Pattern of cutaneous adverse drug reactions in an adverse drug monitoring center at a tertiary care hospital in Kerala

Background: Pre-marketing clinical trials can filter only about 50% of the drug reaction. Hence, to prevent the morbidity and mortality due to severe cutaneous reactions early detection, evaluation and monitoring of adverse drug reaction (ADR) especially cutaneous ADR (CADR) are mandatory. Hence, it is imperative that we update our knowledge of the precise nature of ADR which will prevent the reactions as well as to find the offending drug. Aim and Objectives: The aim of the study was to evaluate the pattern of CADR, the suspected drugs and to perform the causality assessment using WHO casualty assessment scale. Materials and Methods: A retrospective descriptive study was done using the data reported to ADR monitoring center in the Department of Pharmacology by the health-care professionals. Suspected CADR was diagnosed by the consultants concerned. The CADRs collected were categorized according to their morphology into maculopapupar rash (MPR), fixed drug eruptions (FDE), urticaria, Stevens-Johnson syndrome, and toxic epidermal necrolysis. The causality assessment was done using WHO Causality assessment scale. Results: The mean age was 47.20 + 22.31. The most common CADR reported was Urticaria 65.5% followed MPR 23%, FDE 8.8%, and Steven Johnsons Syndrome 2.2%. Anti-microbial drugs were the most frequent cause of the adverse reactions with Amoxicillin clavulinic acid combination being the most frequent suspected drug producing CADR (13.3%). The WHO causality assessment for majority of CADR was Possible (73.5%). Conclusion: Clinical Patterns of CADRs in this set up have some minor variations when compared to studies done across India. Amoxicillin clavulinic acid is the most common suspected drug in this study which was not frequently reported in other ADR monitoring centers.

A study of deterioration of pulmonary function parameters among smokers and recovery among ex-smokers in bus depot workers.

Smoking has deleterious effects on Pulmonary Function Test (PFT) parameters; however, evidences about recovery in ex-smokers are ambiguous. Therefore present study was conducted to quantify relative deterioration of PFT parameters and to assess reversibility of the same. A cross-sectional study was conducted on 84 bus-depot workers consisting of equal number of smokers, ex-smokers and non-smokers. PFT observations were obtained using Medspiror following standard methods and precautions. Comparisons among three groups were performed employing one-way ANOVA and post-hoc tests. There were substantial effects of smoking on PFT parameters (deterioration was up-to half). Partial recovery was found in all the parameters of ex-smokers. Frequency and duration of smoking were negatively correlated with some of the parameters. In conclusion, present study has demonstrated considerable deterioration of PFT parameters in smokers and indications of recovery in ex-smokers. Further detailed study with larger sample size and stricter definition of ex-smokers is recommended.

An evaluation of the mechanical properties of Type III and Type IV gypsum mixed with two disinfectant solutions.

Background and Objectives: This in-vitro study was conducted to evaluate the strength and properties of Type III and Type IV gypsum mixed with disinfectant solutions. Materials and Methods: Type III and Type IV gypsum were used for the study. Three different mixing solutions namely waterqueous solutions of 0.525% sodium hypochlorite and 2% glutaraldehyde were used. Gypsum materials were subjected to further modification by adding a mixture of 1.0% gum arabic and 0.132% calcium hydroxide before mixing with the disinfectant solutions, at two different liquid/powder (L/P) ratios for each. Both, the unmodified and the modified gypsum were tested for compressive and tensile strength after one hour and one week from the start of the mix. The crystalline configuration of the fracture fragments of the unmodified and modified set gypsum were studied under the scanning electron microscope. Results: The disinfectant solutions reduced the strength of both Type III and Type IV gypsum. Water showed higher-strength, which was followed by 0.525% sodium hypochlorite and 2% glutaraldehyde. The modified Type III and Type IV gypsum with reduced L/P ratio also showed strength values less than that of the control groups. Interpretation and Conclusion: Chemical disinfectants reduced the strength of gypsum when used as water substitutes. Gum Arabic and calcium hydroxide additives permitted lower L/P ratio, however, there was still excess water retained in the set gypsum that lowered the strength values of Type III and Type IV gypsum. Hence, further reduction of L/P ratio may increase the properties of the modified Type III and Type IV gypsum.

Evaluation of salivary nitric oxide levels in oral mucosal diseases: A controlled clinical trial.

Lichen planus is a common dermatologic disease to manifest in the oral cavity. Recurrent aphthous ulcers are the most common ulcers of the oral cavity causing discomfort to the patients. These two diseases have different clinical manifestations which require appropriate treatment after correct diagnosis. Though numerous etiological factors have been proposed for these diseases, their true etio-pathogenesis is not yet established and therefore all therapies are palliative and none is effective universally. In light of this, the role of nitric oxide as a mediator in the etio-pathogenesis of these diseases was considered. The present study was undertaken to note the salivary nitric oxide levels as measured through its product nitrite in oral mucosal diseases like lichen planus and recurrent aphthous ulcers and also to ascertain whether salivary nitric oxide level has a role to play as a pathophysiological mediator in these diseases

Prevalence of dental caries among school children in Kulasekharam village: A correlated prevalence survey.

The prevalence of the most common dental disease, dental caries has been a subject of intense debate due to its importance in statistical measurement and for the clinical control of this disease. Kulasekharam, a small village, situated in Kanyakumari District has a large number of hospitals and a dental college; yet the people seem to have a very poor knowledge about dental health. This prompted us to do a study among school children in the age group of 6-12 years to assess the prevalence of dental caries and to increase their awareness toward oral health. This paper further strives to find any correlation between patient awareness and prevalence of dental decay. The dental caries prevalence was noted to be low compared to the WHO-recommended values. The fluoride level was also tested and was found to be far below the optimal level.

Intraoral actinomycotic lesion: a case report.

Actinomycosis often referred to, as the chameleon of the head and neck pathology is a rare disease, uncommon in children. This article refers to a case of intraoral actinomycotic lesion of the palate in a child following a rare aetiology, the relevant literature, clinical course and its successful resolution.