Aceclofenac-Induced Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a rare but severe and potentially life-threatening systemic clinical condition. We report a case of a 44-year-old female, who developed DRESS syndrome after taking two doses of aceclofenac, paracetamol, and thiocolchicoside fixed-dose combination. The patient presented with maculopapular rashes, itching, fever, pedal edema, swelling of the face and lips, difficulty in swallowing, loose stools, and vomiting for 4 days following drug intake. Laboratory and histopathological investigations supported the diagnosis following RegiSCAR criteria. The DRESS syndrome in this patient was definite as per Naranjo’s adverse drug reaction probability scale. The patient was adequately managed using systemic corticosteroids, antibiotics, and intravenous fluids. Aceclofenac is the most likely causative agent of DRESS syndrome in this patient. Early detection and withdrawal of the suspected drug along with adequate supportive treatment are the mainstay of management.

Triphala: The Mystical Herb and Its Role in Dentistry

Ayurveda is well-thought-out as the science of life, for thereason that the ancient Indian system of health care aimedon the views of man and his ailment. From prehistoric timestraditional herbal remedies have been commonly adapted inIndia. Herbal extracts are economical with less adverse effectsas they interact with special chemical receptors within thebody. There is a folk saying in India which says, “No Mother?Do not worry so long as you have Triphala”. As it safeguardsinternal organs, just like a mother shields her offspring.Triphala is made by equal parts of three fruits namelyamalaki (Emblica officinalis), haritaki (Terminalia chebula),and bibhitaki (Terminalia belerica). This herb containsantioxidants, gallic acid and ascorbic acid. It has beneficialeffects in treating various ailments and thus has acquiredimportance in clinical research for its anticaries, antioxidant,anticollagenase and antimicrobial activities. The objective ofthe present article is to provide a brief overview of Triphalaand its various applications in dentistry

Incidence, nature and causality assessment of cutaneous adverse reactions to cosmetics: a pilot study

Background: Adverse reactions (ARs) are one of the most important causes of morbidity, hospitalization and increased healthcare cost. ARs to cosmetics are often underreported. The aim of our study was to assess the incidence, nature, causality and the outcome of ARs to cosmetics.Methods: This was a prospective observational study conducted in a dermatology outpatient clinic of a secondary care hospital of UAE. All the patients with suspected AR to cosmetics and reporting to dermatology clinic were included. The required data were collected from patient case files, patients and their caretakers. The Colipa causality scale was used to assess the causality of reported ARs.Results: The incidence of cutaneous ARs to cosmetics was 1.58%. Shampoo was the most common [7 (16.6%)] type of cosmetic suspected to cause AR, followed by face cream [6 (14.2%)]. The most common cutaneous AR to cosmetics observed in our study was rash and pruritus [13 (30.9%)] followed by itching [10 (23.8%)]. The majority of the cutaneous ARs in our study were on scalp, face and lower limbs each contributing about 21.4%. Causality assessment reveals that 16 (38%) of the cutaneous ARs were very likely type, while 25 (60%) of ARs were of not clearly attributable to use of cosmetic/s.Conclusions: Good number of the adverse reactions documented were mild in nature. Majority of the adverse reactions were not clearly attributable type. The results of this study can form a basis for creating awareness regarding the most common cosmetics associated with ARs. The study fosters the role of initiating cosmetovigilance activities.