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.

Development Of Bioanalytical Standardization Parameters Of Alocasia Indica Tuber By Hptlc Technique

Alocasia indica is perennial herb growing widely and used as traditional medicine in India, China and Bangladesh. The divine herb has potent medicinal values for the treatment of different type of illnesses. The HPTLC techniques were used to separate active components from ethanolic extract of tuber part of A. indica. This examination was intended to designed a HPTLC fingerprint profile of crude extract of the plant in ethanol. A HPTLC method for the isolation of various active constituents in A. indica ethanolic extract have been developed and solvent system for quercetin the mobile phase used was toluene: ethyl acetate: formic acid (5:2:1) and for analysis of β-sitosterol the mobile phase used was chloroform: ethyl acetate: formic acid (6:4:1) . In the present investigation, HPTLC fingerprint of extract of dried tuber part of A. indica have been performed and the results demonstrated that important information for standardization. The HPTLC system for routine quality control of present species can be used for ethanolic extract and serve in qualitative, quantitative and was appropriate for standardization of the plant.

Gastro-Protective Drug Utilization Study In Various Departments Of Tertiary Care Teaching Hospital

Introduction:Four out of ten prescriptions in indoor-patient departments contains gastro-protective drugs. Study aimed to detect classes of gastro protective drugs prescribed with other therapies, to assess trend of co-prescription of gastro-protective with NSAIDs, Anticipated drug interactions with the prescribed gastro-protective and most commonly prescribed gastro-protective group of drug.Materials and Methods: It is Prospective, Observational study, approximately 133 prescription analyzed. Written informed consent was taken from the eligible patients included in the study. Drugs data collected by reviewing the prescriptions prescribed. Gastro-protective duringstudy period. Rationality of drug use was assessed by referring to standard textbooks and guidelines.RESULTSOut of 200 prescriptions, 133 (66.5%) were found prescribing the gastro-protective drugs and more prescribed in the age group of 31-40 (39.84%). Gastro-protective drugs were co-prescribed with different classes of drugs of which NSAIDs (34.83%) were the most common. The Paracetamol (48.10%) were found to be the most commonly prescribedNSAIDs with gastro-protective drugs. The PPIs (66.66%) were found to be the most commonly prescribedgastro-protective. Drug interactions with co-prescribed drugs could be anticipated in 45 cases.Conclusion:The usage of gastro-protective is essential in drug therapy; however,over-use can increase adverse effects, drug interactions, and even wrong therapy.

Adverse Drug Reactions Monitoring In Pentavalent Vaccination Program At A Tertiary Care Teaching Hospital

ABSTRACT Introduction:Four out of ten prescriptions in indoor-patient departments contains gastro-protective drugs. Study aimed to detect classes of gastro protective drugs prescribed with other therapies, to assess trend of co-prescription of gastro-protective with NSAIDs, Anticipated drug interactions with the prescribed gastro-protective and most commonly prescribed gastro-protective group of drug.Materials and Methods: It is Prospective, Observational study, approximately 133 prescription analyzed. Written informed consent was taken from the eligible patients included in the study. Drugs data collected by reviewing the prescriptions prescribed. Gastro-protective during study period. Rationality of drug use was assessed by referring to standard textbooks and guidelines.RESULTSOut of 200 prescriptions, 133 (66.5%) were found prescribing the gastro-protective drugs and more prescribed in the age group of 31-40 (39.84%). Gastro-protective drugs were co-prescribed with different classes of drugs of which NSAIDs (34.83%) were the most common. The Paracetamol (48.10%) were found to be the most commonly prescribedNSAIDs with gastro-protective drugs. The PPIs (66.66%) were found to be the most commonly prescribedgastro-protective. Drug interactions with co-prescribed drugs could be anticipated in 45 cases. Conclusion:The usage of gastro-protective is essential in drug therapy; however,over-use can increase adverse effects, drug interactions, and even wrong therapy.

Clinical Profile of Multiorgan Involvement in Malaria.

Background and aims: In view of high incidence, increasing morbidity and mortality due to malaria in an endemic area like Bikaner, it was planned to study the clinical profile of multiorgan involvement in Plasmodium vivax, Plasmodium falciparum and mixed type of malaria. Material and methods: Prospective data were collected from 201 adult patients with multiorgan involvement, admitted in classified malaria ward and confirmed by asexual parasitemia in peripheral blood film. Results: Prevalence of renal failure was 57.7%, cerebral malaria 47.8%, jaundice 41.8%, severe anemia (hemoglobin [Hb] ≤5 g/dl) in 31.8%, severe thrombocytopenia, shock, septicemia in 19.9%, 12.4%, 8.96%, respectively. Out of this P. vivax was associated with renal failure in 10.4%, with cerebral malaria in 7.46%, with jaundice in 9.5% and with severe anemia in 3.5%. Multiorgan dysfunction was a major cause of death in 25.87% patients (18.4%, P. falciparum 6%, P. vivax 1.5%, mixed). Acute respiratory distress syndrome (ARDS) was found in 14 (7%) of patients out of which 13 expired. Conclusion: P. vivax which was previously considered to be benign, has now turned to be malignant. ARDS came out with the worst outcome. Early institution of dialysis and use of antimalarial drugs aggressively can result in better prognosis.

Autosomal recessive polycystic kidney disease (ARPKD)--a report of two cases.

Autosomal Recessive Polycystic Kidney (ARPKD) is a very rare entity (1 in 15,000 live births) and mostly not compatible with life. Early diagnosis and genetic councelling may help prevent such births. Two interested cases are presented.

Congenital plexiform neurofibroma with a sarcomatous nodule in a three month old child.

Congenital plexiform neurofibroma is regarded as pathognomonic of neurofibromatosis (NF) especially when it is large and involves a major nerve trunk with changes of elephantiasis neuromatosa. Only very rarely malignant changes have been reported in cases who have NF for less than 5 years. 'Borderline' lesions are seen especially in patients with NF. In such cases criteria of mitotic activity should be utilized in establishing the diagnosis of malignancy. A case of 3 month child with congenital plexiform neurofibroma involving neck with elephantiasis neuromatosa with sarcomatous nodule has been described in the present article. The criteria for malignancy in nerve sheath tumors have also been discussed.