Hypersensitivity reactions to intravenous ferric carboxymaltose in a patient with iron deficiency anemia: a rare case report

Ferric carboxymaltose (FCM) is a non-dextran iron preparation recently approved in the United States for intravenous treatment of iron deficiency anemia (IDA) in adult patients with intolerance or poor response to oral iron therapy. Acute hypersensitivity reactions (HSRs) during iron infusions are very rare but can be life-threatening. Adverse events, including immune system disorders (0% in FCM) and skin disorders (7.3% in FCM), are less frequently observed with FCM. On treatment with FCM, the change in hemoglobin from baseline to the highest observed level is about 2.8g/dL. Treatment of IDA with FCM resulted in fewer hypersensitivity reactions. Here, authors report a case of a 23 years old female diagnosed for IDA presented with the picture of adverse drug reaction due to injection FCM given by the physician. The patient was managed with Antibiotics, Corticosteroids and Intravenous fluids and recovered well within 12 hours of admission from this adverse drug reaction. Since such cases have been rarely reported, authors are intended to notify about this potentially dangerous drug reaction due to FCM which is used extensively in the treatment of IDA. Hence management of iron infusions requires very careful and precise observation, and, in the event of an adverse reaction, prompt recognition and severity-related interventions by well-trained medical and nursing staff

The ALICE experiment at the CERN LHC

ALICE (A Large Ion Collider Experiment) is a general-purpose, heavy-ion detector at the CERN LHC which focuses on QCD, the strong-interaction sector of the Standard Model. It is designed to address the physics of strongly interacting matter and the quark-gluon plasma at extreme values of energy density and temperature in nucleus-nucleus collisions. Besides running with Pb ions, the physics programme includes collisions with lighter ions, lower energy running and dedicated proton-nucleus runs. ALICE will also take data with proton beams at the top LHC energy to collect reference data for the heavy-ion programme and to address several QCD topics for which ALICE is complementary to the other LHC detectors. The ALICE detector has been built by a collaboration including currently over 1000 physicists and engineers from 105 Institutes in 30 countries. Its overall dimensions are 161626 m3 with a total weight of approximately 10 000 t. The experiment consists of 18 different detector systems each with its own specific technology choice and design constraints, driven both by the physics requirements and the experimental conditions expected at LHC. The most stringent design constraint is to cope with the extreme particle multiplicity anticipated in central Pb-Pb collisions. The different subsystems were optimized to provide high-momentum resolution as well as excellent Particle Identification (PID) over a broad range in momentum, up to the highest multiplicities predicted for LHC. This will allow for comprehensive studies of hadrons, electrons, muons, and photons produced in the collision of heavy nuclei. Most detector systems are scheduled to be installed and ready for data taking by mid-2008 when the LHC is scheduled to start operation, with the exception of parts of the Photon Spectrometer (PHOS), Transition Radiation Detector (TRD) and Electro Magnetic Calorimeter (EMCal). These detectors will be completed for the high-luminosity ion run expected in 2010. This paper describes in detail the detector components as installed for the first data taking in the summer of 2008

Bleomycin-induced flagellate hyperpigmentation: Clinical Image

Flagellate hyperpigmentation is a unique complication of systemic bleomycin sulfate therapy. It has an onset anywhere between 1 day and several months after administration for various indications and these eruptions are usually dose-dependent. The dose of bleomycin required to produce such an effect is usually more than 100 U but it can also occur at lower doses also. Herewith, we describe a case with clinical image of ovarian dysgerminoma that presented with typical linear and streaked pigmentation following a very low dose (30 U) of systemic bleomycin therapy which appeared within 24 h of administration and increased gradually after subsequent doses

Drug-interaction-induced hemodynamically mediated acute renal failure in postsurgical patient

Acute renal failure is a life threatening condition. Nonsteroidal antiinflammatory drugs (NSAIDs) and cephalosporins are widely used postoperative drugs. NSAID-induced acute renal failure has been reported in the past. In this case, drug interaction and decompensated state of the patient precipitate the condition. NSAIDs inhibit prostaglandins synthesis and thus aggravate ischemia to the kidney that is already facing volume crisis due to surgery. Due to renal dysfunction, plasma ceftriaxone level increases due to decrease clearance and it also acts as nephrotoxic by unknown mechanism. On the other hand, ceftriaxone on its interaction with diclofenac for renal tubular clearance also increases the level of diclofenac and thus further aggravate the ischemia. It is a reversible condition with excluding diclofenac from the treatment regimen and giving adequate hydration to the patient. This highlights the importance of hydration and knowledge of drugs interactions in a postsurgical patient

Tectonic influence on gas hydrate stability zone thickness: -Seismic study from Indian offshore

Deep offshore areas of Andaman forearc basin and Krishna-Godavari basin are the two Indian areas where distinct Bottom Simulating Reflector (BSR), the seismic indicator of gas hydrates is observed. The tectonic settings of Andaman and Krishna-Godavari offshore are very diverse. Krishna-Godavari is a rifted passive margin basin in the east coast of India whereas Andaman forearc basin is in the intra-oceanic subduction zone. An interesting aspect of BSR identified in these two areas, is the large difference in the depth of occurrence of BSR below seafloor. As BSR is the seismic reflector from the base of hydrated layer, the depth of BSR below seafloor is the thickness of the hydrate stability zone (HSZ). It was noticed from seismic sections that depth of BSR below seafloor in Andaman offshore is almost double as that of Krishna-Godavari area for the identical water depths. An effort is made in this study to understand this large difference in the hydrate stability zone thickness between these two areas. The major factors, which affect the thickness of hydrate stability zone, are sea bottom temperature, geothermal gradient and composition of gases forming hydrates. Analysis of available data from both these areas rules out the possibility of large difference in HSZ thickness on account of variations in sea bottom temperature and composition of gases. Available well data show that geo-thermal gradient in Andaman offshore is much lower in comparison to that of Krishna-Godavari offshore. This low geothermal gradient in Andaman is due to the relatively cool plate being suducted. Hence on the basis of available data it can be concluded that the higher thickness of hydrate stability zone in Andaman can be attributed to lower geothermal gradient, which in turn is dependent on the tectonic setting. The present study of HSZ thickness of two tectonically diverse offshore basins has brought out the influence of tectonic settings on gas hydrate stability zone thickness

Synergy of nanocarriers with CRISPR-Cas9 in an emerging technology platform for biomedical appliances : Current insights and perspectives

Genetic editing technologies have emerged as a potential therapeutic tool in various biomedical fields owing to their applications against cancer, neurological diseases, diabetes, autoimmune disorder, muscu-lar dystrophy, bacterial infections (AMR), and cardiovascular diseases. CRISPR is one such valuable genetic editing tool with extensive therapeutic appliances but with a major challenge in terms of deliv-ery. Herein, we have strived to exploit a synergy of nanocarriers and CRISPR against the aforementioned diseases for their medical applications and explicated their clinical significance including the enhanced delivery via endosomal escape and environmental factors such as light, pH, and stimuli. In addition to highlighting the delivery strategies of nano-carriers for CRISPR and their characterization, we have expounded on the reliant factor of the CRISPR-Cas Complex