Drug-induced Stevens-Johnson syndrome: A case series

Stevens-Johnson syndrome (SJS) can be defined as a rare, serious disorder of the skin and mucous membrane characterized by widespread vesiculobullous rash with epidermal sloughing and necrosis involving mainly eyes, oral cavity, and skin. SJS can be diagnosed if there is <10% of the skin involvement. SJS occurs as an idiosyncratic reaction to various medications. Among them, the most common are antimicrobial agents (AMAs), antiepileptics, and non-steroidal anti-inflammatory drugs (NSAIDs). SJS is one of the dermatological emergencies for which initial treatment can only be supportive like fluids and nasogastric or parenteral feeding and symptomatic measures like analgesic mouth rinse for mouth ulcer. Beyond this, no treatment for SJS is approved. Cases of drug-induced SJS as diagnosed by Skin and VD department were included in the study. Interpretations were drawn out from that data and causality assessment was done according to the WHO-UMC causality assessment. Total four cases of drug-induced SJS were available. two cases of male patients and two of female patients. Out of them, three cases were by NSAIDs induced and one case was anti-epileptic (phenytoin) induced. In the present study, it was found that three of the cases of drug-induced SJS were caused NSAIDs and one case by anti-epileptic. According to the WHO-UMC Causality assessment, three cases were probable and one was unclassified.

Translation and Validation of Marathi Version of Oral Health Impact Profile?14, a Measure of Oral Health?Related Quality of Life

Background: A quality of life (QoL) assessment tool needs to be translated and validated in the language of the participants to whom it is administered. Therefore, the oral health impact profile-14 (OHIP-14) scale, developed originally in English, has been translated into different languages like Hindi, Gujrati, etc. The Marathi version of OHIP-14 will be useful to assess in regions where the Marathi language is prominently spoken. Thus, the present study was carried out to translate and validate the Marathi version of the OHIP-14 instrument to measure the oral health-related quality of life. Aims & Objectives: To translate and validate the English Version of the OHIP-14 instrument in the Marathi Language. Materials and Methods: This was a descriptive cross-sectional study in which 128 participants were selected through a convenient sampling method. The English version of the OHIP-14 was translated using the forward-backward translation technique, and participants were given English and the Marathi versions of the OHIP-14 questionnaire. The filled questionnaires were subjected to statistical analysis. Result: The difference in mean scores was not statistically significant(p=0.828). Pearson’s correlation coefficient test was 0.999, suggesting that the translated Marathi version is highly correlated with the original English version. Conclusion: The Marathi version of OHIP-14 is a valid, and reliable instrument for assessing QoL among the population who speak Marathi.

Renal involvement in multiple myeloma.

The present study is a retrospective chart analysis of 33 patients who satisfied the diagnostic criteria of multiple myeloma. Sixteen (49.5%) of these 33 patients developed renal failure at some point in time. The mean age +/- 1SD of patients who developed renal failure was 59.2 +/- 13 years (range 34-85 years). There were 12 males and 4 females. The precipitating factors for renal failure were dehydration (12.5%), hypercalcemia (62.5%) and use of non-steroidal antiinflammatory drugs (6.2%). Hypercalcemia was observed in 10 of the 16 patients who developed renal failure while it was seen in only 4 of the 17 cases who did not develop renal failure (relative risk 5.4). In 11 (68.7%) patients, the renal function improved with hydration, treatment of hypercalcemia and chemotherapy. The 1 and 3 year actuarial survival of patients with renal failure and multiple myeloma was 87% and 74% respectively.

Elevated polymorphonuclear phagocytic function in thalassemia patients by chemiluminescence.

Twenty five patients with beta thalassemia major, with no evidence of infection were evaluated for their polymorphonuclear cell (PMN) metabolic function and serum opsonic activity by chemiluminescence assay. These were divided into Group I of normal adults (n = 21), Group II thalassemia major < 5 years (n = 9) and Group III thalassemia major > 5 years (n = 16). The ability of the chemiluminescence assay (CL) to reflect opsonic and phagocytic dysfunction suggested its potential application in the evaluation of phagocytic function. The peak count of Group I was (1.07 +/- 0.24 x 10(-5)), Group II (1.60 +/- 0.83 x 10(-5)) and Group III was (2.71 +/- 0.98 x 10(-5)) respectively in the presence of autologous sera. The peak count compared between Group I and III was found to be statistically significant (p < 0.05). The peak count of Group I and II when compared showed a trend in the increase activity not statistically significant. The polymorph function of all the groups were compared with autologous serum as well as normal serum. There was no increase in polymorph function of Group III in the presence of thalassemia serum, nor any decrease in the polymorph function of thalassemia patients of Group II and III. This concluded that polymorphs of thalassemia patients are active in the presence of autologous as well as normal serum. The increased activity of thalassemia polymorphs may be due to antigenic stimulation which may be due to multiple transfusion and not due to circulating iron load.