Itraconazole-induced Torsade de Pointes in a patient receiving methadone substitution therapy

Issues. Methadone, a pharmacological agent used to treat heroin dependence is relatively safe, but may cause cardiac arrhythmias in the concurrent presence of other risk factors. Approach and Key Findings. This case report highlights the risk of Torsade de Pointes, a life-threatening cardiac arrhythmia, in a heroin-dependent patient receiving methadone substitution therapy who was prescribed itraconazole for vaginal thrush. The patient presented to the accident and emergency department for chest discomfort and an episode of syncope following two doses of itraconazole (200 mg). Electrocardiogram monitoring at the accident and emergency department showed prolonged rate-corrected QT interval leading to Torsade de Pointes. The patient was admitted for cardiac monitoring, and electrocardiogram returned to normal upon discontinuation of methadone. Implication. This cardiac arrhythmia was most likely as a result of a drug interaction between methadone and itraconazole because the patient presented with no other risk factors. Conclusion. Given the benefits of methadone as a substitution treatment for heroin-dependent individuals, the association between methadone and cardiac arrhythmias is of great concern. Physicians treating heroin-dependent patients on methadone substitution therapy should therefore be cautious of the potential risk of drug interactions that may lead to fatal cardiac arrhythmias

On the period of the coherent structure in boundary layers at large Reynolds numbers

The period of the large coherent structure in a subsonic, compressible, turbulent boundary layer was determined using the autocorrelation of the velocity and pressure fluctuations for Reynolds numbers between 5,000 and 35,000. In low Reynolds number flows the overall correlation period scaled with the outer variables - namely, the free stream velocity and the boundary layer thickness

The overlap lattice Dirac operator and dynamical fermions

I show how to avoid a two level nested conjugate gradient procedure in the context of Hybrid Monte Carlo with the overlap fermionic action. The resulting procedure is quite similar to Hybrid Monte Carlo with domain wall fermions, but is more flexible and therefore has some potential worth exploring.Comment: Further expanded version. 12 pages, plain Te

Chiral Symmetry Restoration in the Schwinger Model with Domain Wall Fermions

Domain Wall Fermions utilize an extra space time dimension to provide a method for restoring the regularization induced chiral symmetry breaking in lattice vector gauge theories even at finite lattice spacing. The breaking is restored at an exponential rate as the size of the extra dimension increases. Before this method can be used in dynamical simulations of lattice QCD, the dependence of the restoration rate to the other parameters of the theory and, in particular, the lattice spacing must be investigated. In this paper such an investigation is carried out in the context of the two flavor lattice Schwinger model.Comment: LaTeX, 37 pages including 18 figures. Added comments regarding power law fitting in sect 7. Also, few changes were made to elucidate the content in sect. 5.1 and 5.3. To appear in Phys. Rev.

Domain Wall Fermions and the Eta Invariant

We extend work by Callan and Harvey and show how the phase of the chiral fermion determinant in four dimensions is reproduced by zeromodes bound to a domain wall in five dimensions. The analysis could shed light on the applicability of zeromode fermions and the vacuum overlap formulation of Narayanan and Neuberger for chiral gauge theories on the lattice.Comment: uuencoded file with 3 figures; uses macros harvmac, epsf. Revised discussion of the Chern-Simons form and SU(2) anomaly in section 4, as well as additional minor change

Trade impact of SADC-India FTA on textiles and clothing sectors

Pluri-lateral trade agreements have been the topic of the hour in trade circles, since late 2000’s, though they have been slowed down in recent trade policy developments in UK and USA. However, countries like India and African nations that have been left out of such mega deals have been considering striking deals among themselves. In this paper, we examine the potential impact of India-SADC (South African Development Community) FTA on these countries, especially focusing on their crucial Textiles and Clothing (T&C) sectors. Apart from the widely used GTAP framework, we also employ the Revealed Comparative Advantage (RCA) analysis in conjunction with it, to draw implications on FTA impct on RCA, which is mostly positive as per our analysis. Otherwise, India stands to gain, while the SADC countries have mixed effects across sectors, with an overall positive effects

Uplink Linear Receivers for Multi-cell Multiuser MIMO with Pilot Contamination: Large System Analysis

Base stations with a large number of transmit antennas have the potential to serve a large number of users at high rates. However, the receiver processing in the uplink relies on channel estimates which are known to suffer from pilot interference. In this work, making use of the similarity of the uplink received signal in CDMA with that of a multi-cell multi-antenna system, we perform a large system analysis when the receiver employs an MMSE filter with a pilot contaminated estimate. We assume a Rayleigh fading channel with different received powers from users. We find the asymptotic Signal to Interference plus Noise Ratio (SINR) as the number of antennas and number of users per base station grow large while maintaining a fixed ratio. Through the SINR expression we explore the scenario where the number of users being served are comparable to the number of antennas at the base station. The SINR explicitly captures the effect of pilot contamination and is found to be the same as that employing a matched filter with a pilot contaminated estimate. We also find the exact expression for the interference suppression obtained using an MMSE filter which is an important factor when there are significant number of users in the system as compared to the number of antennas. In a typical set up, in terms of the five percentile SINR, the MMSE filter is shown to provide significant gains over matched filtering and is within 5 dB of MMSE filter with perfect channel estimate. Simulation results for achievable rates are close to large system limits for even a 10-antenna base station with 3 or more users per cell.Comment: Accepted for publication in IEEE Transactions on Wireless Communication