A study of cutaneous adverse drug reactions in the outpatient department of Dermatology at a tertiary care center in Gujarat, India

Background: The data for adverse cutaneous drug reactions (ACDRs) is limited in Gujarat. The ACDRs are one of the frequent ADRs and cause of significant morbidity and mortality in patients of all areas of healthcare today. They are responsible for significant number of hospital admissions. Thus, the present study emphasises on the need and importance of an effective pharmacovigilance programme.Methods: A prospective study was undertaken in a 183 cases tertiary care teaching hospital of India. Male to female ratio, most common class of drug, individual drug causing ACDR, common types of ACDRs Parameters were studied. Other Parameters like Causality, preventability and severe or non-severe reactions were analyzed.Results: Majority of the patients (48%) with CADR belonged to the age group 25-44 followed by 45-64 (28%). Most frequent adverse cutaneous drug reactions reported were Urticaria (40%), Maculopapular rash (25%) & Fixed drug eruptions (21%) in decreasing order of frequency. Majority of reactions (96%) were Bizarre/Unpredictable in nature. As a group, antimicrobials (46%) were most frequently associated with CADR followed by NSAIDs (31%) and antiepileptics (11%). Most of the reactions (93%) were mild-moderate and probable (77%) in nature. Approximately 60% of ACDRs reported in this study were preventable.Conclusions: There was slight male preponderance except acneiform eruptions. Cotrimoxazole being the most common offending drug then after Ibuprofen, Phenytoin among the anti-inflammatory, analgesics, antiepileptics class. Causality assessment resulted in high score 77% of probable category.

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Clinical pattern and causative agents of adverse cutaneous drug reactions in a tertiary care hospital SKIMS Soura Srinagar.

JMS SKIMS ◽

10.33883/jms.v20i2.21 ◽

2017 ◽

Vol 20 (2) ◽

pp. 73-76 ◽

Cited By ~ 1

Author(s):

Surjeet Singh ◽

Zahoor A Wafai ◽

Ajaz Koul

Keyword(s):

Adverse Drug Reactions ◽

Tertiary Care ◽

Maculopapular Rash ◽

Care Hospital ◽

Drug Reactions ◽

Drug Eruptions ◽

Fixed Drug ◽

Pharmacovigilance Center ◽

Causative Agents ◽

Cutaneous Drug Reactions

Background: Adverse drug reactions are the most frequent side effects of drugs. Most of them being benign but can prove fatal sometimes. Aim: To study the different clinical spectrum of cutaneous adverse drug reactions and to determine causative drugs. Methods: It was a prospective hospital based study carried out for a period of 3 years. It was part of continuous adverse drug reaction monitoring carried out by our pharmacovigilance center at SKIMS. Results: Out of 1225 total adverse drug reactions 685 were enrolled as cutaneous ADR’s. Most common types observed were maculopapular rash (43.9%), fixed drug eruptions (36.2%) and urticaria (15.1%). The drugs most incriminated for various cutaneous ADR’s were antimicrobials (48.7%), anticonvulsants (22%), and NSAIDS (17.9%). Antimicrobials were also responsible for maximum of (58.3%) of severe cutaneous ADR’s like TEN and SJS. Conclusion: Pattern of cutaneous ADR’s and their causative drugs are similar to those observed in other regions with small variations, as reported by similar studies. However, due to emergence of newer drugs and differing trends in use of drugs, both pattern of cutaneous ADR’s as well as drugs causing them are changing every year. Further studies of similar nature with more expertise are required for safe use of drugs in future. JMS 2017;20(2):73-76

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A study of adverse cutaneous drug reactions in the department of dermatology of a teaching hospital in Jamnagar, India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20173756 ◽

2017 ◽

Vol 6 (9) ◽

pp. 2259

Author(s):

Jagruti G. Dhanani ◽

Anupama Sukhlecha

Keyword(s):

Adverse Drug Reactions ◽

Teaching Hospital ◽

Hospital Admissions ◽

Causality Assessment ◽

Adverse Drug Reaction Reporting ◽

Drug Reactions ◽

Dermatology Department ◽

Female Ratio ◽

Drug Eruptions ◽

Cutaneous Drug Reactions

Background: Adverse drug reactions cause significant morbidity and mortality in health care set up. They are responsible for a significant number of hospital admissions. The data for adverse cutaneous drug reactions (ACDRs) is limited our country. Thus, the present study emphasises on the need of an effective adverse drug reaction reporting programme.Methods: A prospective study to assess the ACDRs in Dermatology department was conducted in a teaching hospital of India. Male to female ratio, most common class of drug, individual drugs causing ACDRs, common types of ACDRs were studied. Other parameters like causality assessment, preventability and seriousness of ACDRs were also studied.Results: A majority of the patients (38%) with ACDR were in the age group of 25-44 years followed by 45-64 years (31%). The rate of ACDRs was more in males (54%). The most frequent ACDR reported was maculopapular rash (38%), followed by urticaria (19%) and fixed drug eruptions (12%). Most of the reactions (93%) were bizarre/ unpredictable in nature. Amongst drug groups, antimicrobials (48%) were most frequently associated with ACDRs followed by NSAIDs (30%) and antiepileptics (12%). Most of the reactions (94%) were mild-moderate in nature. Only 9% of ACDRs reported in this study were preventable. Paracetamol was the most common offending drug followed by cotrimoxazole, ibuprofen, amoxicillin, phenytoin in decreasing order. Causality assessment found ACDRs in probable category (68%) using WHO-UMC criteria.Conclusions: It is important to monitor and report adverse drug reactions in order to promote safe and rational use of medicines.

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A study of adverse cutaneous drug reactions (ACDR) owing to antiepileptics at a rural-based tertiary-care center, Gujarat

National Journal of Physiology Pharmacy and Pharmacology ◽

10.5455/njppp.2016.6.0511201597 ◽

2016 ◽

Vol 6 (2) ◽

pp. 140

Author(s):

Rita Vora ◽

Nilofar Diwan ◽

Nidhi Jivani ◽

Rochit Singhal

Keyword(s):

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Drug Reactions ◽

Cutaneous Drug Reactions

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Retrospective analysis of hospital admissions due to cutaneous Adverse Drug Reactions in a tertiary care center

Journal of Pharmacovigilance ◽

10.4172/2329-6887.s1.014 ◽

2014 ◽

Vol 02 (05) ◽

Author(s):

C Vasanthi

Keyword(s):

Retrospective Analysis ◽

Adverse Drug Reactions ◽

Hospital Admissions ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Drug Reactions

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PATHOLOGICAL STUDY OF BODY FLUIDS IN A TERTIARY CARE CENTER IN SOUTH INDIA.

10.36106/ijsr/5701996 ◽

2021 ◽

pp. 60-61

Author(s):

Earla Lakshmi Bai ◽

Buddaiahgari Swathi ◽

Siva Chaithanya Bangi

Keyword(s):

Cell Count ◽

Care Center ◽

Tertiary Care ◽

Clinical Pathology ◽

Major Type ◽

Pathology Laboratory ◽

Female Ratio ◽

Atypical Cells ◽

A Prospective Study ◽

Male To Female

Body cavities uid analysis is done routinely in both clinical pathology and cytology departments of Pathological laboratory. Any imbalance between uid 1. formation and removal leads to effusion, as stated by Starling's law The peritoneal, pleural, cerebrospinal and pericardial uids comprise the major chunk of 2 body uids . Accumulation of uid in various body cavities can occur in vast range of benign conditions and it also a frequent clinical presentation and complication of malignant disorder. METHODS: A prospective study was conducted in the Department of Pathology, Osmania general hospital Hyderabad, Telangana, India, during January 2020 to December 2020 and analyzed 880 uid samples collected from patients for cell count and cytology. The data collected was tabulated using Microsoft excel and analyzed using standard statistical tools. RESULTS -Of total 880 uids analyzed peritoneal uid (42%) constitutes the major type of uid sent frequently for analysis followed by cerebrospinal uid (41%) with male to female ratio of 1.9:1. 62.7% of uids had clear gross appearance . Of total 880 uid samples analyzed 649 samples (73.7%) had shown lymphocyte predominance. Of total 880 uids samples analyzed 9 samples (1%) were found positive for atypical cells, conrmed on cytology suggesting there malignant origin. CONCLUSION: uid aspiration from body cavities constitutes one of the common day care procedures for clinicians. Effusion uid analysis is key in delineating the background cause in the patient ranging from reactive, inammatory and malignant conditions. Fluid cell count coupled by cytological analysis of uids in pathology laboratory is a time tested tool having good sensitivity and specicity when interpreted along with biochemical parameters.

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Prevalence and pattern of adverse cutaneous drug reactions presenting to a tertiary care hospital

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20164248 ◽

2017 ◽

Vol 3 (1) ◽

pp. 74

Author(s):

B. Janardhan ◽

D. Shailendra

Keyword(s):

Drug Reaction ◽

Adverse Drug Reactions ◽

Tertiary Care ◽

Clinical Manifestations ◽

Care Hospital ◽

Drug Reactions ◽

Medical Sciences ◽

Female Ratio ◽

The Mean ◽

Cutaneous Drug Reactions

Background: An adverse cutaneous drug reaction (ACDR) is defined as an undesirable clinical manifestation resulting from administration of a particular drug. With an ever increasing number of drugs and varied formulations being continuously made available it is important that a close watch on the risks of adverse drug reactions is looked for, to ensure safe use of medicines in the interest of the patient. In the present study our aim is to study the prevalence & pattern of cutaneous adverse drug reactions reported to department of dermatology at MediCiti Institute of Medical Sciences, Hyderabad, India.Methods: All suspected cutaneous adverse drug reactions reported to the department of dermatology at MediCiti Institute of Medical Sciences during the two year period from January 2013 to December 2014 were included in this study. A thorough clinical examination of all these cases & details related to the drug use and clinical manifestations of the cutaneous adverse drug reaction were documented using a structured proforma. Naranjo scale was used to assess causality in all the causes of cutaneous adverse drug reactions.Results: The mean age of the patients was 42 years (age range: 1-64 years). Most of them were in the age group of 30-39 years. The male to female ratio was 1.78:1. The most common type of skin eruptions observed were maculopapular rash (35.55%), urticaria (26.19%) and fixed drug eruption (17.87%). The mean duration between drug intake and appearance of rash was 4 days (range: 1-120 days). Conclusions: The pattern of ACDRs and the drugs causing them in this study were similar to that reported in other studies both in terms of disease burden and clinical pattern. Knowledge of adverse cutaneous drug reactions will help to identify common medications contributing to dermatological reactions, so as to anticipate, prevent and limit their undue consequences.

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Adverse cutaneous drug reactions reporting in a tertiary care teaching hospital in Eastern India: a retrospective study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20203623 ◽

2020 ◽

Vol 9 (9) ◽

pp. 1381

Author(s):

Manika Bose ◽

Debasish Misra ◽

Sansita Parida ◽

Smita Das ◽

Swati Mishra ◽

...

Keyword(s):

Tertiary Care ◽

Drug Reactions ◽

Morphological Pattern ◽

Common Drug ◽

Drug Eruptions ◽

Fixed Drug ◽

Cutaneous Reactions ◽

Cutaneous Drug Reactions ◽

Major Drug ◽

Cutaneous Drug Reaction

Background: Any unwanted changes to mucous membrane, skin, its appendages and drug eruptions related adverse events are known as adverse cutaneous drug reaction (ACDR). It has 2-5% incidence in developing countries. The current study was undertaken to analyse adverse cutaneous drug reactions spectrum clinically, drugs responsible, assessment of causality, severity, and preventability in our setup.Methods: Current study was an observational, retrospective, non-interventional analysis of voluntarily reported ADRs forms, between April 2018 and January 2020. All cutaneous ADRs reported within this period were identified. Data obtained were expressed in numbers, percentages.Results: 130 cutaneous ADRs was reported during the period of study. Fixed drug eruptions (30%) was the most common cutaneous reaction. The most common causal drug groups were antimicrobials (58.5%). Amongst antimicrobials, ornidazole (8.5%) was the most common drug. The most common drug in NSAID group was paracetamol (14.6%). The major drug causing ACDRs in our study was Paracetamol (14.6%). Assessment of causality revealed 37.7% were probable and 62.3% were possible reactions. Assessment of severity showed 78.5% as mild and 21.5% as moderate. Assessment of preventability showed that 6.1% probably preventable and 93.9% not preventable.Conclusions: Knowledge of the pattern of cutaneous reactions and the causative drugs guides us in early diagnosis of the condition, better management and associated decrease in morbidity, mortality. In the current study, the most common causal drug group were antimicrobials. The most common morphological pattern and drug causing ACDRs were fixed drug eruptions and paracetamol, respectively.

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Clinical profile of rhinosporidiosis in a tertiary care center of an endemic area

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181382 ◽

2018 ◽

Vol 4 (3) ◽

pp. 659 ◽

Cited By ~ 2

Author(s):

Suneer R. ◽

Sivasankari L.

Keyword(s):

Tamil Nadu ◽

Endemic Area ◽

Histopathological Examination ◽

Care Center ◽

Tertiary Care ◽

Granulomatous Inflammation ◽

Clinical Profile ◽

Medical College ◽

Male Preponderance ◽

A Prospective Study

Background: Rhinosporidiosis is a chronic granulomatous inflammation caused by Rhinosporidium seeberi. It is water borne disease endemic in Kanyakumari district of South India. The objective of the study was to study the clinical profile of rhinosporidiosis in an endemic area of Kanyakumari districtMethods: This is a prospective study of 50 surgically treated cases of rhinosporidiosis carried out in the department of ENT, Kanyakumari Government Medical College from January 2016 to December 2017. All were diagnosed on clinical basis and were treated by excision and electrocautery of the base. The specimens were sent for histopathological examination. Results: The cases in this study were in the age group between 6 to 70 years. Of these 38 were males and 12 were females indicating a male preponderance. The main presenting symptom was epistaxis in about 80% cases. Nose is the common site involved. Extra nasal spread is common in recurrent cases.Conclusions: The study reflects the endemicity of this disease in Kanyakumari district of Tamil Nadu. High incidence is noted in those bathing in ponds. Extra nasal spread is common in recurrent cases and raising health awareness will go a long way in decreasing its incidence.

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Clinico etiological study of adverse cutaneous drug reactions

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20193243 ◽

2019 ◽

Vol 5 (3) ◽

pp. 559

Author(s):

Peram Karunakar ◽

Garimella Venkateswara Rao ◽

Kilaru Krishna Rajesh

Keyword(s):

Hospital Admissions ◽

Case Series ◽

Maculopapular Rash ◽

Drug Reactions ◽

Drug Induced ◽

Case Series Study ◽

Acneiform Eruption ◽

Etiological Study ◽

Cutaneous Drug Reactions ◽

Relationship Of

Background: Adverse cutaneous drug reactions (ACDR) are the most frequent ADRs (30-45%) and are responsible for about 2% of hospital admissions and few can result in significant morbidity, health care costs, hospitalization, and death. To study different clinical patterns of ACDR, assess the cause and identify the offending drug and to study the relationship of ACDRs to age and sex among patients referred to the department of DVL, NRI General Hospital.Methods: This is a retrospective study of 70 cases of colorectal carcinoma analysing incidence, clinicopathological features and outcome after different therapies including surgery, radiotherapy and chemotherapy. It was a descriptive hospital-based case series study. All out-patients and in-patients referred to the department of DVL, NRIGH, Chinakakani and in whom a diagnosis of ACDR is made, form the subjects for this study. The study was conducted over a period of two years.Results: 100 patients with adverse cutaneous drug reactions were included in the study. 42 (42%) were males and 58 (58%) were females. The age group ranged from 6 to 80 years with a maximum (43) belonging to 21 to 40 years. Maculopapular rash was most common followed by urticarial drug reaction, FDE, acneiform eruptions, EMF, erythroderma, DRESS, SJS, SJS/TEN, TEN and drug-induced hyperpigmentation. NSAIDs were the commonest culprits followed by antibiotics, antiepileptics and ATT.Conclusions: The commonest ACDR was maculopapular rash followed by urticaria, FDE and acneiform eruption. Antimicrobials as a group were the most common offending agents followed by individual drugs like diclofenac (13%), isoniazid (11%), efavirenz (9) and prednisolone (8%).

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The current trend of cutaneous drug reactions at a tertiary care hospital

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20191086 ◽

2019 ◽

Vol 5 (2) ◽

pp. 264

Author(s):

Naveen Nagaraju ◽

Puneetha .

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Current Trend ◽

Care Hospital ◽

Drug Reactions ◽

Drug Induced ◽

Morphological Pattern ◽

Cross Sectional ◽

Female Ratio ◽

Cutaneous Drug Reactions

Background: Cutaneous adverse drug reactions (CADR) are common yet important entity in dermatological clinical practice. This study is to investigate the clinical spectrum of CADR reactions and assess its causality relationship to offending drug.Methods: It was a cross-sectional observational study, conducted at a tertiary care hospital over a period of two years. Total of 200 patients with cutaneous drug rash diagnosed based on detailed history, correlation between drug intake and the onset of rash, thorough clinical examination and laboratory parameters were included and patients without details of drugs were excluded.Results: Among 200 cases, mean age was 33.57 years (6 months to 87 years). The commonest age group was 19-30 years (27%) and Male: female ratio was 0.94:1. The most common morphological pattern was maculopapular rash seen in 46 cases (23%), followed by FDE- 34 (17%), urticaria- 22 (11%), acneiform eruptions- 20 (10%), drug induced hyperpigmentation- 13 (6.5%), EMF- 12 (6%), lichenoid eruptions- 12 (6%), photosensitivity- 11 (5.5%), eczematous dermatitis- 6 (3%), pruritus- 6 (3%), angioedema- 6 (3%) and SJS- 6 (3%), DRESS- 2 (1%), TEN- 2 (1%), DHS and psoriasiform dermatitis in 1 each (0.5%) respectively. The most common drug was analgesics (31.2%), followed by anti-microbials (26.25%), corticosteroids (8.75%), antiepileptics (7.5%), anti-leprosy drugs (7.5%), anti-retroviral drugs (6.87%), antitubercular drugs (3.75%) and other drugs (8.12%).Conclusions: Many dermatological conditions can be induced, imitated or aggravated by drugs hence it is necessary for the health care system to promote periodic reporting to regional pharmacovigilance centres to ensure drug safety for clinician’s awareness.

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