Steven Johnson Syndrome – A Triad of Mucosal Lesions, Cutaneous Involvement and History of Recent Drug Exposure

Steven Johnson Syndrome is relative a rare but yet an acute life-threatening condition. A middle aged lady presented to us in an emergency condition with high grade fever (104oF), oral mucosal ulcers, purulent discharge from both eyes, photophobia, generalized skin rashes, flank bruises, dyspnea, severe odynophagia along with dysphagia and blisters on both hands and feet. Because of extensive oral thrush, mouth ulcers and purulent discharge from eyes, the patient was initially suspected to be a case of oral candidiasis and bacterial conjunctivitis. However, due to wide spread muco-cutaneous involvement and after obtaining detailed drug history and getting opinion from dermatology and ophthalmology department, a diagnosis of Steven Johnson Syndrome was established. The treatment was started accordingly and the patient responded dramatically to the treatment, got improved and was subsequently discharged.

Pollution Based Study of Heavy Metals in Medicinal plants Aloe vera and Tamarix aphylla.

The main objective of this study was to generate perception in community regarding pollution of heavy metals contained in Aloe vera and Tamarix aphylla plants which have wide range of medicinal use but having toxic concentration of heavy metals. The plant samples were collected at three different areas referred as spots i.e. polluted (spot 1), less polluted (spot 2) and non- polluted (spot 3) from District Kohat, Khyber Pakhtunkhwa, Pakistan. In the present study, essential heavy metals such as Cobalt (Co), Nickel (Ni), Chromium (Cr), Copper (Cu), Iron (Fe) and Zinc (Zn) and non-essential heavy metals Cadmium (Cd), Lead (Pb) were analyzed in Aloe vera leaves and Tamarix aphylla by using Flame atomic absorption spectrophotometer. Heavy metals concentration in different spots were found to be in order as Spot 1> Spot 2>Spot 3 with the concentration range of found heavy metals., Cd 0.25-0.51 mg/kg, Pb BDL-15.23, Co 1.90-3.31mg/kg, Ni 2.98-4.01 mg/kg, Cr 4.86- 6.01 mg/kg, Cu 2.32-3.01 mg/kg, Fe 12.42-22.47 mg/kg, Zn 34.53-53.08 mg/kg for Aloe vera leaves and concentrations of the same heavy metals like Cd 0.13-0.31 mg/kg, Pb 1.00-18.01 mg/kg, Co 0.25-2.90 mg/kg , Ni 3.75-5.93 mg/kg , Cr 3.83-5.32 mg/kg , Cu 1.01-1.90 mg/kg, Fe 23.65-30.10 mg/kg , Zn 13.70-25.63 mg/kg were observed in the bark of Tamarix aphylla. Thus it was concluded from the present study that the samples collected from polluted area were found more contaminated with heavy metals as compared to less polluted and nonpolluted area.