A Study Of Fixed Drug Eruption: Single Center Analysis From Central India

Background: Fixed drug eruption is a common cutaneous adverse drug reaction which is characterised by sharply demarcated skin lesions with recurrences at the same site with each subsequent exposure to the culprit drug. The causative drugs for fixed drug eruption (FDE) in any population changes depend on many factors. The knowledge of peculiar clinical features of FDE helps the treating physician to recognise at early stage and avoidance of mismanagement of such cases. Material and method:In this context, we did a descriptive-analytical study of patients who were diagnosed with FDE in single center between Feb 2013 to Sep 2017 from central India. Results: Ninety seven patients who developed FDE were studied in the study with 65% males and 35% females. Mean age at presentation in males and females were 34.95±16.90 and 37.12±12.98 years, respectively. Multiple lesions were present in 80.4% of patients. Seventy four percent of patients gave the history of prior episodes. In 68% patients, symptoms started and lesions developed within <24 hours of the drug exposure. Mucosal lesions were seen in 46.4% and skin lesions (non-mucosal) were seen in 36.1% and in rest 17.5% patients both mucosal and skin lesions were present. Antibiotics and NSAIDS were the most common group of medications to cause FDE. Thirty two percent of patients were caused by Fixed Dose Combinations of antibiotics and anti-protozoals. Conclusion: In conclusion, FDE is a common acute cutaneous drug eruption that if not diagnosed timely leads not only to recurrences but also causes apprehension and morbidity.

Are NSAIDS Really Responsible For Increasing Incidence Of Duodenal Perforation – Our Experience

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly prescribed drugs for pain and inflammation all over the world by medical practitioners. Long-term overuse of these drugs leads to severe gastrointestinal complications such as peptic ulcers and erosions. Aim of study is to evaluate the incidence of NSAIDS related peptic ulcer perforation in our region and to know the role of NSAIDS in the causation of duodenal perforation. Methods: This was retrospective study conducted in the Department of General Surgery Rohilkhand Medical College and Hospital on 51 patients of duodenal perforations to know its causation with NSAIDS. The results obtained were compiled in a tabulated form. Mean ± Standard Deviation (SD) were analyzed using with Statistical Package for Social Sciences (SPSS 23.0). The level P < 0.05 was considered as the cutoff value for significance. Results: The Mean age of all patients was 43.86±11.05 years. In majority of 28 (54.90%) patients NSAIDS was responsible either alone or concomitantly associated with excessive smoking and alcohol in 20(71.42%) patients and NSAIDS alone in 8(28.57%) patients. Conclusion: Excessive high dose intake of these drugs and intake of the combination of two NSAIDS instead of single NSAIDS therapy has resulted in increased chances of peptic ulcer perforation. So indiscriminate use of NSAIDS should be avoided.

Flurbiprofen toxicity in 2 dogs / 대한수의학회지

Two dogs were presented with melena, vomiting and depression after accidental swallowing of candy form of Strepsils (flurbiprofen), which is one of non-steroidal anti-inflammatory drugs used in human medicine for controlling a sore throat. These dogs had common signs of anemia induced by gastrointestinal ulceration and hemorrhage with azotemia and leukocytosis. The dogs were treated with blood transfusion, fluid therapy, proton-pump inhibitor, antiemetics, mucus protectant and antibiotic. Although most of clinical signs of two dogs were resolved, azotemic problem with evidence of renal injury have remained.

Gastritis necrotizante: caso clínico / Necrotizing gastritis: case report

Necrotizing gastritis is an infrequent severe pathology. The rich vascular supply and intramural arterial anastomosis protects stomach from vascular disease and embolism. Gastric infarction and necrosis presents as an acute abdominal emergency that requires rapid resolution, which in general includes surgery. Other important etiologies reported are chemical agents, mechanical distention, postoperative, bulimia and infectious diseases. In this article, we report a case of necrotizing gastritis in a 29 years-old male patient, with chronic consumption of NSAIDs for low back pain. He was admitted in the emergency room due to acute abdominal pain that appeared, after alcohol and raw fish consumption. Antral wall thickening was observed in the abdominal computed tomography. Upper gastric endoscopy showed necrosis of antral mucosa and biopsies confirmed necrotizing gastritis. He received medical therapy with antibiotics and proton pump inhibitors with an excellent response with clinical and endoscopic resolution in one month.

La gastritis necrotizante es una patología infrecuente muy grave. Esto se debe en parte a la rica irrigación y a las anastomosis arteriales intramurales que protegen al estómago de enfermedades vasculares y embolias. El infarto gástrico se presenta como una urgencia abdominal, que requiere resolución precoz, frecuentemente quirúrgica. Otras etiología importantes reportadas incluyen agentes químicos, factores mecánicos, bulimia e infecciones. En este artículo se presenta el caso de un paciente de 29 años, sexo masculino, con antecedentes de uso crónico de anti-inflamatorios no esteroidales (AINES), que ingresa a urgencia con dolor abdominal agudo, posterior al consumo de alcohol y pescado crudo. Destaca un engrosamiento antral marcado, sin neumatosis en la tomografía computada de abdomen. En la endoscopia digestiva alta se observa extensa necrosis de la mucosa antral y se confirma el diagnóstico de gastritis necrotizante por biopsias. El paciente tuvo una excelente respuesta a tratamiento con reposo intestinal, antibióticos e inhibidores de bomba de protones. Luego de 1 mes, presentó recuperación completa clínica y endoscopía.

Non-Ulcer dyspepsia relation with environmental factors - A study in Sub Himalayas, India.

Non ulcer dyspepsia is a common gastrointestinal problem, the etiopathogenesis of which is not well established. This study was planned to see the effect of environmental factors like smoking, tea, alcohol, and NSAIDs consumption with non-ulcer dyspepsia. This study was conducted in the department of Gastroenterology, Medicine and Radiology of I.G. Medical College, Shimla, India. Three hundred patients of non-ulcer dyspepsia were included in the study. Each case was matched with community control of same age and sex. A detailed history of smoking, tea, alcohol, and NSAIDs consumption was taken from the patients and controls. Consumption of tea as an environmental factor was found to be statistically significant in non-ulcer dyspepsia patients as compared to controls using multivariate regression. In the present study, environmental factors like smoking, alcohol, NSAIDs consumption did not show positive co-relation with non-ulcer dyspepsia.

Inhibitory and apoptosis-inducing effects of aspisol on proliferation of B16 melanoma / 中国药理学通报

Aim To study the inhibitory and apoptosis-inducing effects of aspisol on proliferation of B16 melanoma in vitro and in vivo. Methods The effect of aspisol on the proliferation of B16 cells was analyzed by MTT assay; its effect on cell apoptosis was measured by flow cytometry. The suspension of melanoma cells was injected subcutaneously into forelimb axillas of C57BL/6J mice to establish xenograft models. From the next day, the mice received intraperitoneal injection of aspisol in different concentrations once a day for 28 days; the mice received injection of dacarbazine (DTIC) were used as positive controls,and received injection of normal saline (NS) were used as negative controls. The inhibition rate of tumor growth was calculated .The apoptosis rate was detected by TUNEL assay. The expression of Survivin and C-erbB-2 was detected by immunohistochemistry. Results Aspisol inhibited the proliferation of B16 cells, with the inhibition rate up to (68.78?1.27)%, and induced the apoptosis with the highest apoptosis rate up to 15.8%.The inhibition rate of tumor growth was 15.0% in 200 mg?kg-1 aspisol group, 32.3% in 400 mg?kg-1 aspisol group, 49.4% in 800 mg?kg-1 aspisol group,and 51.4% in 40 mg?kg-1 DTIC group. Typical apoptotic morphologic changes were seen in the 4 groups. Survivin and C-erbB-2 expression was significantly lower in aspisol groups than in NS group. Conclusion Aspisol could inhibit proliferation and induce apoptosis of B16 melanoma cells in vitro and in vivo, which may be correlated to down-regulation of Survivin and C-erbB-2.