ABSTRACT
Background : Substance abuse is an important health hazard and also a major preventable cause of morbidity and mortality. This habit not only affects health, education and occupational career, but also incurs huge financial and social burden to the society specially when the doctors are involved in it. Aims and objectives : To estimate the prevalence of substance abuse, its pattern and causes among the MBBS students of West Bengal. Methods : A questionnaire based cross-sectional retrospective study was designed to collect data from the Medical Officers of the State to record their experience of substance abuse during their MBBS course. Results : The prevalence of substance abuse was 22% among the study participants. Smoking Tobacco was most common (16.67%). 76% of the subjects with substance abuse spend Rs1000 or less per month. The prevalence was 25% in upper class and 22.22% among those who belonged to lower class of socio-economic status as per BG Prasad Classification. Curiosity was the reason as per 34.5% of the subjects followed by depression (23.25%), peer pressure (13%) study pressure by 15%; media influence by 11%; to cope with home problems by 10.75% and parental influence by 2.25% of the study subjects. Conclusion : The institution should keep a Psychological Counselor who can guide the students who suffer from problems related to Depression, Peer pressure, Study pressure that may lead to substance abuse. Allotting, hobbies, sports and recreation would help in keeping away from substance abuse
ABSTRACT
Background: Although extensively studied in adults, Nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity in children, especially in young children, remains a poorly defined area in both its clinical and epidemiologic aspects. Methods: The present observational study was conducted in the department of Dermatology of a tertiary care hospital in Eastern India. Twenty children (20) were screened with suspected NSAID-associated fixed drug eruption (FDE) in the outpatient department. A thorough history taking and clinical examination was performed for each of the cases of FDE. These cases were then managed conservatively after discontinuation of the suspected medication. Rechallenge with the putative offending drug was not done due to ethical reasons. WHO-UMC Causality Assessment criteria and Naranjo probability scale were used for causality assessment of each of the cases of FDE. The severity of reported reactions was assessed by using Modified Hartwig and Siegel Scale and Preventability of the ADRs was assessed by Modified Schumock and Thornton Scale. Results: Patients aged between 5 to 12 years and with a male preponderance of 3:2. The offending NSAID was ibuprofen for 8 of the patients, paracetamol and diclofenac for 4 each and ketorolac for 4 of the patients. These patients were prescribed the offending drugs for fever, rheumatoid arthritis and minor trauma. For each patient, history and clinical signs was consistent with the diagnosis of drug-induced FDEs. Causality assessment for each of the cases revealed ‘possible’ association predominantly (80%). Severity of the suspected ADR (adverse drug reaction) assessed using Modified Hartwig and Siegel Scale, revealed that the ADRs were mild(30%) to moderate (70%) in severity and of ‘probable’ preventibility (90%). Conclusions: 20 new cases of NSAID-induced FDEs over a period of 6 months suggest that this is not a rare entity as was presumed. There is a growing need for a strict monitoring of such off label offending drugs, known to cause ADRs especially among pediatric patients to ensure safe and rational therapeutics.