Intravenous Immunoglobulin in the Treatment of Vancomycin-Induced Toxic Epidermal Necrolysis

Toxic epidermal necrolysis (TEN), an uncommon but potentially life-threatening skin reaction, is frequently induced by drugs. The mucocutaneous reaction is characterised by bullous detachment of the epidermis and mucous membranes. We present a 9-month-old male with methylmalonic acidaemia, generalised hypotonia, and global developmental delay. He presented with a 3-day history of fever, cough, shortness of breath, and vomiting. Eruption appeared after 5 days of vancomycin treatment. The eruption involved almost 60% of the total body surface area and both eyes. He was successfully treated with intravenous immunoglobulin (IVIG), antibiotics,and appropriate wound management and made a full recovery with negligible sequelae despite the severity of his disease. Important components of successful treatment include early recognition, intensive care, prompt withdrawal of the causative agent, early administration of IVIG, appropriate fluid resuscitation, and control of infection. IVIG might be beneficial in the treatment of TEN; however, controlled studies are needed to evaluate IVIG compared to other modalities

Semilobar Holoprosencephaly with Neurogenic Hypernatraemia : Two new cases

Holoprosencephaly (HPE) is a developmental defect of the embryonic forebrain and midface. It is due to the non-cleavage of the embryonic forebrain into two cerebral hemispheres and the incomplete development of the paramedian structures. The overall prevalence is 1.31 per 10,000 births. The aetiology could be genetic,environmental, or both. HPE is classified into alobar, semilobar, and lobar subtypes based on the degree of separation of the cerebral hemispheres. We report two new cases of semilobar HPE with neurogenic hypernatraemia. Lack of thirst and hypodypsia associated with chronic hypernatraemia in patients with HPE is highly suggestive of neurogenic hypernatraemia. Early identification of neurogenic hypernatraemia is important as it improves with forced fluid therapy and does not require any medication

Updated Constraints on the Minimal Supergravity Model

Recently, refinements have been made on both the theoretical and experimental determinations of the i.) mass of the lightest Higgs scalar (m_h), ii.) relic density of cold dark matter in the universe (Omega_CDM h^2), iii.) branching fraction for radiative B decay BF(b \to s \gamma), iv.) muon anomalous magnetic moment (a_\mu), and v.) flavor violating decay B_s \to \mu^+\mu^-. Each of these quantities can be predicted in the MSSM, and each depends in a non-trivial way on the spectra of SUSY particles. In this paper, we present updated constraints from each of these quantities on the minimal supergravity (mSUGRA) model as embedded in the computer program ISAJET. The combination of constraints points to certain favored regions of model parameter space where collider and non-accelerator SUSY searches may be more focussed.Comment: 20 pages, 6 figures. Version published in JHE

A systematic study of the radion in the compact Randall-Sundrum model

We systematically study the question of identification and consistent inclusion of the radion, within the Lagrangian approach, in a two brane Randall-Sundrum model. Exploiting the symmetry properties of the theory, we show how the radion can be identified unambiguously and give the action to all orders in the radion field and the metric. Using the background field method, we expand the theory to quadratic orders in the fields. We show that the most general classical solutions, for the induced metric on the branes in the case of a constant radion and a factorizable 4D metric, correspond to Einstein spaces. We discuss extensively the diagonalization of the quadratic action. Furthermore, we obtain the 4-dimensional effective theory from this and study the question of the spectrum as well as the couplings in these theories.Comment: revtex, 17 page

Direct Detection of Dark Matter in Supersymmetric Models

We evaluate neutralino-nucleon scattering rates in several well-motivated supersymmetric models, and compare against constraints on the neutralino relic density, BF( b\to s\gamma ) as well as the muon anomalous magnetic moment a_\mu . In the mSUGRA model, the indirect constraints favor the hyperbolic branch/focus point (HB/FP) region of parameter space, and in fact this region is just where neutralino-nucleon scattering rates are high enough to be detected in direct dark matter search experiments! In Yukawa unified SUSY SO(10) models with scalar mass non-universality, the relic density of neutralinos is almost always above experimental bounds, while the corresponding direct detection rates are below experimental levels. Conversely, in five dimensional SO(10) models where gauge symmetry breaking is the result of compactification of the extra dimension, and supersymmetry breaking is communicated via gaugino mediation, the relic density is quite low, while direct detection rates can be substantial.Comment: 25 page latex file including 18 EPS figures; revised version with references added and cross sections rescaled; figures changed. A copy of the paper with better resolution figures can be found at http://www.hep.fsu.edu/~belyaev/projects/directz1

Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19

Importance: Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality. // Objective: To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality. // Design, Setting, and Participants: The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis. // Exposures: SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated. // Main Outcomes and Measures: The primary end point was all-cause mortality within the primary hospitalization. // Results: Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19–related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86). // Conclusions and Relevance: The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Nephropathic Cystinosis: First reported case in Oman

Cystinosis is an autosomal recessive, lysosomal storage disease characterised by the accumulation of the amino acid cystine in different organs and tissues. It is a multisystemic disease that can present with renal and extra renal manifestations. There are three types of cystinosis, infantile nephropathic cystinosis being the most severe form. In this report we present the classic clinical features of nephropathic cystinosis in an Omani child. This condition remains quite rare in the Middle East and is the first reported case of nephropathic cystinosis in the Omani population