ABSTRACT
Anticonvulsant hypersensitivity syndrome (AHS) is a potentially fatal drug-induced, multi-organ syndrome. The syndrome has been reported with anticonvulsants such as carbamazepine, phenytoin, phenobarbitone, and lamotrigine. A 17-year-old female who presented with papules and desquamation all over was diagnosed with AHS. She gave a history of fever, earache, peripheral edema, and erythematous papular eruptions 3 days prior. She gave a history of carbamazepine treatment since 15 days for generalized tonic-clonic seizures. On examination, there was cervical lymph node enlargement without tenderness. Investigations revealed elevated absolute eosinophil count at 550/mm3 and positive C-reactive protein tests. Carbamazepine was immediately withdrawn. Symptomatic treatment was administered, and resolution of the symptoms was observed. In this case, causalty assessment using Naranjo adverse drug reaction probability scale showed that carbamazepine was a probable cause for the AHS (Score - 7).
ABSTRACT
Background: According to WHO’s definition, “self-medication is the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms”. A sensible clinical use of antimicrobials is crucial to prevent the occurrence of antimicrobial resistance. As undergraduate medical students are aware of the various antimicrobial agents and diseases, this study assessing antimicrobial self- medication carries a significant value. Methods: A cross-sectional questionnaire-based study was conducted among the undergraduate medical students of Adichunchanagiri Institute of Medical Sciences, BG Nagar, Mandya, Karnataka. Results: The prevalence of antimicrobial self-medication among the medical undergraduates was 48.4%. Male student participation was 53.2%, whereas female students 46.8%. Among the antimicrobial agents self-medicated, azithromycin (55.6%) was the most common, followed by amoxicillin (12.3%), ciprofloxacin (7.4%), ofloxacin (6.2%), cefixime (4.9%), levofloxacin (3.7%), metronidazole (2.5%), amoxicillin + clavulanic acid (2.5%) and others (5%). The indications for self-medication reported were upper respiratory infection (66.6%), gastroenteritis (12.3%), fever (11.1%), boils (3.7%), acne, tonsillitis and urinary tract infection, 1.2% each. Reasons for seeking self-medication: About 54.4% students felt that their illness is mild in nature and 21% were confident about the illness and treatment. Choice of antimicrobial agents was based on previous prescription of physicians (51.6%) and textbook knowledge (39%). 90% of students had completed the course of treatment, 76.1% were aware of antimicrobial resistance and 92% students considered self-medication as a component of self-care. Conclusions: Our study shows that antimicrobial self-medication is widely practiced among under-graduate medical students of the institute. In this situation, faculties should create awareness and educate their students regarding advantages and disadvantages of antimicrobial self-medication.
ABSTRACT
Background: Self-medication with analgesics is widely practiced among medical students. Self-medication is defined as “the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms.” It assumes a special significance among the undergraduate medical students as they are aware of the available analgesic medications. Our study would evaluate the pattern of analgesic self-medication among undergraduate medical students of Adichunchanagiri Institute of Medical Sciences (AIMS), BG Nagar. Methods: A cross-sectional questionnaire-based study was done from January to March 2014 among undergraduate medical students, AIMS, BG Nagar. 218 students consented for the study out of 250 students and filled in the questionnaire. 20 incomplete questionnaires were excluded and the remaining 198 were analyzed. Results: Our study showed that 63.6% of the students practiced analgesic selfmedication. 68.2% sought self-medication for headache followed by body pain (9.7%), low backache (5.1%), fever (4.5%) and joint pain (3.8%). Paracetamol was used by 47.2%, diclofenac by 20.5%, ibuprofen by 7.5%, aspirin by 6.8%, and aceclofenac by 4.1%. Self-medication was based on the use of previous prescriptions in 42.1% of the students and textbook knowledge in 39.1% of the students. 26.4% students complained that pain reduced concentration in studies. 61.6% students stated the mild nature of illness as the reason for self-medication. 91.9% of the students felt that self-medication is a part of self-care. 61.2% of the students were aware of the side-effects of the analgesic medications. Conclusion: Our study shows that self-medication with analgesics is high among the undergraduate medical students of this institute. Although it is an easy way to treat mild to moderate pain, it may be accompanied with side effects, drug interactions, and toxicities. Hence, we conclude that there is a need to create awareness, and educate the students regarding the possible harmful effects of self-medication with analgesics.
ABSTRACT
Phenobarbital (PHB) (International Non-proprietary Name) or Phenobarbitone (British Approved Name) is a long acting barbiturate and the most widely used antiseizure medication globally. Fever, skin reactions, limb edema, and drug-induced hypersensitivity have been reported in children because of various drugs, mainly aromatic antiepileptic drugs such as phenytoin, PHB, carbamazepine, and primidone. The skin reactions differ in severity and range from a mild maculopapular erythema to exfoliative dermatitis. A 2-month-old male baby was brought to the dermatology out-patient department with complaints of redness and scaling all over the body (erythroderma) after 2-3 weeks of PHB treatment for convulsions. PHB was stopped, and corticosteroids (topical and systemic) were started. The baby improved over a period of 2 weeks. According to Naranjo’s adverse drug reaction probability scale, the causality relation between erythroderma and PHB was found to be a probable one.