Soldier who lost 4 limbs has double-arm transplant

The first soldier to survive after losing all four limbs in the Iraq war has received a double-arm transplant.

Brendan Marrocco had the operation on Dec. 18 at Johns Hopkins Hospital in Baltimore, his father said Monday. The 26-year-old Marrocco, who is from New York City, was injured by a roadside bomb in 2009.

He also received bone marrow from the same dead donor who supplied his new arms. That novel approach is aimed at helping his body accept the new limbs with minimal medication to prevent rejection.

The military is sponsoring operations like these to help wounded troops. About 300 have lost arms or hands in the wars.

"He was the first quad amputee to survive" from the wars in Iraq and Afghanistan, and there have been four others since then, said Brendan Marrocco's father, Alex Marrocco. "He was really excited to get new arms."

The Marroccos want to thank the donor's family for "making a selfless decision ... making a difference in Brendan's life," the father said.

Surgeons plan to discuss the transplant at a news conference with the patient on Tuesday.

The 13-hour operation was led by Dr. W.P. Andrew Lee, plastic surgery chief at Johns Hopkins, and is the seventh double-hand or double-arm transplant done in the United States. Lee led three of those earlier operations when he previously worked at the University of Pittsburgh, including the only above-elbow transplant that had been done at the time, in 2010.

Marrocco's "was the most complicated one" so far, Lee said in an interview Monday. It will take more than a year to know how fully Marrocco will be able to use the new arms, Lee said.

"The maximum speed is an inch a month for nerve regeneration," he explained. "We're easily looking at a couple years" until the full extent of recovery is known.

While at Pittsburgh, Lee pioneered the novel immune suppression approach used for Marrocco. The surgeon led hand transplant operations on five patients, giving them marrow from their donors in addition to the new limbs. All five recipients have done well and four have been able to take just one anti-rejection drug instead of combination treatments most transplant patients receive.

Minimizing anti-rejection drugs is important because they have side effects and raise the risk of cancer over the long term. Those risks have limited the willingness of surgeons and patients to do more hand, arm and even face transplants. Unlike a life-saving heart or liver transplant, limb transplants are aimed at improving quality of life, not extending it.

Quality of life is a key concern for people missing arms and hands — prosthetics for those limbs are not as advanced as those for feet and legs.

Lee has received funding for his work from AFIRM, the Armed Forces Institute of Regenerative Medicine, a cooperative research network of top hospitals and universities around the country that the government formed about five years ago. With government money, he and several other plastic surgeons around the country are preparing to do more face transplants, possibly using the new minimal immune suppression approach.

Marrocco expects to spend three to four months at Hopkins, then return to a military hospital to continue physical therapy, his father said. Before the operation, he had been living with his older brother in a handicapped-accessible home on New York's Staten Island built with the help of several charities.

The home was heavily damaged by Superstorm Sandy last fall.

Despite being in a lot of pain for some time after the operation, Marrocco showed a sense of humor, his father said. He had a hoarse voice from a tube in his throat during the long surgery, decided that he sounded like Al Pacino, and started doing movie lines.

"He was making the nurses laugh," Alex Marrocco said.

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AP writer Alex Dominguez contributed to this report.

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Boy Scouts to Discuss Lifting National Gay Ban

The Boy Scouts of America, under growing pressure from troops across the country to end its 100-year-old ban on gay leaders and members, said today it is "discussing" ending its national discrimination policy, leaving such decisions to the discretion of individual troops.

"Currently, the BSA is discussing potentially removing the national membership restriction regarding sexual orientation," BSA spokesman Deron Smith said in a prepared statement.
"This would mean there would no longer be any national policy regarding sexual orientation, and the chartered organizations that oversee and deliver Scouting would accept membership and select leaders consistent with each organization's mission, principles, or religious beliefs."

Individual members and parents would be able to set policy guidelines as they see fit when organizing their troops and leadership, according to the statement.

The BSA will review the matter at its regularly scheduled board meeting next week, Smith said.

Rich Ferraro, a spokesman for the gay advocacy group GLAAD, pointed to two factors upon hearing the announcement today.

"I think it was a mix of the change.org petitions and the corporate sponsors that had dropped out," Ferraro said.

Last September, the Intel Foundation announced it would end $700,000 in annual donations to the Boys Scouts. The Merck Foundation also severed its ties in December.

"UPS adopted a new policy that stated that grantees had to follow their nondiscrimination policy," Ferraro said. "There were also more in the coming weeks that were dropping their support of Scouts."

Several U.S. councils have tried to buck the longtime ban, putting the issue to a vote with their local parents in recent months, including a Boy Scout troop in California and a Cub troop in Maryland.

"I am extraordinarily excited," said Eagle Scout Zach Wahls, who has spent the past seven months heading up Scouts for Equality, which advocates for ending the ban. "It's a positive step, and big change.

"This is absolutely a step in the right direction, but we have a long way to go," Wahls, 21, said today. "Discrimination has no place in scouting."

Wahls, whose parents are lesbians, was a YouTube sensation two years ago when he testified before the Iowa legislature on same-sex marriage.

He delivered a petition in June from change.org with more than 1 million signatures, demanding that the Boy Scouts end the ban on openly gay membership.

"Once an Eagle Scout, always an Eagle Scout," Wahls said at the time. "I am unwilling to quit because of a single policy. They do so many things right."

The policy change under discussion would allow individual groups -- religious, civic or educational ones -- to determine their own rules.

"The national organization has to make it clear to all units that being anti-gay is unacceptable," said Wahls, who identifies as straight. "What happens next is little unclear, but it seems the Boy Scouts of America is starting to thaw on this issue."

BSA's Smith said, "The Boy Scouts would not, under any circumstances, dictate a position to units, members, or parents. Under this proposed policy, the BSA would not require any chartered organization to act in ways inconsistent with that organization's mission, principles or religious beliefs."

In October, California Boy Scout
Ryan Andresen of Moraga, Calif., was denied the coveted Eagle Scout award, even though he had completed all the requirements because he is gay.

His mom, Karen Andresen, was so upset by the troop's decision that she posted a petition on change.org.

A local troop committee approved his award, but the council did not send it on to the national organization because of the gay ban.

Advocacy groups have been vocal on the issue.

"The Boy Scouts of America have heard from scouts, corporations and millions of Americans that discriminating against gay scouts and scout leaders is wrong," GLAAD President Herndon Graddick said. "Scouting is a valuable institution and this change will only strengthen its core principles of fairness and respect."

Until now, the Boy Scouts have stood firm on the issue, even taking it to the highest court.

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Egypt protesters defy curfew after emergency rule imposed

ISMAILIA/CAIRO, Egypt (Reuters) - Thousands of Egyptian protesters ignored a curfew on Monday to take to the streets in cities along the Suez canal, defying a state of emergency imposed by Islamist President Mohamed Mursi to end days of violence that has killed at least 51 people.

One man was killed in violence late on Monday in Port Said and another was shot dead earlier in Cairo as a wave of violence raged on, unleashed last week on the eve of the two-year anniversary of the popular revolt that brought down autocrat Hosni Mubarak.

Political opponents spurned a call by Mursi for talks to try to end the violence, with main opposition groups refusing to attend a meeting.

Instead, huge crowds of protesters took to the streets in the capital Cairo, Alexandria and in the three Suez Canal cities - Port Said, Ismailia and Suez - where Mursi imposed emergency rule and a curfew on Sunday.

"Down, down with Mohamed Mursi! Down, down with the state of emergency!" crowds shouted in Ismailia in defiance of the curfew. In Cairo, flames lit up the night sky where protesters set police vehicles ablaze.

In Port Said, men attacked police stations after dark. A security source said some police and troops were injured. A medical source said one man was killed in clashes.

"The people want to bring down the regime," crowds chanted in Alexandria. "Leave means go, and don't say no!" they shouted.

The demonstrators accuse Mubarak's successor Mursi of betraying the revolution that brought down Mubarak. Mursi and his supporters accuse the protesters of seeking to overthrow the country's first ever democratically elected leader through undemocratic means.

Monday was the second anniversary of one of the bloodiest days in the revolution, which erupted on January 25, 2011 and ended Mubarak's iron rule 18 days later.

The past two years have seen the Islamists win two referendums, two parliamentary elections and a presidential vote. But that legitimacy has been challenged by an opposition that accuses Mursi of imposing a new form of authoritarianism, and punctuated by repeated waves of unrest that have prevented a return to stability in the most populous Arab state.

The army has already been deployed in Port Said and Suez and the government agreed a measure to let soldiers arrest civilians as part of the state of emergency.

A cabinet source told Reuters any trials would be in civilian courts, but the step is likely to anger protesters who accuse Mursi of using tactics like those used by Mubarak.

VOLLEYS OF TEARGAS

Propelled to the presidency in a June election by the Muslim Brotherhood, Mursi has lurched through a series of political crises and violent demonstrations while trying to shore up the economy and of prepare for a parliamentary election to cement the new democracy in a few months.

The instability unnerves Western capitals, where officials worry about the direction of a key regional player that has a peace deal with Israel. The United States condemned the deadly violence and called on Egyptian leaders to make clear violence is not acceptable. ID:nW1E8MD01C].

In Cairo on Monday, police fired volleys of teargas at stone-throwing protesters near Tahrir Square, cauldron of the anti-Mubarak uprising. Protesters stormed into the down town Semiramis Intercontinental hotel and burned two police vehicles.

A 46-year-old bystander was killed by a gunshot early on Monday, a security source said. It was not clear who fired.

"We want to bring down the regime and end the state that is run by the Muslim Brotherhood," said Ibrahim Eissa, a 26-year-old cook, protecting his face from teargas wafting towards him.

The political unrest has been exacerbated by street violence linked to death penalties imposed on soccer supporters convicted of involvement in stadium rioting in Port Said a year ago.

As part of emergency measures, a daily curfew will be imposed on the three canal cities from 9 p.m. (1900 GMT) to 6 a.m. (0400 GMT).

The president announced the measures on television on Sunday: "The protection of the nation is the responsibility of everyone. We will confront any threat to its security with force and firmness within the remit of the law," Mursi said.

His demeanor in the address infuriated his opponents, not least when he wagged a finger at the camera.

He offered condolences to families of victims. But his invitation to Islamist allies and their opponents to hold a national dialogue was spurned by the main opposition National Salvation Front coalition. Those who attended were mostly Mursi's supporters or sympathizers.

SENDING A MESSAGE

The Front rejected the offer of talks as "cosmetic and not substantive" and set conditions for any future meeting that have not been met in the past, such as forming a government of national unity. The group also demanded that Mursi declare himself responsible for the bloodshed.

"We will send a message to the Egyptian people and the president of the republic about what we think are the essentials for dialogue. If he agrees to them, we are ready for dialogue," opposition politician Mohamed ElBaradei told a news conference.

The opposition Front has distanced itself from the latest flare-ups but said Mursi should have acted far sooner to impose security measures that would have ended the violence.

"Of course we feel the president is missing the real problem on the ground, which is his own policies," Front spokesman Khaled Dawoud said after Mursi made his declaration.

Other activists said Mursi's measures to try to impose control on the turbulent streets could backfire.

"Martial law, state of emergency and army arrests of civilians are not a solution to the crisis," said Ahmed Maher of the April 6 movement that helped galvanize the 2011 uprising. "All this will do is further provoke the youth. The solution has to be a political one that addresses the roots of the problem."

Rights activists said Mursi's declaration was a backward step for Egypt, which was under emergency law for Mubarak's entire 30-year rule. His police used sweeping arrest provisions to muzzle dissent and round up opponents, including members of the Brotherhood and even Mursi himself.

Heba Morayef of Human Rights Watch in Cairo said the police, still hated by many Egyptians for their heavy-handed tactics under Mubarak, would once again have the right to arrest people "purely because they look suspicious", undermining efforts to create a more efficient and respected police force.

"It is a classic knee-jerk reaction to think the emergency law will help bring security," she said. "It gives so much discretion to the Ministry of Interior that it ends up causing more abuse, which in turn causes more anger."

(Additional reporting by Yasmine Saleh in Cairo, Yusri Mohamed in Ismailia and Abdelrahman Youssef in Alexandria; Editing by Peter Graff)

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Asia's gambling apartheid

SEOUL: The casino industry is booming across Asia, offering anyone looking for high-stakes action a wide choice of venues, from high-tech South Korea to the Himalayan nation of Nepal and communist Vietnam.

Anyone, that is, except South Koreans, Nepalese or Vietnamese.

For conservative Asian countries, the financial pros and social cons of casino gambling pose something of a dilemma - one that several have chosen to resolve by adopting a foreigner-only access policy.

The upsides are obvious in a region where rapid development has nurtured a taste and capacity for high-end leisure activities.

Casinos provide a consistent source of hard currency revenue, fuel tourism - especially from sought-after high rollers from mainland China - and boost the local economy.

Macau, now the world's largest gaming hub, saw its gaming revenue jump 13.5 percent to a record $38 billion in 2012.

But the social impact of gambling is equally well documented, in terms of addiction and broken families, as well as criminal activities like loan-sharking.

So a number of Asian countries have tried to have their cake and eat it, by building glitzy casinos but barring - or strictly limiting - entry to their own citizens.

Kim Jin-Gon, director of tourism in South Korea's Culture Ministry, cited a widely-held belief that Koreans are particularly susceptible to gambling addiction.

"Our feeling is that Korea does not have a mature culture that could enjoy gambling simply as a leisure activity," Kim said. "We block Koreans from casinos because the fallout would be too big."

South Korea's ban is not total. Of the country's 17 licensed casinos, one - Kangwon Land Resort - is open to locals.

Its remote location in a mountainous area, several hundred kilometres and a three-hour express bus ride from Seoul, was supposed to deter salarymen from nightly excursions during the working week.

But special "bullet taxis" offer a high-speed, white-knuckle service that promises to get punters there in half the time, and attendance and revenue figures seem to support the theories about Koreans' proclivity for gambling.

Kangwon Land pulls in an average 10,000 visitors a day - around five times the actual seating capacity - and boasted revenue of nearly 1.2 trillion won (1.1 billion dollars) in 2011, more than all the 16 foreigner-only casinos combined.

This despite rules that restrict any individual from gambling more than 15 days a month - ID cards must be shown - and impose a maximum house wager of 300,000 won ($280).

The overcrowding led to calls for other casinos to be opened to Koreans but the government has resisted, insisting that Kangwon Land was a one-off project with the sole aim of revitalising an economically depressed area.

Director Kim warned that other casinos, especially in major cities, would be swamped if access was extended to all.

"If we let Koreans in, there would be no room left for foreigners, which would defy the whole purpose of the casinos in the first place," he said.

Nepal and Vietnam operate 100 percent foreigner-only casino policies, although in the case of Nepal it's a regulation often observed in the breach.

Vietnam's first casino opened in 1992 and there are now seven, with two more in the pipeline.

According to the finance ministry, casinos generated around 1.5 trillion dong ($72 million) in tax revenues in 2012.

For Vietnamese nationals, all gambling apart from a state-run lottery is banned, although illegal betting - on everything from cock-fighting to English Premier League football matches - is widespread.

While Vietnamese gamblers have no access to a place like Kangwon Land, they can simply cross into Cambodia, where huge casinos have been built near the border that cater almost exclusively to Vietnamese tourists.

Cambodians, needless to say, are not legally allowed to gamble in their own casinos, though presumably they would be welcomed at those in Vietnam.

Perhaps aware of the contradictions thrown up by foreigner-only policies, Singapore has opted for a compromise of open casino access but with special restrictions for the island state's citizens and long-term residents.

A S$100 (US$80) entry fee aimed to filter out low-income gamblers, while any Singaporean who had filed for bankruptcy or received long-term financial state aid was automatically barred.

After a 2011 official survey showed an increasing proportion of low-income gamblers playing with large sums, the ban was expanded in June last year to include the unemployed and those on short-term welfare.

Casinos that fail to comply face a maximum fine that used to be capped at Sg$1.0 million but can now reach as high as 10 percent of annual gross gaming revenue.

Despite these measures, Prime Minister Lee Hsien Loong admitted during a visit to Australia in October that his government was still "watching anxiously" to determine the impact of the casino experiment.

"From a social point of view, we would like to say that it has been all right, but it is too early to say because the casinos have been operating only for two years and a half," Lee said.

Commercially, Singapore's two casino resorts have been an undeniable success, with a combined gaming revenue of around $5.0 billion in 2011.

That level of return has fuelled debate in countries like Japan about lifting its ban on casinos, which forces Japanese gamblers to travel to South Korea, Macau and Singapore to play the tables.

Taiwanese, meanwhile, may soon have a domestic option after the people of outlying Matsu island voted in July last year to open Taiwan's first legal casino.

The casino would be open to everyone except, perhaps inevitably, the Matsu islanders themselves.

- AFP/de

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BJP naming PM candidate could split NDA: Togadia

BHOPAL: Vishwa Hindu Parishad (VHP) leader Praveen Togadia on Sunday said that Bharatiya Janata Party (BJP) should not announce a prime ministerial candidate before the 2014 general elections. Togadia said that such an attempt would weaken the BJP and the NDA alliance.

"Announcing the name of PM candidate could work as a strategy in favour of UPA parties. It could split both the BJP and its NDA alliance partners. Best would be for BJP to democratically elect its leader after winning the elections,'' Togadia told reporters here.

Asked if VHP would support the BJP in 2014 Lok Sabha polls, Togadia explained, "VHP neither supports nor opposes any political party or person. VHP's only intention is to strengthen Hindutva. However, we are not in favour of political parties that hit-out and defame Hindus.''

Togadia argued that recent controversy over Union home minister Sushil Kumar Shinde's comment on Hindu terrorism "is one such instance of how greed to placate minority vote-bank politics makes political parties to give statements that work in favour of Pakistan.''

"Rebellion against Hindus is equated with secularism presently. Congress party should pressurize home minister Shinde to withdraw his statement which might work out as an advantage to Pakistan on the international forum. And voters should start contemplating on such remarks and give a fitting reply to such allegations,'' he added.

Meanwhile, VHP stands firm on the issue of the disputed Bhojshala structure in Dhar in Madhya Pradesh. It could be yet another trying law and order situation as Basant Panchami fall on Friday, February 15 this year. "Bhojshala belongs to Hindus and Muslims have nothing to do with it. VHP will keep up the struggle for Bhojshala. There will be no compromise on the issue.''

Bhojshala is an 11th century Archaeological Survey of India (ASI) protected monument in Dhar town, 350 km south of Bhopal, which Hindus believe is a temple of goddess Waghdevi (Saraswati) while Muslims treat it as a mosque. In 2003, the VHP started a movement claiming the structure was a university established by Raja Bhoj with a temple of the goddess of learning inside the premises.

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CDC: Flu seems to level off except in the West

New government figures show that flu cases seem to be leveling off nationwide. Flu activity is declining in most regions although still rising in the West.

The Centers for Disease Control and Prevention says hospitalizations and deaths spiked again last week, especially among the elderly. The CDC says quick treatment with antiviral medicines is important, in particular for the very young or old. The season's first flu case resistant to treatment with Tamiflu was reported Friday.

Eight more children have died from the flu, bringing this season's total pediatric deaths to 37. About 100 children die in an average flu season.

There is still vaccine available although it may be hard to find. The CDC has a website that can help.

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CDC: http://www.cdc.gov/flu/

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Brazil Nightclub Fire: 232 Dead, Hundreds Injured

Flames raced through a crowded nightclub in southern Brazil early Sunday, killing more than 230 people as panicked partygoers gasped for breath in the smoke-filled air, stampeding toward a single exit partially blocked by those already dead. It appeared to be the world's deadliest nightclub fire in more than a decade.

Witnesses said a flare or firework lit by band members may have started the blaze in Santa Maria, a university city of about 225,000 people.

Television images showed smoke pouring out of the Kiss nightclub as shirtless young men who had attended a university party joined firefighters using axes and sledgehammers to pound at windows and walls to free those trapped inside.

Guido Pedroso Melo, commander of the city's fire department, told the O Globo newspaper that firefighters had a hard time getting inside the club because "there was a barrier of bodies blocking the entrance."

Teenagers sprinted from the scene desperately seeking help. Others carried injured and burned friends away in their arms.

"There was so much smoke and fire, it was complete panic, and it took a long time for people to get out, there were so many dead," survivor Luana Santos Silva told the Globo TV network.

The fire spread so fast inside the packed club that firefighters and ambulances could do little to stop it, Silva said.

Germano Roratto/AFP/Getty Images

Another survivor, Michele Pereira, told the Folha de S. Paulo newspaper that she was near the stage when members of the band lit flares that started the conflagration.

"The band that was onstage began to use flares and, suddenly, they stopped the show and pointed them upward," she said. "At that point, the ceiling caught fire. It was really weak, but in a matter of seconds it spread."

Guitarist Rodrigo Martins told Radio Gaucha that the band, Gurizada Fandangueira, started playing at 2:15 a.m. "and we had played around five songs when I looked up and noticed the roof was burning"

"It might have happened because of the Sputnik, the machine we use to create a luminous effect with sparks. It's harmless, we never had any trouble with it.

"When the fire started, a guard passed us a fire extinguisher, the singer tried to use it but it wasn't working"

He confirmed that accordion player Danilo Jacques, 28, died, while the five other members made it out safely.

Police Maj. Cleberson Braida Bastianello said by telephone that the toll had risen to 233 with the death of a hospitalized victim — he said earlier that the death toll was likely made worse because the nightclub appeared to have just one exit through which patrons could exit.

Officials counted 232 bodies that had been brought for identification to a gymnasium in Santa Maria, which is located at the southern tip of Brazil, near the borders with Argentina and Uruguay.

Federal Health Minister Alexandre Padhilha told a news conference that most of the 117 people treated in hospitals had been poisoned by gases they breathed during the fire. Only a few suffered serious burns, he said.

Brazil President Dilma Roussef arrived to visit the injured after cutting short her trip to a Latin American-European summit in Chile.

"It is a tragedy for all of us," Roussef said.

Most of the dead apparently were asphyxiated, according to Dr. Paulo Afonso Beltrame, a professor at the medical school of the Federal University of Santa Maria who went to the city's Caridade Hospital to help victims.

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Nightclub fire kills at least 232 in Brazil

SANTA MARIA, Brazil (Reuters) - A nightclub fire killed at least 232 people in southern Brazil early on Sunday when a band's pyrotechnics show set the building ablaze and fleeing partygoers stampeded toward blocked and overcrowded exits in the ensuing panic, officials said.

The blaze in the university town of Santa Maria was started by a band member or someone from its production team igniting a flare, which then set fire to the ceiling, said Luiza Sousa, a civil police official. The fire spread "in seconds," she said.

Local fire officials said at least one exit was locked and that bouncers, who at first thought those fleeing were trying to skip out on bar tabs, initially blocked patrons from leaving. The security staff relented only when they saw flames engulfing the ceiling.

The tragedy, in a packed venue in one of Brazil's most prosperous states, comes as the country scrambles to improve safety, security and logistical shortfalls ahead of the 2014 World Cup soccer tournament and the 2016 Olympics, both intended to showcase the economic advances and first-world ambitions of Latin America's largest nation.

In Santa Maria, a city of more than 275,000 people, rescue workers and weary officials wept alongside family and friends of the victims at a local gymnasium being used as a makeshift morgue.

"It's the saddest, saddest day of my life," said Neusa Soares, the mother of one of those killed, 22-year-old Viviane Tolio Soares. "I never thought I would have to live to see my girl go away."

President Dilma Rousseff cut short an official visit to Chile and flew to Santa Maria, where she wept as she spoke to relatives of the victims at the gym.

"All I can say at the moment is that my feelings are of deep sorrow," said Rousseff, who began her political career in Rio Grande do Sul, the state where the fire occurred.

News of the fire broke on Sunday morning, when local news broadcast images of shocked people outside the Boate Kiss, as the nightclub was known. Gradually, grisly details emerged.

The vast majority of the victims, most of them university students, died of smoke inhalation, officials said. Others were crushed in the stampede.

"We ran into a barrier of the dead at the exit," Colonel Guido Pedroso de Melo, commander of the fire brigade in Rio Grande do Sul, said of the scene that firefighters found on arrival. "We had to clear a path to get to the rest of those that were inside."

Officials said more than 1,000 people may have been in the club, possibly exceeding its legal capacity. Though Internet postings about the venue suggested as many as 2,000 people at times have crammed into the club, Pedroso de Melo said no more than half that should have been inside.

He said the club was authorized to be open but its permit was in the process of being renewed.

However, Pedroso de Melo did point to several egregious safety violations - from the flare that went off during the show to the locked door that kept people from leaving.

'HAPPENED SO FAST'

When the fire began at about 2:30 a.m., many revelers were unable to find their way out amid the chaos, confusing restroom doors for exits and finding resistance from bouncers when they did find an exit.

"It all happened so fast," survivor Taynne Vendrusculo told GloboNews TV. "Both the panic and the fire spread rapidly, in seconds."

Once security guards realized the building was on fire, they tried in vain to control the blaze with a fire extinguisher, according to a televised interview with one of the guards, Rodrigo Moura. He said patrons were getting trampled as they rushed for the doors, describing it as "a horror film."

One of the club's owners has surrendered to police for questioning, GloboNews reported.

TV footage showed people sobbing outside the club before dawn, while shirtless firefighters used sledge hammers and axes to knock down an exterior wall to open up an exit.

Rescue officials moved the bodies to the local gym and separated them by gender. Male victims were easier to identify because most had identification on them, unlike the women, whose purses were left scattered in the devastated nightclub.

The disaster recalls other incidents including a 2003 fire at a nightclub in West Warwick, Rhode Island, that killed 100 people, and a Buenos Aires nightclub blaze in 2004 that killed nearly 200. In both incidents, a band or members of the audience ignited fires that set the establishment ablaze.

The Rhode Island fire shocked local and federal officials because of the rarity of such incidents in the United States, where enforcement of safety codes is considered to be relatively strict. After the Buenos Aires blaze, Argentine officials closed many nightclubs and other venues and ultimately forced the city's mayor from office because of poor oversight of municipal codes.

The fire early on Sunday occurred in one of the wealthiest, most industrious and culturally distinct regions of Brazil. Santa Maria is about 186 miles west of Porto Alegre, the capital of a state settled by Germans and other immigrants from northern Europe.

Local clichés paint the region as stricter and more squared away than the rest of Brazil, where most residents are a mix descended from native tribes, Portuguese colonists, African slaves, and later influxes of immigrants from southern Europe.

Rio Grande do Sul state's health secretary, Ciro Simoni, said emergency medical supplies from all over the state were being sent to the scene. States from all over Brazil offered support, and sympathy messages poured in from foreign leaders.

(Additional reporting by Guillermo Parra-Bernal, Gustavo Bonato, Jeferson Ribeiro, Eduardo Simões, Brian Winter and Guido Nejamkis.; Writing by Paulo Prada; Editing by Todd Benson, Kieran Murray and Eric Beech)

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Sailing: Olympic sailing champion visits Singapore

SINGAPORE: Xu Lijia, the 25 year old who became the first Chinese to win a gold medal in the dinghy class after finishing first in the laser radial class at the 2012 London Olympics, is in town.

The Chinese athlete shared her experiences with local sailors at a talk, which attracted 500 participants. The talk also saw the launch of the Character Development Through Sailing programme.

The Shanghai native, who won bronze in the same class at the 2008 Olympics in Beijing, said that it was not just about winning, but also enjoying the journey.

She had to beat many odds including injuries, physical limitations and the lack of a proper support structure for the sport in China.

"It is about promotion, promoting this sport not only in Singapore, China but... in whole of Asia. I hope that Asia can become stronger and stronger and (compete) with the European countries," she said.

- CNA/jc

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Swine flu pandemic infected at least one in five Indians: Study

LONDON: The 2009 global H5N1 swine flu pandemic - the first in over 41 years that swept throughout the globe in record time -- infected at least one in five Indians with the highest rates of infection being among children.

A joint Imperial College, London, and the World Health Organization global study released on Saturday found that 47% of those aged five to 19 showed signs of having caught the deadly influenza virus in India.

Older people were affected less, with only 11% of people aged 65 or above becoming infected.

The study analyzed data from 19 countries, including India, UK, US and China, to assess the global impact of the 2009 pandemic.

It collated results from over two dozen research studies involving more than 90,000 blood samples collected before, during and after the pandemic and showed that the virus that continues to infect and kill Indians now affected 20-27% people studied during the first year of the pandemic.

The study was published in "Influenza and Other Respiratory Viruses" journal on January 26.

Imperial College's Dr Maria Van Kerkhove said, "This study is the result of a combined effort by more than 27 research groups worldwide, who all shared their data with us to help improve our understanding of the impact the pandemic had globally.'' She said the samples were tested for antibodies produced in response to the specific flu strain that caused the pandemic.

While this study did not set out to look at mortality, the authors also used previously published estimates of pandemic influenza mortality together with mortality estimates that are still in progress to estimate the proportion of people infected who died from the pandemic virus.

Based on an estimate of approximately 200,000 deaths, they suggest that the case fatality ratio was less than 0.02%.

The study said multiple exposures to previously circulating influenza viruses may have given older people some protection against the strain.

Blood samples from before the pandemic showed that 14% people aged 65 or above had antibodies that reacted to the 2009 strain.

WHO's Dr Anthony Mounts said, "Knowing the proportion of the population infected in different age groups and the proportion of those infected who died will help public health decision-makers plan for and respond to pandemics.'' He said this information will be used to quantify severity and develop mathematical models to predict how flu outbreaks spread and what effect different interventions may have."

The study said data used to estimate age-specific incidence were available from 11 countries and 12 studies. ``The overall incidence of H1N1 was 24% and varied significantly by age. The highest age-specific incidence was found among children 5-19 years old (46%) followed by 0-4 years old (37%) and decreased by age from 20 years old and older (20-44 years old 20% and 14% among 45-64 years olds). Overall incidence was 28% lower in Asia when compared with Europe."

The WHO in August 2009 issued the swine flu alert to the highest pandemic level, signaling that a global epidemic of the H1N1 virus had begun. It first detected the novel pandemic influenza H1N1 virus in Mexico and the US in April 2009.

The last flu pandemic was declared in 1968 when H3N1 virus strain killed an estimated 1 million people.

The US Centres for Disease Control and Prevention (CDC), Atlanta, recently said India may have grossly underestimated the might of 21st century's most aggressive pandemic.

A recent CDC study, with help from New Delhi's All India Institute of Medical Sciences, published in medical journal Lancet said the deaths caused by H1N1 pandemic flu in its first year (2009-10) could be 15 times higher than the number of laboratory-confirmed deaths previously reported to the WHO.

During the pandemic, 18,500 laboratory-confirmed H1N1-deaths were reported worldwide from April 2009 to August 2010.

The CDC research indicated that the death toll was anywhere between 1.51 lakh and 5.75 lakh during the first year when the virus circulated worldwide.

The results said that 80% deaths occurred in people younger than 65, contrary to seasonal influenza where most deaths occur among the elderly.

Additionally, the study suggested that 51% deaths may have occurred in south-east Asia and Africa home to 38% of the world's population.

"China and India, where about a third of the world's population live have garnered little information about the burden of influenza," it said.

India's age-adjusted respiratory and cardiovascular mortality rate associated with 2009 pandemic influenza H1N1 per 100 000 individuals stood at 4.1-6 per 100,000 population.

"An additional 83,300 cardiovascular deaths associated with the 2009 pandemic influenza were estimated to have occurred in people older than 17 years globally, resulting in a total of 284,400 respiratory and cardiovascular deaths. Around 20% of these deaths occurred in people older than 64 years," the CDC study said.

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