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We present a case of a 55-year-old diabetic woman who presented to the clinic with an erythematous, scaly, itchy rash and generalized abdominal pain with vomiting. Owing to the symptoms of peripheral neuropathy, she had been prescribed carbamazepine 100 mg twice daily. Initially, the patient presented with the rash on her face along with sticky eyelashes, which later spread to chest, abdomen, and thighs. Blood cultures and wound swabs were taken, carbamazepine was stopped, a working diagnosis of toxic epidermal necrolysis (TEN) with prerenal acute kidney injury was made. Her renal functions were deranged with a serum urea of 170 mg/dL, serum creatinine 3.3 mg/dL, lactic acid 43 mg and estimated glomerular filtration rate (eGFR)15.3 ml/min/1.73 m2. There was no biochemical improvement observed, postdialysis. She developed left leg arterial ischemia with numbness, bluish discoloration of the skin, and hypotension. Ultimately, the patient went into multi-organ failure and unfortunately passed away. Serious and, sometimes, fatal dermatological reactions have been reported during the treatment with carbamazepine. Although carbamazepine-induced TEN is not a rare presentation, other similar drugs with a safer side effect profile could be used instead as in the case of our patient. [ABSTRACT FROM AUTHOR]

Legume crops have played a significant role in the historical dietary regime of Afghan peoples. Recently, production of common beans has increased on Afghan farms relative to other leguminous crops. However, compared with other pulse crops, common beans are more prone to water stress. To select drought resistant common beans, several varieties were assessed in the field during a sequence of restricted water supplies for two years and the local drought regime was analyzed for a 12-years period. The first experiment in 2018 compared five bean varieties under four irrigation regimes. White and black beans with long maturation periods and climber habits, and motley beans, characterized by moderate maturity and semi-climber structures, were susceptible to drought and did not mature well under restricted irrigation and ambient climate conditions. The other two varieties, red and pied beans, adapted to restricted water supplies and the long dry summers; these two varieties were assessed again in 2019. Statistical analyses and inferences based on the 2019 study suggest that red beans are more adaptable to water deficit treatments compared to pied beans. Therefore, red beans are considered a better option given the frequent mid- to late-summer droughts that occur in this region, together with the generally harsh mountain climate and short growing season of the central Afghanistan highlands. As a second varietal choice, pied beans are reasonably drought tolerant based on our findings. [ABSTRACT FROM AUTHOR]