Anti-tubercular therapy (ATT) induced exfoliative dermatitis-A case series.

Tuberculosis is a serious contagious disease mainly affecting the lungs and is common in the developing countries. The essential component of all antitubercular regimens include Isoniazid, pyrazinamide as first-line drugs. A serious cutaneous adverse drug reaction namely exfoliative dermatitis (erythroderma) is associated with isoniazid use though uncommon but is common among pyrazinamide users. Here we report 3 cases of tuberculosis patients on antitubercular therapy (ATT) for 8 weeks, came to hospital OP (outpatient) with severe generalized redness and scaling with itching distributed all over the body and trunk. Immediately ATT was discontinued and all the three patients were administered antihistaminic and corticosteroid. The patients recovered within 3 weeks. To confirm ATT induced erythroderma and narrow down the offending agents, sequential rechallenge with ATT was done and again these patients had similar lesions erupt all over the body only with isoniazid and pyrazinamide. Antihistamine, steroids were started and the symptoms resolved and completely recovered within 3 weeks. Prompt withdrawal of the culprit drug along with appropriate medications and supportive measures is necessary for good prognosis. Physicians must be judicious while prescribing ATT especially, isoniazid and pyrazinamide as these can precipitate fatal cutaneous adverse reactions. Strict vigilance may help in early detection of this type ADR and timely management.

Monkeypox outbreak in the post-eradication era of smallpox.

Human monkeypox (MPOX) which recently hit the headlines is a rare, emerging zoonotic disease, only next to smallpox yet never attended adequately to halt the epidemic outbreak threat. MPOX is caused by Orthopox virus, which is a double-stranded, linear DNA virus, transmitted from infected animals, commonly rodents to humans. Monkeypox is endemic to the tropical jungles in Central-West Africa; occasional cases reported in other nations could be due to people traveling from endemic regions of MPOX. Transmission may occur via direct contact with human body secretions, cutaneous or mucosal lesions in the mouth or throat or respiratory droplets, and contaminated objects. Typical MPOX symptoms are fever, lymphadenopathy, skin rashes, intense headache, muscle, back pain, etc. Lesions can range from a few to numerous and may be filled with clear or yellowish fluid that later dries up or crusts, eventually falling off. MPOX is often considered as infrequent and self-limiting; nonetheless, the latest sporadic reports call for urgent vigilance, precautionary preparedness, and immediate response. Paucity of the data available about MPOX virus diversity and incomplete information on validated management protocols instigate a sense of impending danger and loom large as a global health emergency. MPOX is a completely preventable infection, and this article will cater to the need for creating general awareness and developing cutting-edge surveillance measures to curtail the spread of the disease. Genomic investigations of new cases of MPOX must be undertaken to check for mutations which can lead to higher human susceptibility. Local health stakeholders and clinicians should emphasize early identification and give out appropriate treatment as per the existing protocol.

Capecitabine and Hand-foot Syndrome: A Case Report.

Capecitabine, a prodrug of 5-fluorouracil, is an FDA-approved drug for adjuvant treatment of colon, metastatic colorectal, and breast cancer. A variety of mucocutaneous adverse effects has been recognized with capecitabine. The pathogenesis of such manifestations still remains an enigma though various theories have been proposed. Here, we report two such cases. A 59-year-old female with carcinoma of the sigmoid colon on palliative therapy developed localized cutaneous hyperpigmentation of the palms and soles secondary to capecitabine in her 2nd cycle. Another case was of a 42-year-old female with stomach adenocarcinoma, who developed similar adverse effects after administration of capecitabine in her 4th cycle. Since these drugs have been widely used in recent years due to their relative ease in administration, the relative unawareness of Hand-foot syndrome (HFS) caused due to this drug makes it a prudent topic to be reported.

A study of risk factors and complications in elderly hypertensive subjects.

BACKGROUND: Hypertension among the elderly is a major, highly prevalent yet treatable cardiovascular disease. AIMS & OBJECTIVES: Study aims to highlight the risk factors for hypertension in the elderly in an urban setup for the benefit of improving quality of life and also reduce the incidence of the cardiovascular related complications. METHODOLOGY: This is a Cross-sectional observational study. Included 125 study subjects based on selection criteria. The selected patients were subjected to a preformed and pretested schedule of questions pertaining to the risk factors. RESULTS: Among the known hypertensive patients above 60 years of age, 125 subjects were included in the study. Smoking (62%), alcohol consumption (21%), family history of hypertension (26%), family history of diabetes (70%) were statistically significant risk factors observed for the development of hypertension. CONCLUSION: Sedentary lifestyle (physically less active) and anthropometric measures like overweight and obesity, abnormal waist circumference, and abnormal waist hip ratio were all identified as remarkable risk for hypertension. Myocardial infarction (20%), stroke (14%), and heart failure (12%) were the chart buster complications of hypertension in the vulnerable geriatric population.

The combined effect of Trigonella foenum seeds and Coriandrum sativum leaf extracts in alloxan-induced diabetes mellitus wistar albino rats.

Diabetes mellitus is a group of heterogeneous disorders commonly presenting with episodes of hyperglycemia and glucose intolerance, as a result of lack of insulin, ineffective insulin action, and/or both. It is our interest to study the effect of ethanolic extract of Trigonella foenum seeds (fenugreek) and Coriandrum sativum leaves (dhaniya) or its combination in alloxan induced diabetes mellitus wistar albino rats. Rats were randomly separated into six groups where group 1 animals received 2% acacia, group 2 animals received alloxan dose of 150 mg/kg, group 3 animals received glibenclamide dose of 0.5 mg/kg and group 4, 5 and 6 animals received ethanolic extracts of Trigonella foenum seeds, Coriandrum sativum leaves and combination of both extracts at the dose of 100mg/kg for 21 days. Different biochemical parameters such as hepatic and renal biomarkers and histopathology of pancreas were studied. Combination of both extracts showed significant decrease in blood glucose, cholesterol, triglycerides, LDL, VLDL levels, SGOT, SGPT, urea, creatinine and increase in HDL levels and body weight than individual extracts. Thus, we show the antidiabetic activity of poly herbal formulation using biochemical and histo pathological data.