets back to the heart," Goldstein explained.

It should have no long-term consequences if her doctors are saying she has suffered no neurological damage from it, he said.

Dr. Joseph Broderick, chairman of neurology at the University of Cincinnati College of Medicine, also called Clinton's problem "relatively uncommon" after a concussion.

He and Goldstein said the problem often is overdiagnosed. They said scans often show these large "draining pipes" on either side of the head are different sizes, which can mean blood has pooled or can be merely an anatomical difference.

"I'm sure she's got the best doctors in the world looking at her," and if they are saying she has no neurological damage, "I would think it would be a pretty optimistic long-term outcome," Broderick said.

A review article in the New England Journal of Medicine in 2005 describes the condition, which more often occurs in newborns or young people but can occur after a head injury. With modern treatment, more than 80 percent have a good neurologic outcome, the report says.

In the statement, Clinton's doctors said she "is making excellent progress and we are confident she will make a full recovery. She is in good spirits, engaging with her doctors, her family, and her staff."

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Online:

Medical journal: http://dura.stanford.edu/Articles/Stam_NEJM05.pdf

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What Happens If We Go Over the Fiscal Cliff?

America is swiftly approaching the fiscal cliff.

President Obama and congressional leaders have talked for weeks with varying degrees of frequency and success at compromising, and one precept resonates throughout the public statements of politicians and economists: the so-called "fiscal cliff" would be a very bad thing.

But what actually happens if Washington takes us over it?

As has been well documented, the "cliff" is not one thing, but a ball of expiring economic provisions that lead to automatic policy changes at year's end, loosely grouped under the catch phrase. They fall into two categories, taxes and spending.

Should we fall off the cliff, the tax code would change most dramatically with the expiration of the so-called "Bush tax cuts," which created new brackets and lowered tax rates for both middle-class and high earners. According to the Tax Policy Center at the Washington, D.C.-based Brookings Institution, the average American taxpayer would see a tax hike of $3,446, ABC's David Muir reported for "World News."

Where do the hikes fall, exactly? For many tax brackets, rates would jump by at least three percentage points. The middle class would see the worst of it, according to analysis from the Congressional Research Service, the nonpartisan research arm that studies policy changes at Congress's request.

Charles Dharapak/AP Photo|Bill O'Leary/The Washington Post via Getty Images

For high earners, married couples making more than $222,300 but less than $397,000, rates would jump from 33 percent to 36 percent. For the highest earners, couples making over $397,000, taxes would rise from 35 percent to 39.6 percent.

But they'd rise for almost everyone else, too. Couples making $145,900 - $222,300 would see a rate jump from 28 percent to 31 percent. Couples making $72,300 - $145,900 would see rates jump from 25 percent to 28 percent.

The middle class would take the biggest hit: Married couples earning $60,350 - $72,300 would see tax rates jump from 15 percent to 28 percent. That means that without any credits or deductions, a couple making $65,000 would go from taking home $55,250 to taking home $46,800 next year if Congress and the president fail to strike a deal.

The cliff's tax implications go beyond the simple income-tax rate: The Alternative Minimum Tax (AMT) and the estate tax are also on the table with year-end deadlines.

The AMT is a tax that prevents high earners from escaping income-tax liability by claiming too many deductions. Taxpayers over a certain income add back certain deductions to see if they must pay a minimum rate. Ever since Bush's tax cuts, Congress has repeatedly extended an "AMT patch" to maintain the income threshold. According to the Congressional Research Service, if Congress doesn't act again this year, that threshold will drop from $74,450 to $45,000 for married couples and from $48,450 to $33,750 for individuals, exposing more people to the alternative minimum.

The estate tax, demonized by Republicans as the dreaded "death tax," would change significantly. Right now, estates of over $5.12 million are taxed at a maximum of 35 percent. If Congress doesn't act, next year estates of over $1 million will be taxed at 55 percent.

No one likes paying taxes, but the spending side of the cliff isn't supposed to be all that fun, either.

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Chavez suffers new post-surgery complications

CARACAS (Reuters) - Venezuelan President Hugo Chavez is suffering more complications linked to a respiratory infection that hit him after his fourth cancer operation in Cuba, his vice president said in a somber broadcast on Sunday.

Vice President Nicolas Maduro flew to Cuba to visit Chavez in the hospital as supporters' fears grew for the ailing 58-year-old socialist leader, who has not been seen in public nor heard from in three weeks.

Chavez had already suffered unexpected bleeding caused by the six-hour operation on December 11 for an undisclosed form of cancer in his pelvic area. Officials said doctors then had to fight a respiratory infection.

"Just a few minutes ago we were with President Chavez. He greeted us and he himself talked about these complications," Maduro said in the broadcast, adding that the third set of complications arose because of the respiratory infection.

"Thanks to his physical and spiritual strength, Comandante Chavez is confronting this difficult situation."

Maduro, flanked by his wife Attorney-General Cilia Flores, Chavez's daughter Rosa Virginia and her husband, Science Minister Jorge Arreaza, said he would remain in Havana while Chavez's condition evolved.

He said Chavez's condition remained "delicate" - a term he has used since the day after the surgery, when he warned Venezuelans to prepare for difficult times and urged them to keep the president in their prayers.

"We trust that the avalanche of love and solidarity with Comandante Chavez, together with his immense will to live and the care of the best medical specialists, will help our president win this new battle," Maduro said.

A senior government official in Caracas said the New Year's Eve party in the capital's central Plaza Bolivar had been canceled. "Everyone pray for strength for our comandante to overcome this difficult moment," the official, Jacqueline Faria, added on Twitter after making the announcement.

OIL-FINANCED SOCIALISM

Chavez's resignation for health reasons, or his death, would upend politics in the OPEC nation where his personalized brand of oil-financed socialism has made him a hero to the poor but a pariah to critics who call him a dictator.

His condition is being closely watched around Latin America, especially in other nations run by leftist governments, from Cuba to Bolivia, which depend on subsidized fuel shipments and other aid from Venezuela for their fragile economies.

Chavez has not provided details of the cancer that was first diagnosed in June 2011, leading to speculation among Venezuela's 29 million people and criticism from opposition leaders.

Chavez's allies have openly discussed the possibility that he may not be able to return to Venezuela to be inaugurated for his third six-year term as president on the constitutionally mandated date of January 10.

Senior "Chavista" officials have said the people's wishes were made clear when the president was re-elected in October, and that the constitution makes no provision for what happens if a president-elect cannot take office on January 10.

Opposition leaders say any postponement would be just the latest sign that Chavez is not in a fit state to govern and that new elections should be called to choose his replacement. If Chavez had to step down, new elections would be called within 30 days.

Opposition figures believe they have a better shot against Maduro, who was named earlier this month by Chavez as his heir apparent, than against the charismatic president who for 14 years has been nearly invincible at the ballot box.

Any constitutional dispute over succession could lead to a messy transition toward a post-Chavez era in the country that boasts the biggest oil reserves in the world.

Maduro has become the face of the government in Chavez's absence, imitating the president's bombastic style and sharp criticism of the United States and its "imperialist" policies.

In Sunday's broadcast, Maduro said Chavez sent New Year greetings to all Venezuelans, "especially the children, whom he carries in his heart always."

(Additional reporting by Deisy Buitrago and Mario Naranjo; Editng by Kieran Murray and Christopher Wilson)

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Nine dead after bus careens into Oregon ravine

LOS ANGELES: A Canada-bound bus crashed through a guard rail on an icy road in Oregon on Sunday and careened into a ravine, killing at least nine people and injuring at least 18 others, state police said.

The bus fell a couple hundred feet before stopping, Oregon State Police said on its website, adding that the chartered bus was reportedly heading home to Vancouver, Canada from Las Vegas, Nevada.

Police in the northwestern state are still investigating the cause of the crash, which occurred in the morning near the city of Pendleton, in northeastern Oregon.

The rescue effort was complicated by the drop-off from the highway, and police said "personnel trained for rope rescues" were called in to help.

About 40 passengers appeared to have been onboard the bus, but the numbers have not yet been confirmed.

The names and nationalities of the victims and other passengers were not immediately released, but many "are believed to be out of country residents," according to police.

Although the bus driver survived the crash, investigators have not been able to interview him due to the severity of the injuries.

There was at least one other fatal crash in northeastern Oregon early Sunday due to snowy and icy conditions, police said, urging all drivers to take precautions while traveling.

-AFP/ac

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Castrate all rapists, says Zubin Mehta

BEIJING: World famous composer of Indian origin, Zubin Mehta, called for castration of all accused in the Delhi gang-rape case and others found committing the rape in India. He expressed excitement about the protests against the gang-rape of Nirbhaya and expects positive changes to come out of it.

"I am fuming, but I see a very healthy sign of public objection, public demonstration. I hope it will not die down. I hope it will not be short-lived," Mehta told Toi in an exclusive interview.

He said the Indian government should realize what the people really want from it. "It is not only about justice, but the future of India. Police has to take it seriously".

Mehta said the issue is being discussed the world over like the case of Malala, the Pakistani girl, and brought shame to Indians. He also questioned the government's decision to shift the rape victim for medical treatment to Singapore. "Where they trying to remove her from the locality, for her own safety?" he asked.

The least that should be done is to castrate all the four accused in the Delhi gang rape case, he said. "I heard that a girl who reported rape was advised to marry one of the criminals. How can a human being do such a thing?" he asked.

"An important issue that needs to be addressed is how to look after the poor ladies who have been attacked," he said.

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Kenya hospital imprisons new mothers with no money

NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.

Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.

Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.

"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."

"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."

The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.

Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.

"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.

She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.

A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.

"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.

Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.

One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.

Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.

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Associated Press reporter Tom Odula contributed to this report.

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Hillary Clinton Hospitalized With Blood Clot

Dec 30, 2012 8:11pm

(MICHAL CIZEK/AFP/Getty Images)

Secretary Hillary Clinton was hospitalized today after a doctors doing a follow-up exam discovered a blood clot had formed, stemming from the concussion she sustained several weeks ago.

She is being treated with anti-coagulants and is at NewYork-Presbyterian Hospital so that they can monitor the medication over the next 48 hours, Deputy Assistant Secretary Philippe Reines said.

Her doctors will continue to assess her condition, including other issues associated with her concussion. They will determine if any further action is required, Reines said.

Clinton, 65, originally fell ill from a stomach virus following a whirlwind trip to Europe at the beginning of the month, which caused such severe dehydration that she fainted and fell at home, suffering a concussion. No ambulance was called and she was not hospitalized, according to a state department official.

The stomach virus had caused Clinton to cancel a planned trip to North Africa and the United Arab Emirates, and also her scheduled testimony before Congress at hearings on the attack on the U.S. consulate in Benghazi, Libya.

According to a U.S. official, the secretary had two teams of doctors, including specialists, examine her after the fall.  They also ran tests to rule out more serious ailments beyond the virus and the concussion. During the course of the week after her concussion, Clinton was on an IV drip and being monitored by a nurse, while also recovering from the pain caused by the fall.

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India gang rape victim dies in Singapore hospital

SINGAPORE (Reuters) - The Indian gang rape victim whose assault in New Delhi triggered nationwide protests died of her injuries on Saturday in a Singapore hospital, potentially threatening fresh protests in India where her case is a rallying point for women's rights.

The 23-year-old medical student, severely beaten, raped and thrown out of a moving bus in New Delhi two weeks ago, had been flown to Singapore in a critical condition by the Indian government on Thursday for specialist treatment.

"We are very sad to report that the patient passed away peacefully at 4:45 a.m. on Dec 29, 2012 (3:45 p.m. ET Friday). Her family and officials from the High Commission (embassy) of India were by her side," Mount Elizabeth Hospital Chief Executive Officer Kelvin Loh said in a statement.

Most rapes and other sex crimes in India go unreported and offenders are rarely punished, women's rights activists say. But the brutality of the December 16 assault sparked public outrage and calls for better policing and harsher punishment for rapists.

The case has received blanket coverage on cable television news channels. The woman has not been identified but some Indian media have called her "Amanat", an Urdu word meaning "treasure".

"We are saddened to learn that she has succumbed to her injuries, and would like to extend our deepest condolences to her family during this time of bereavement," Singapore's Ministry of Foreign Affairs said in a statement.

Earlier on Friday, the hospital had reported that the woman's condition had taken a turn for the worse. It said that her family had been informed and were by her side.

T.C.A. Raghavan, the Indian High Commissioner to Singapore, said after her death that the family had expressed a desire for her body to be flown back to India. Moments later, the woman's body was loaded into a van and driven away.

Talking to reporters earlier on Saturday, Raghavan declined to comment on reports in India accusing the government of sending her to Singapore to minimize the possible backlash in the event of her death.

Some Indian medical experts had questioned the decision to airlift the woman to Singapore, calling it a risky maneuver given the seriousness of her injuries. They had said she was already receiving the best possible care in India.

Prime Minister Manmohan Singh's government has been battling criticism that it was tone-deaf to the outcry and heavy handed in its response to the protests in the Indian capital.

"It is deeply saddening and just beyond words. The police and government definitely have to do something more," said Sharanya Ramachandran, an Indian national working as an engineer in Singapore.

"They should bring in very severe punishment for such cases. They should start recognizing that it is a big crime."

"SIGNIFICANT BRAIN INJURY"

The Singapore hospital said earlier that the woman had suffered "significant brain injury" and was surviving against the odds. She had already undergone three abdominal operations before being flown to Singapore.

Protests over the lack of safety for women erupted across India after the attack, culminating last weekend in pitched battles between police and protesters in the heart of New Delhi.

New Delhi has been on edge since the weekend clashes. Hundreds of policemen have been deployed on the streets of the capital and streets leading to the main protest site, the India Gate war memorial, have been shut for long periods, severely disrupting traffic in the city of 16 million.

Commentators and sociologists say the rape has tapped into a deep well of frustration that many Indians feel over what they see as weak governance and poor leadership on social and economic issues.

Many protesters have complained that Singh's government has done little to curb the abuse of women in the country of 1.2 billion. A global poll by the Thomson Reuters Foundation in June found that India was the worst place to be a woman because of high rates of infanticide, child marriage and slavery.

New Delhi has the highest number of sex crimes among India's major cities, with a rape reported on average every 18 hours, according to police figures. Government data show the number of reported rape cases in the country rose by nearly 17 percent between 2007 and 2011.

(Additional reporting by Ross Colvin in New Delhi and Saeed Azhar and Edgar Su in Singapore; Editing by Michael Roddy and Mark Bendeich)

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Old rites for New Year

PARIS: As the clock strikes 12 on Monday, millions will pop champagne corks and light fireworks while others indulge in quirkier New Year's rituals like melting lead, leaping off chairs or gobbling grapes.

One of the world's oldest shared traditions, New Year's celebrations take many forms, but most cultures have one thing in common -- letting one's hair down after a long, hard year.

For much of the globe this involves sipping bubbly with friends until the sun comes up, seeing out the old year with bonfires and flares and off-key renditions of Auld Lang Syne.

But others have rather more curious habits, often steeped in superstition.

In Finland, say tour guides, people pour molten lead into cold water to divine the year ahead from the shape the metal sets in. If the blob represents a ship it is said to foretell travel, if it's a ball, good luck.

In Denmark, people stand on chairs and jump off in unison as the clock strikes midnight, literally leaping into the new year.

The Danes also throw plates at their friends' homes during the night -- the more shards you find outside your door in the morning the more popular you are said to be.

The Dutch build massive bonfires with their Christmas trees and eat sugary donuts -- one of many cultures to consume round New Year's foods traditionally believed to represent good fortune.

Spaniards, in turn, gobble a dozen grapes before the stroke of midnight, each fruit representing a month that will either be sweet or sour.

In the Philippines, revellers wear polka dots for good luck, while in some countries of South America people don brightly coloured underwear to attract fortune -- red for love and yellow for financial success.

Despite regional and cultural differences, for most the New Year's festivities are a chance to let off steam before the annual cycle starts all over again.

"This is a holiday that is about relaxation and letting go," explained George Washington University sociologist Amitai Etzioni.

"The whole year people are chained by social requirements, morals, laws... "And then there comes some occasion in which society says for today, 24 hours, for this evening, all bets are off, all norms are suspended, and it's OK.

"The next day we have to get back in line."

Historians say people have been marking the year change for thousands of years.

The ancient Romans, who gave us the solar calendar, celebrated in a way similar to ours.

Playing, eating, drinking

"It was a day of public celebration. People spent the day playing, eating and drinking," according to French historian John Scheid of the College de France.

"During the period of the empire, the first four centuries AD, this originally Roman custom became a general festival in the whole Roman world, and so it remained until today."

January 1 became the day widely marked as New Year's Day only in 46 BC, when the emperor Julius Caesar introduced a new calendar. March 1 had been the first day of the year until then.

Medieval Europe, though, continued celebrating New Year's Day on dates with religious significance, including Christmas.

In 1582, Pope Gregory XIII replaced the Julian calendar with the Gregorian one, correcting mathematical inconsistencies.

Most Catholic countries immediately adopted the calendar and its January 1 start, but Protestant nations did so only gradually.

Britain and its then-colonies, including the United States, were among the last to introduce the new calendar, from 1752.

While most of the world has now adopted January 1 as the official start of the year, some still hold their festivities on other dates.

Orthodox churches celebrate on January 14 (January 1 on the Julian calendar), while the Chinese New Year can fall on any date between January 21 and February 20, depending on the position of the moon.

Next year, it will be February 10.

- AFP/ck

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Short-tenure appointments to top security posts raise eyebrows

NEW DELHI: A flurry of senior postings in paramilitary, intelligence and home ministry have raised more than a few eyebrows as appointments to key jobs fail to keep in view the need to provide incumbents at least a year in their assignments.

The shift of Ajay Chadha, who was special secretary (internal security) in the home ministry, as Indo-Tibetan Border Police chief seems puzzling as he was holding an important assignment in North Block and will retire by August next year.

If shifting Chadha -- a well regarded officer who has served in Delhi Police -- is surprising, the move to replace him with an officer who will have a short tenure is also causing some comment although the decision is yet to be finalized.

In the meantime, Subhash Joshi, who was serving as director general of National Security Guard, has moved to Border Security Force where he will remain till February 2014. Arvind Rajan, who takes charge of NSG, is also slated for a short stint.

Joshi headed NSG for a little more than six months while before him, Rajan Medhekar was in charge for nearly 20 months.

The postings seem to reinforce the impression of a degree of ad-hocism in dealing with important security-related assignments with some officers arguing that the Manmohan Singh government has lacked a serious engagement with policing and intelligence.

The nature of appointments to intelligence arms like IB and RAW in recent years have not resulted in the strategic upgrade in capacities and analysis that a major terror event like 26/11 should have resulted in. When West Bengal governor M K Narayanan was national security advisor, he took a keen interest in police appointments although he was also not seen to have built systems although he was a hands-on spook.

Chadha has moved to BSF but continues to hold effective charge of special secretary (internal security). His move to the paramilitary outfit was necessitated by Ranjit Sinha being appointed chief of the Central Bureau of Investigation.

Sinha's appointment has already drawn some controversy with Delhi Police commissioner Neeraj Kumar objecting to being excluded from the shortlist and BJP leaders Arun Jaitley and Sushma Swaraj asking the appointment to be stayed till a collegium is set up.

The appointment of Asif Ibrahim as Intelligence Bureau chief saw the claims of Yashovardhan Azad and S Jayaraman being overlooked. The latter is now seen in the running for special secretary (internal security). Some feel that the appointment of Ibrahim's predecessor Nehchal Sandhu as deputy national security advisor could mean his continued say in IB matters as he is unlikely to have a foreign policy role.

The other intelligence appointment saw Alok Joshi being named head of the Research and Analysis Wing. His tenure follows that of Sanjeev Tripathi who is seen to have enjoyed an unremarkable tenure as RAW head.

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