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

An epep collider 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. This scheme could lead to a future $ep$ collider using the LHC for the proton beam and a compact electron accelerator of length 170 m, producing electrons of energy up to 100 GeV. The parameters of such a collider are discussed as well as conceptual layouts within the CERN accelerator complex. The physics of plasma wakefield acceleration will also be introduced, with the AWAKE experiment, a proof of principle demonstration of proton-driven plasma wakefield acceleration, briefly reviewed, as well as the physics possibilities of such an $ep$ collider.Comment: 6 pages, 2 figures, to appear in the proceedings of the DIS 2014 Workshop, 28 April - 2 May, Warsaw, Polan

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

A novel precipitate-based manganese(II) sensor

176A new heterogeneous precipitate-based Mn(II) selective electrode has been prepared. The electrode is selective for Mn(II) ions in the presence of Zn(II), Cu(II), Mg(II), Fe(II), Ca(II), Ba(II), A1(II), NH4(I). It gives a linear response In the concentration range of 1 x 10-1 to 5 x 10-6 mol dm-3 and can be used as an indicator electrode in the precipitation titration of Mn(II) against phosphate ion

Ground state of a double-exchange system containing impurities: bounds of ferromagnetism

We study the boundary between ferromagnetic and non-ferromagnetic ground state of a double-exchange system with quenched disorder for arbitrary relation between Hund exchange coupling and electron band width. The boundary is found both from the solution of the Dynamical Mean Field Approximation equations and from the comparison of the energies of the saturated ferromagnetic and paramagnetic states. Both methods give very similar results. To explain the disappearance of ferromagnetism in part of the parameter space we derive from the double-exchange Hamiltonian with classical localized spins in the limit of large but finite Hund exchange coupling the $t-J$ model (with classical localized spins).Comment: 5 pages, 8 eps figures, latex; minor typos correcte

Dissociation Constants of Glycine, Alanine, Proline, Valine, Glutamine & γ-Aminobutyric Acid in Methanol & Ethanol-Water Mixtures

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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