A cross-sectional study of cutaneous drug reactions in a private dental college and government medical college in eastern India

Background: Cutaneous drug reactions are a common impediment in therapy, the incidence ranging from 2% to 8%. This cross-sectional study was designed to compare different trends of cutaneous drug reaction in two different socioeconomic groups of patients in the same region.Aims: The aim was to evaluate common drugs implicated in causing reactions, describe the adverse cutaneous drug reactions, study the characteristics of patients presenting with the reactions.Study Design: This is an observational study of cross-sectional type.Materials and Methods: The study was carried out in the department of Oral and Maxillofacial surgery in a Private dental College and department of General Medicine in a Medical College only on outdoor basis for 3 years. Out of 2000 patients observed in each college for their necessary treatment 75 patients in the dental College and 200 patients in the Medical College were reported to have various types of cutaneous drug reactions. Diagnosis was based on detailed history including temporal correlation between drug intake and onset of rash and thorough clinical examination Apart from history of drug intake, information regarding associated other allergy, comorbidity and severity (whether hospitalization was required or not) was recorded. Rechallenge with the drug was not possible due to ethical problem.Results: Out of 2000 patients observed in each college 75 patients in dental College and 200 patients in Medical College were documented to have different kinds of cutaneous drug reactions. A total of 30 were male and 45 female in dental college whereas 90 male and 110 female patients were enrolled in Medical College. The age group of the patients in both the colleges ranged from 18 to 75 years. Common culprits observed in this study were antibiotics and NSAIDs. They had contributed 53% and 40% of the total skin reactions respectively in dental college and 47.5% and 45% in Medical College. We encountered 6 patients of systemic lupus erythematosus (SLE), 20 patients with allergic rhinitis and 12 patients with bronchial asthma in the whole proceedings. The duration of drug intake varied from 15 minutes to 2 weeks. The most common reaction noted was maculopapular rash 37 (50.5%), urticaria 15 (20%), fixed drug eruption (FDR) 15 (20%), angioedema 6 (8%) in dental College whereas a little different trend was observed in the medical college. Hospitalization was required in two cases of Steven--Johnson syndrome caused by NSAIDS in the dental College whereas 11 patients were hospitalized for the same indication in the medical College. Except for maculopapular rash, all other skin reactions were observed more frequently with NSAIDS in dental College whereas Steven--Johnson syndrome is predominantly observed in Medical College with anticonvulsants. In all the cases causative drugs were withdrawn. A total 40% of the patients required only antihistaminic, 35% required antihistaminic and topical corticosteroid and rest required a combination of antihistaminic, oral and topical corticosteroids.Conclusion: Commonest drugs causing drug reactions are antibiotics mainly beta lactams and quinolones. Severe reactions were seen in our series with anticonvulsants and NSAIDS. Association with other diseases could not be inferred due to this modest patient pool

Pseudorandom Generators for Width-3 Branching Programs

We construct pseudorandom generators of seed length $\tilde{O}(\log(n)\cdot \log(1/\epsilon))$ that $\epsilon$-fool ordered read-once branching programs (ROBPs) of width $3$ and length $n$. For unordered ROBPs, we construct pseudorandom generators with seed length $\tilde{O}(\log(n) \cdot \mathrm{poly}(1/\epsilon))$. This is the first improvement for pseudorandom generators fooling width $3$ ROBPs since the work of Nisan [Combinatorica, 1992]. Our constructions are based on the `iterated milder restrictions' approach of Gopalan et al. [FOCS, 2012] (which further extends the Ajtai-Wigderson framework [FOCS, 1985]), combined with the INW-generator [STOC, 1994] at the last step (as analyzed by Braverman et al. [SICOMP, 2014]). For the unordered case, we combine iterated milder restrictions with the generator of Chattopadhyay et al. [CCC, 2018]. Two conceptual ideas that play an important role in our analysis are: (1) A relabeling technique allowing us to analyze a relabeled version of the given branching program, which turns out to be much easier. (2) Treating the number of colliding layers in a branching program as a progress measure and showing that it reduces significantly under pseudorandom restrictions. In addition, we achieve nearly optimal seed-length $\tilde{O}(\log(n/\epsilon))$ for the classes of: (1) read-once polynomials on $n$ variables, (2) locally-monotone ROBPs of length $n$ and width $3$ (generalizing read-once CNFs and DNFs), and (3) constant-width ROBPs of length $n$ having a layer of width $2$ in every consecutive $\mathrm{poly}\log(n)$ layers.Comment: 51 page

Collider design issues based on proton-driven plasma wakefield acceleration

Recent simulations have shown that a high-energy proton bunch can excite strong plasma wakefields and accelerate a bunch of electrons to the energy frontier in a single stage of acceleration. It therefore paves the way towards a compact future collider design using the proton beams from existing high-energy proton machines, e.g. Tevatron or the LHC. This paper addresses some key issues in designing a compact electron-positron linear collider and an electron-proton collider based on existing CERN accelerator infrastructure

An assessment of psychiatric disturbances in graves disease in a medical college in eastern India

Background: Graves’ disease is a unique conglomeration of cardiovascular, neurological, ophthalmological, and other systemic manifestations. In this study we have tried to explore the psychiatric dimensions of this disease. Aims: This study attempted to explore clinical features, types, and treatment outcome of psychiatric disturbances in Graves disease.Study Design: This is a purposive study following the criteria of DSM IV. Materials and Methods: A total of 36 adult patients of newly diagnosed Graves disease and 30 age- and sex-matched controls were included. Data enumerated were age, sex, date of admission, analysis of psychiatric signs, and symptoms by one independent observer, diagnostic categorization, effect of treatment, and outcome. Follow-up evaluation was done after 1 year.Statistical Analysis: Statistical analysis was done by the standard error of difference, the chi-square test, and paired Student’s T-test.Results: Among 36 patients 32 were female and 4 were male. Fifteen patients (41.67%) were diagnosed with generalized anxiety disorders (GAD), 6 (16.67%) with mood disorder, 6 (16.67%) with obsessive compulsive disorder (OCD), and 2 each with personality disorder and schizophreniform disorder. The common symptoms were insomnia, irritability, and anxiety. The Frequency of GAD was statistically more significant in the Graves disease group in comparison to control.Fourteen patients agreed to take both antithyroid and antipsychotropic medications (group 1). The rest were treated with only antithyroid drug (group 2). There was significant improvement in both groups and no difference between the groups.Conclusion: The prevalence of certain psychiatric manifestations in Graves’ disease was significantly higher than in the control group. There was no significant difference between therapy with antithyroid drugs and combination of antithyroid with psychotropic medications

Dynamical Mean Field Theory of Double Perovskite Ferrimagnets

The dynamical mean field method is used to analyze the magnetic transition temperature and optical conductivity of a model for the ferrimagnetic double perovskites such as $Sr_2FeMoO_6$. The calculated transition temperatures and optical conductivities are found to depend sensitively on the band structure. For parameters consistent with local spin density approximation band calculations, the computed transition temperatures are lower than observed, and in particular decrease dramatically as band filling is increased, in contradiction to experiment. Band parameters which would increase the transition temperature are identified.Comment: Supercedes cond-mat/000628 (PRB64 024424/1-4 (2001

Structural domain and spin ordering induced glassy magnetic phase in single layered manganite Pr0.22_{0.22}Sr1.78_{1.78}MnO4_4

The single layered manganite Pr$_{0.22}$Sr$_{1.78}$MnO$_4$ undergoes structural transition from high temperature tetragonal phase to low temperature orthorhombic phase below room temperature. The orthorhombic phase was reported to have two structural variants with slightly different lattice parameters and Mn-3$d$ levels show orbital ordering within both the variants, albeit having mutually perpendicular ordering axis. In addition to orbital ordering, the orthorhombic variants also order antiferromagnetically with different N\'eel temperatures. Our magnetic investigation on the polycrystalline sample of Pr$_{0.22}$Sr$_{1.78}$MnO$_4$ shows large thermal hysteresis indicating the first order nature of the tetragonal to orthorhombic transition. We observe magnetic memory, large relaxation, frequency dependent ac susceptbility and aging effects at low temperature, which indicate spin glass like magnetic ground state in the sample. The glassy magnetic state presumably arises from the interfacial frustration of orthorhombic domains with orbital and spin orderings playing crucial role toward the competing magnetic interactions.Comment: 6 pages, 4 figures, Accepted in Europhysics Letter