Fatal Stevens-Johnson syndrome induced by phenytoin: a case report.

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare (one to two per 10,00,00 population per year) but life threatening adverse drug reactions. Drugs commonly implicated are anti-epileptics, anti-microbials and non-steroidal anti-inflammatory drugs (NSAIDS). Amongst anti-epileptics, carbamazepine and phenytoin are the major culprits. We report here a fatal case of SJS due to phenytoin.

Evaluation of knowledge, attitude and behavior about rational use of medicines in second year medical students.

Background: To assess the knowledge about various issues concerned with rational use of medicines in second year medical students Methods: This was a survey-based, cross-sectional study in which a self developed, pre-tested, semi-structured questionnaire was used. Respondents were 153 students of second year MBBS (beginning of third semester). They were explained about nature and purpose of study and necessary consent obtained. Questions were framed to obtain information about various issues concerned with use of medicines, common beliefs /misconceptions, purchase of medicines, sources of information about medicines etc. Results were expressed as counts and percentages. Results: Majority of respondents were aware about OTC (54%) and generic medicines (96.7%), importance of reading medicine label (58.8%), that medicines are not needed for every illness (86.2%), medicines manufactures by big multinational companies are not always better (67.9%). 75.8% respondents were not influenced by direct to consumer advertising for purchase of medicines and 69.9% opined that medicines obtained from government hospital are not of inferior quality. 83.6% of respondents opined that they never mixed treatment of more than one doctor at a time and 83% always purchased all medicines written in prescription. For 93.4% respondents’ doctors’ advice was the most important factor that influenced medicine purchase. Conclusion: Though majority of respondents were aware about most of the issues addressed in the questionnaire which seems to be a positive finding, those still unaware needs to be educated by adopting suitable interventions.