Flu Symptoms Drove Boston Mayor to Hospital

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When Boston Mayor Thomas Menino ended his vacation in Italy short this fall and checked into a Boston hospital complaining of a respiratory infection, it led doctors to find and treat a blood clot in his leg, a fracture in his back, an infection around the fracture and type 2 diabetes.


Cold and flu symptoms from respiratory infections can be a hassle, but sometimes that fever and cough can be good for just getting people to the doctor.












“That’s why every patient needs a careful evaluation because every once in a while, what the patient thinks is the flu or reports as the flu is not,” said Dr. William Schaffner, chairman of preventative medicine at Vanderbilt University in Tennessee. “I would say 99 percent of people who present to the emergency room and doctor’s office with symptoms of influenza – that is cough, fever and the like – are certainly going to have influenza.”


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Menino, 69, arrived at Brigham and Women’s Hospital on Oct. 25, complaining of fatigue and a cough, and doctors described him as “extremely washed out” with some “malaise.” In addition to the respiratory infection, doctors found a blood clot that traveled from Menino’s leg to his lungs.


Respiratory illnesses, like the one that initially drove Menino to seek medical attention, can often range from mild to severe, Schaffner said.


“He was feeling poorly enough to end what was supposed to be a very pleasant vacation, and when he got here, he was very weak and very washed out,” Dr. Dale Adler, Menino’s doctor, said during a press conference in mid-November.


Doctors can usually tell whether flu-like symptoms are the result of a respiratory infection or something else soon after the patient is admitted. If not, they can perform a series of tests to find out.


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(The flu can lead to other ailments, the most common of which is pneumonia, or an infection of the lungs, Schaffner said.


About 1.1 million pneumonia patients were hospitalized and discharged in 2009, according to the latest data from the Centers for Disease Control and Prevention. On average, they stayed in the hospital 5.2 days.)


Weeks later, Menino was still in the hospital. Although his illness and clot had been resolved, he was complaining of back pain, which doctors discovered was the result of a compression fracture and an infection around the fracture.


Finally, doctors discovered that Menino had underlying type 2 diabetes, which may have contributed to the infection, Menino’s doctor said during a press conference on Monday.


It’s not clear how Menino’s initial flu-like symptoms tied into his other ailments, but doctors said they are positive about his prognosis. The mayor relocated to a rehabilitation center on Monday.


“It is a run of bad luck,” Morris said of Menino. “He will rebound from this.”


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Protesters pack Tahrir Square, dispute Morsi

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CAIRO (AP) — The same chants used against Hosni Mubarak were turned against his successor Tuesday as more than 200,000 people packed Egypt's Tahrir Square in the biggest challenge yet to Islamist President Mohammed Morsi.


The massive, flag-waving throng protesting Morsi's assertion of near-absolute powers rivaled some of the largest crowds that helped drive Mubarak from office last year.


"The people want to bring down the regime!" and "erhal, erhal" — Arabic for "leave, leave" — rang out across the plaza, this time directed at Egypt's first freely elected president.


The protests were sparked by edicts Morsi issued last week that effectively neutralize the judiciary, the last branch of government he does not control. But they turned into a broader outpouring of anger against Morsi and his Muslim Brotherhood, which opponents say have used election victories to monopolize power, squeeze out rivals and dictate a new, Islamist constitution, while doing little to solve Egypt's mounting economic and security woes.


Clashes broke out in several cities, with Morsi's opponents attacking Brotherhood offices, setting fire to at least one. Protesters and Brotherhood members pelted each other with stones and firebombs in the Nile Delta city of Mahalla el-Kobra, leaving at least 100 people injured.


"Power has exposed the Brotherhood. We discovered their true face," said Laila Salah, a housewife at the Tahrir protest who said she voted for Morsi in last summer's presidential election. After Mubarak, she said, Egyptians would no longer accept being ruled by an autocrat.


"It's like a wife whose husband was beating her and then she divorces him and becomes free," she said. "If she remarries she'll never accept another day of abuse."


Gehad el-Haddad, a senior adviser to the Brotherhood and its political party, said Morsi would not back down on his edicts. "We are not rescinding the declaration," he told The Associated Press.


That sets the stage for a drawn-out battle that could throw the nation into greater turmoil. Protest organizers have called for another mass rally Friday. If the Brotherhood responds with demonstrations of its own, as some of its leaders have hinted, it would raise the prospect of greater violence after a series of clashes between the two camps in recent days.


A tweet by the Brotherhood warned that if the opposition was able to bring out 200,000 to 300,000, "they should brace for millions in support" of Morsi.


Another flashpoint could come Sunday, when the constitutional court is to rule on whether to dissolve the assembly writing the new constitution, which is dominated by the Brotherhood and its Islamist allies. Morsi's edicts ban the courts from disbanding the panel; if the court defies him and rules anyway, it would be a direct challenge that could spill over into the streets.


"Then we are in the face of the challenge between the supreme court and the presidency," said Nasser Amin, head of the Arab Center for the Independence of the Judiciary and the Legal Profession. "We are about to enter a serious conflict" on both the legal and street level, he said.


Morsi and his supporters say the decrees were necessary to prevent the judiciary from blocking the "revolution's goals" of a transition to democracy. The courts — where many Mubarak-era judges still hold powerful posts — have already disbanded the first post-Mubarak elected parliament, which was led by the Brotherhood. Now it could also take aim at the Islamist-led upper house of parliament.


Morsi's decrees ban the judiciary from doing so and grant his decisions immunity from judicial review. Morsi also gave himself sweeping powers to prevent threats to the revolution, stability or state institutions, which critics say are tantamount to emergency laws. These powers are to remain in effect until the constitution is approved and parliamentary elections are held, not likely before spring 2013.


Opponents say the decrees turn Morsi — who narrowly won last summer's election with just over 50 percent of the vote — into a new dictator, given that he holds not only executive but also legislative powers, after the lower house of parliament was dissolved.


Tuesday's turnout was an unprecedented show of strength by the mainly liberal and secular opposition, which has been divided and uncertain amid the rise to power of the Brotherhood over the past year. The crowds were of all stripes, including many first-time protesters.


"Suddenly Morsi is issuing laws and becoming the absolute ruler, holding all powers in his hands," said Mona Sadek, a 31-year-old engineering graduate who wears the Islamic veil, a hallmark of piety. "Our revolt against the decrees became a protest against the Brotherhood as well."


"The Brotherhood hijacked the revolution," agreed Raafat Magdi, an engineer who was among a crowd of some 10,000 marching from the Cairo district of Shubra to Tahrir to the beat of drums and chants against the Brotherhood. Reform leader Mohammed ElBaradei led the march.


"People woke up to (Morsi's) mistakes, and in any new elections they will get no votes," Magdi said.


Many in the crowd said they were determined to push ahead with the protests until Morsi retreats. A major concern was that Islamists would use the decree's protection of the constitutional assembly to drive through their vision for the next charter, with a heavy emphasis on implementing Shariah, or Islamic law. The assembly has been plagued with controversy, and more than two dozen of its 100 members have quit in recent days to protest Islamist control.


"Next Friday will be decisive," protester Islam Bayoumi said of the upcoming rally. "If people maintain the same pressure and come in large numbers, they could manage to press the president and rescue the constitution."


A fellow protester, Saad Salem Nada, said of Morsi: "I am a Muslim and he made me hate Muslims because of the dictatorship in the name of religion. In the past, we had one Mubarak. Now we have hundreds."


Even as the crowds swelled in Tahrir, clashes erupted nearby between several hundred protesters throwing stones and police firing tear gas on a street leading to the U.S. Embassy. Clouds of tear gas hung over the area, where clashes have broken out for several days, fueled by anger over police abuses.


A photographer working for the AP, Ahmed Gomaa, was beaten by stick-wielding police while covering the clashes. Police took his equipment and Gomaa was taken to a hospital for treatment.


Rival rallies by Morsi opponents and supporters turned into brief clashes in the Mediterranean city of Alexandria, where anti-Morsi protesters broke into the local office of the Muslim Brotherhood, throwing furniture out the windows and trying unsuccessfully to set fire to it. Protesters also set fire to Brotherhood offices in the city of Mansoura.


Morsi's supporters canceled a massive rally planned for Tuesday in Cairo, citing the need to "defuse tension." Morsi's supporters say more than a dozen of their offices have been ransacked or set ablaze since Friday. Some 5,000 demonstrated in the southern city of Assiut in support of Morsi's decrees, according to witnesses there.


So far, there has been little sign of a compromise. On Monday, Morsi met with the nation's top judges and tried to win their acceptance of his decrees. But the move was dismissed by many in the opposition and the judiciary as providing no real concessions.


Saad Emara, a senior Muslim Brotherhood member, said Morsi will not make any concessions, especially after the surge of violence and assaults on Brotherhood offices.


Emara accused the opposition "of resorting to violence with a political cover," claiming that former ruling party and Mubarak-era businessmen were hiring thugs to attack Brotherhood offices with the opposition's blessing.


"The story now is that the civilian forces are playing with fire. This is a dangerous scene."


___


Associated Press writer Hamza Hendawi in Cairo contributed to this report.

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Dog days in Cuba: from shih tzus to schnauzers

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HAVANA (AP) — The Cuban capital has played host to political summits and art festivals, ballet tributes and international baseball competitions. Now dog lovers are getting their chance to take center stage.


Hundreds of people from all over Cuba and several other countries came to a scruffy field near Revolution Plaza this past week to preen and fuss over the shih tzus, beagles, schnauzers and cocker spaniels that are the annual Fall Canine Expo’s star attractions. There were even about a dozen bichon habaneros, a mid-sized dog bred on the island since the 17th century.












As dog lovers talked shop, the merely curious strolled the field, checking out the more than 50 breeds on display while carefully dodging the prodigious output of so many dogs.


The four-day competition, which ended Sunday, included competitions in several breeding categories, and judges were flown in from Nicaragua, Colombia and Mexico.


“This is a small, poor country, but Cubans love dogs,” said Miguel Calvo, the president of Cuba’s dog federation, which organized the show. “We make a great effort to breed purebred animals of quality.”


Winners don’t receive any trophy or prize money, but that doesn’t mean the competition is any less fierce.


Anabel Perez, owner of a cocker spaniel named Lisamineli after the U.S. actress, spent more than half an hour coifing the dog’s hair in preparation for the competition, while the owner of a shih tzu named Tiguer meticulously brushed his coat nearby.


“I’m a hairdresser for humans,” explained Tiguer’s owner, Miguel Lopez. “So it’s easy for me. I like shih tzus because they are a lot of work to keep well groomed.”


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Beyonce to direct documentary about herself for HBO

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LOS ANGELES (Reuters) – Pop superstar Beyonce is stepping behind the camera to direct a behind-the-scenes documentary about her personal and professional life, U.S. cable channel HBO said on Monday.


The currently untitled film will debut on February 16 and show the Grammy-winning singer’s life in the recording studio, readying for live performances and running her own TV and music production company.












“Everybody knows Beyonce’s music, but few know Beyonce the person,” HBO Programming President Michael Lombardo said in a statement. “Along with electrifying footage of Beyonce on stage, this unique special looks beyond the glamour to reveal a vibrant, vulnerable, unforgettable woman.”


The documentary will also feature moments in the “Crazy in Love” singer’s family life and first-person footage Beyonce captured on her laptop.


Beyonce, 31, who is married to hip hop artist and mogul Jay-Z, will headline the Super Bowl halftime show in New Orleans on February 3.


(Reporting By Eric Kelsey, editing by Jill Serjeant and Andrew Hay)


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FDA suspends peanut butter plant linked to salmonella outbreak

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(Reuters) – The U.S. Food and Drug Administration suspended operations on Monday at a New Mexico food producer linked to salmonella-tainted peanut butter that has sickened at least 41 people this year, the agency said in a statement.


The FDA said it had suspended Sunland Inc‘s food facility registration “in the interest of public health,” following the national outbreak and a history of food safety violations reaching back over three years.












“The fact that peanut butter made by the company has been linked to an outbreak … that has sickened 41 people in 20 states, coupled with Sunland’s history of violations led FDA … to suspend the company’s registration,” the FDA statement said, referring to an outbreak that began in June.


Registration with the administration is required for any facility that makes, processes, packs or holds food for consumption in the United States. If a facility’s registration is suspended, it is banned from distributing food for sale.


The FDA said a review of Sunland Inc’s product testing records showed that 11 product lots of nut butter tested positive for salmonella between June 2009 and September 2012.


Between March 2010 and September 2012, at least a portion of eight product lots of nut butter that the firm’s own testing program identified as containing salmonella was distributed by the company to consumers, the organization said.


Additionally, the FDA found the presence of salmonella during its inspection of the plant in September and October, both in samples taken in food production areas and in food products themselves.


Attempts to reach Sunland on Monday were unsuccessful, but in a November 15 statement the company said “at no time in its twenty four year history has Sunland, Inc. released for distribution any products that it knew to be potentially contaminated with harmful microorganisms.”


The company said it “has followed internal testing protocols that it believed resulted in the isolation and destruction of any product that did not pass the test designed to detect the presence of any contaminants.”


Salmonella typically causes diarrhea, fever and abdominal pain. It can be fatal for old people, young children and people with weakened immune systems. The FDA said it would reinstate the firm’s registration only when it determines that the company has implemented procedures to produce safe products.


(Reporting by Tim Gaynor; Editing by Cynthia Johnston and Bob Burgdorfer)


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Sandy cost New York $32 billion

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ALBANY, N.Y. (AP) — Top political leaders in New York put their heads together Monday on big requests for federal disaster aid as Gov. Andrew Cuomo announced that Superstorm Sandy ran up a bill of $32 billion in the state and the nation's largest city.

The cost is for repairs and restoration and does not include an additional accounting of over $9 billion to head off damage in the next disastrous storm, including steps to protect the power grid and cellphone network.

"It's common sense; it's intelligent," Cuomo said. "Why don't you spend some money now to save money in the future? And that's what prevention and mitigation is."

New York Mayor Michael Bloomberg had announced earlier in the day that Sandy caused $19 billion in losses in New York City — part of the $32 billion estimate Cuomo used.

New York taxpayers, Cuomo said, can't foot the bill.

"It would incapacitate the state. ... Tax increases are always a last, last, last resort."

Cuomo met with New York's congressional delegation to discuss the new figures and present "less than a wish list." The delegation, Cuomo and Bloomberg will now draw up a request for federal disaster aid.

States typically get 75 percent reimbursement for the cost of governments to restore mass transit and other services after a disaster.

The most basic recovery costs for roads, water systems, schools, parks, individual assistance and more total $15 billion in New York City; $7 billion for state agencies; $6.6 billion in Nassau County and $1.7 billion in Suffolk County, both on suburban Long Island; and $527 million in Westchester County and $143 million in Rockland County, both north of New York City, according to a state document used in the private briefing of the delegation and obtained by The Associated Press.

Hard times were already facing the state and city governments that were staring at deficits of more than $1 billion before Sandy hit in late October. State tax receipts have also missed projections, showing a continued slow recovery from a recession that could hit taxpayers in the governments' budgets this spring. And there's the looming fiscal cliff, the combination of expiring federal tax cuts and major spending cuts that could rattle the economy.

"Make no mistake, this will not be an easy task, particularly given the impending fiscal cliff, and a Congress that has been much less friendly to disaster relief than in the past," Schumer said. "We will work with the (Obama) administration on supplemental legislation, to be introduced in the upcoming December session of Congress, that will set us on the road to meeting New York's needs. This will be an effort that lasts not weeks, but many months, and we will not rest until the federal response meets New York's deep and extensive needs."

Rep. Peter King, a Long Island Republican who, like Schumer, is a powerful member of his chamber, said he is seeking cooperation from House leaders to find enough disaster aid.

"It really is survival," King said. "This is an emergency. This should be separate of all the debate about the fiscal cliff and everything else."

The Cuomo administration has gained the public support of President Barack Obama and FEMA in New York's proposal for full reimbursement for storm damage, but state officials have privately worried about how much the state can get now.

In the city, Bloomberg is asking federal lawmakers to put up nearly $10 billion to reimburse government agencies and private businesses. That would be additional funding on an expedited basis over the $5.4 billion in standard disaster aid that the city projects it will receive from the Federal Emergency Management Agency.

That FEMA money and private insurance won't cover all the public and private expenses from the storm, which included damaged streets and restaurants closed because of flooding, Bloomberg said.

"While the impact of the storm will be felt for some time and the challenges are great, I am confident that the city will rebound and emerge stronger than ever," Bloomberg wrote to the congressional delegation.

Reinsurance company Swiss Re showed the extent of private sector pain. It estimates that claims stemming from Sandy will cost the company about $900 million and that total losses from insured damage will be between $20 billion and $25 billion.

Reinsurance firms provide coverage to insurance companies for great losses stemming from events like natural disasters.

Other states are seeking federal assistance, too. FEMA has already paid out nearly $250 million in New Jersey, where Gov. Chris Christie says the preliminary damage estimate is $29.4 billion and could rise.

___

Associated Press writers Jennifer Peltz and Meghan Barr in New York City contributed to this report.

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Israel successfully tests missile defense system

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JERUSALEM (AP) — Israel successfully tested its newest missile defense system Sunday, the military said, a step toward making the third leg of what Israel calls its “multilayer missile defense” operational.


The “David’s Sling” system is designed to stop mid-range missiles. It successfully passed its test, shooting down its first missile in a drill Sunday in southern Israel, the military said.












The system is designed to intercept projectiles with ranges of up to 300 kilometers (180 miles).


Israel has also deployed Arrow systems for longer-range threats from Iran. The Iron Dome protects against short-range rockets fired by militants in the Gaza Strip and Hezbollah guerrillas in Lebanon. Iron Dome shot down hundreds of rockets from Gaza in this month’s round of fighting.


Israeli Defense Minister Ehud Barak said the success of Iron Dome highlighted the “immense importance” of such systems.


“David’s Sling,” also known “Magic Wand,” is developed by Israel’s Rafael Advanced Defense Systems and U.S.-based Raytheon Co. and is primarily designed to counter the large arsenal of Hezbollah rockets in Lebanon.


The military said the program, which is on schedule for deployment in 2014, would “provide an additional layer of defense against ballistic missiles.”


The next generation of the Arrow, now in the development stage, is set to be deployed in 2016. Called the Arrow 3, it is designed to strike its target outside the atmosphere, intercepting missiles closer to their launch sites. Together, the two Arrow systems would provide two chances to strike down incoming missiles.


Israel also uses U.S.-made Patriot missile defense batteries against mid-range missiles, though these failed to hit any of the 39 Scud missiles fired at Israel from Iraq In the first Gulf War 20 years ago. Manufacturers say the Patriot system has been improved since then.


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Nokia imaging chief to quit

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HELSINKI (Reuters) – Nokia‘s long-time imaging chief Damian Dinning has decided to leave the loss-making cellphone maker at the end of this month, the company said in a statement.


The strong imaging capabilities of the new Lumia smartphone models are a key sales argument for the former market leader, which has been burning through cash while losing share in both high-end smartphones and cheaper handsets.












Nokia’s Chief Executive Stephen Elop has replaced most of the top management since he joined in late 2010 and Dinnig is the latest of several executives to leave.


Dinning did not want to move to Finland as part of the phonemakers’ effort to concentrate operations and will join Jaguar Land Rover to head innovations in the field of connected cars, he said on Nokia’s imaging fan site PureViewclub.com.


(Reporting By Tarmo Virki, editing by William Hardy)


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Grammy-winning bassist injured in Swiss bus crash

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GENEVA (AP) — Grammy-winning jazz bassist Marcus Miller and several members of his band were injured when their bus overturned Sunday on a busy highway in Switzerland, killing the driver, police said.


The German-registered private bus tipped over as it drove into a bend on the A2 highway in central Switzerland and came to a rest on its side, police in the canton (state) of Uri said. The bus was carrying 13 people — two drivers and 11 members of the Marcus Miller Band, including Miller.












Over his career, the bassist has worked with jazz greats such as Miles Davis, Dizzy Gillespie and Wayne Shorter, according to his website. He won two Grammys, his first coming in 1991 for Best Rhythm & Blues Song (“Power of Love”) along with Luther Vandross and Teddy Vann, and the second came in 2001 for Best Contemporary Jazz Album (“M2″).


The band was on its way from Monte Carlo to the Dutch town of Hengelo, the next stop on the American band’s tour, where it was due to perform Monday.


The driver who was at the wheel at the time of the accident sustained fatal injuries. Police spokesman Karl Egli said the 12 passengers were injured and taken to hospitals, but none had life-threatening injuries.


Miller was discharged from the hospital later Sunday, as were fellow band members Alex Han and Kris Bowers, but some other band and crew members were being kept in hospitals overnight, according to a post on Miller’s official Facebook page.


The cause of the accident was not immediately clear. Police believe no other vehicles were involved.


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Psoriasis patients look to Hong Kong government for help – and hope

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HONG KONG (Reuters) – When Gary Lai first came down with the skin disease psoriasis, he got so tired of the stigma he faced in the outside world that he would lock himself away in his apartment whenever he didn’t have to be at work.


“When you have to apply ointment all over your body, it is impractical. It also has a smell and when you go to work, your colleagues will start asking questions,” said Lai, who was 24 when he was diagnosed.












Now Lai, 41, and other Hong Kong residents suffering from psoriasis – a lifelong autoimmune disease that covers the skin in red, scaly plaques – have joined hands to press the government to help subsidize their high treatment costs.


Affecting up to two percent of the population in Asia, or 125 million people worldwide, this disfiguring disease can take a higher physical and mental toll on patients than cancer and heart disease, past surveys have found.


“During all that time, I experienced great stress and prejudice. In the subway, people around me will stare at me and they think I may infect them,” said Lai, a data analyst. “I can tell from their eyes even if they don’t say anything.”


In psoriasis patients, skin cells grow too fast and rapidly pile up, forming red and inflamed scales or plaques on the skin. While cell reproduction in normal skin takes 28 days, that process in psoriasis patients takes only four days.


The exact cause of psoriasis remains unknown although experts believe it is linked to the immune system where a class of fighter cells attack the body’s own healthy skin cells by mistake. They cite a combination of risk factors, including genetic predisposition and environmental factors.


Dermatologist Yeung Chi-keung said first-line treatments such as creams, exposure to ultraviolet light and oral drugs tend not to work for about 10 percent of patients, who will then require second-line drugs, which are injected.


These injectable drugs now cost an average of HK$ 10,000 (US$ 1,282) a month and getting on Hong Kong‘s general list will mean patients need only pay a nominal administrative fee of $ 10.


“In the last month, we (dermatologists in Hong Kong) proposed to the government to consider subsidizing these drugs,” said Yeung, who is honorary clinical associate professor of dermatology at the University of Hong Kong’s department of medicine.


A spokesman for the Hospital Authority, the body that oversees all public hospitals in Hong Kong, said it would have to make a detailed study before deciding if it will subsidize the treatment of such patients.


“The review process would take into account scientific evidence on safety, efficacy and cost-effectiveness as well as actual clinical experience in the use of drugs. Views of professionals and patient groups will also be considered,” the spokesman added.


For the patients who wait and hope, the stress never goes away.


“When I go to the pool, other swimmers think it is contagious and that I will pollute the water, so they complain to the lifeguard to get rid of me,” Lai said. “We hope the government will put these drugs on their general (subsidized) list.”


(Reporting by Tan Ee Lyn, editing by Elaine Lies)


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