This expert group recommends prompt withdrawal of the culprit drug, meticulous supportive care, and judicious and early (preferably within 72 h) initiation of moderate to high doses of oral or parenteral corticosteroids (prednisolone 1-2 mg/kg/day or equivalent), tapered rapidly within 7-10 days. Cyclosporine (3-5 mg/kg/day) for 10-14 days may also be used either alone, or in combination with corticosteroids. Owing to the systemic nature of the disease, a multidisciplinary approach in the management of these patients is helpful.
An aggressive malignant peripheral nerve sheath tumor of an atypical site such as the scalp, in which complete surgery may not always be possible, could benefit from postoperative radiotherapy. A dose of approximately 60 Gy could be effectively delivered with a satisfactory outcome.
Background
– COVID-19 caused by SARS-CoV-2 leads to myriad range of organ involvement including liver dysfunction.
Aim
To analyse the liver function in patients with COVID-19 and their association with respect to age, sex, severity of disease and clinical features.
Materials and methods
This study was a cross-sectional study done at Rajendra Institute of Medical Sciences, Ranchi. 91 patients admitted with confirmed SARS-CoV-2 infection were included in this study and divided into asymptomatic, mild, moderate and severe groups. Liver function tests were compared among different severity groups.
Results
Of 91 patients with COVID-19, 70 (76.9%) had abnormal liver function. Aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin levels was 1–2 × ULN in 33(36.3%), 34(37.3%), 12(13.2%), 6(6.6%) cases and >2 × ULN in 20(22%), 18(19.8%), 7(7.7%) and 2 (2.2%) cases respectively. Mean AST and ALP levels among different severity groups of COVID-19 was statistically significant (p < 0.05) whereas mean ALT and total bilirubin levels was statistically non-significant (p > 0.05). There was no statistical difference between males and females with regard to abnormal liver function. Liver injury was seen in 64.3% cases of hypertension and 73.3% cases of diabetes. Fever, myalgia, headache and breathlessness were found to be correlated significantly with severity of disease.
Conclusion
Liver injury is common in SARS-CoV-2 infection and is more prevalent in the severe disease group. Aspartate transaminase and alkaline phosphatase are better indicators of covid-19 induced liver injury than alanine transaminase and total bilirubin.
String/M theory compactifications with low energy supersymmetry tend to predict that dark matter has two components: axions and WIMPs [1,2]. In accord with this, we show that the tentative 130 GeV γ-line signal reported in [3] can be interpreted as arising from the annihilation of 145 GeV mass, Wino-like WIMPs into a Z-boson and a photon. In this context, the signal implies a second component of dark matter which we interpret as being composed of axions -the relative Wino/Axion abundances being approximately equal. Further predictions are implied: signals in both diffuse and monochromatic photons from dwarf spheroidal galaxies; monochromatic photons with energy 145 GeV; for the LHC, the Higgs boson mass has been predicted in this framework [4], and the current Higgs limits provide interesting constraints on the mass of the Gluino.
To the best of our knowledge, radiation for the recurrent ABC at the temporal bone has not been described in the literature. However, in view of the response evident in this patient, radiotherapy seems to be effective for recurrent cases of ABC at the temporal bone and a dose of around 30 to 36 Gy could be effectively delivered with satisfactory results.
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