scholarly journals Improper Use of Topical Corticosteroids in Tinea Infections in a Tertiary Care Hospital

2021 ◽  
Vol 19 (1) ◽  
pp. 71-75
Author(s):  
Sushil Paudel ◽  
Niraj Parajuli ◽  
Sudip Chandra Dahal ◽  
Sudarshan Paudel
Keyword(s):  
Tertiary Care ◽  
Topical Steroids ◽  
Care Hospital ◽  
Over The Counter ◽  
Dermatology Department ◽  
Topical Corticosteroids ◽  
Regulatory Guidelines ◽  
Improper Use ◽  
Tinea Incognito ◽  
Topical Medications

Background: Steroid-modified tinea, also known as tinea incognito, is an infection by the dermatophytes, where the clinical morphology is modified due to corticosteroids, either systemic or topical. Rampant use of topical corticosteroids has led to increasing recurrence in tinea infections. Methods: All consenting cases of tinea presenting to outpatient department of dermatology department of Civil Service Hospital from March to August 2020 for a total of 6 months were included in this study. Tinea infection involving only the palms, soles, nails or scalp were excluded.Results: A total of 200 patients were included in this study. Among these, 175 patients (87.5%) were using topical corticosteroids. A significant association was noted between dermatophyte infection of more than one month and topical corticosteroids use (p<0.05). This study revealed that males were using super-potent topical corticosteroids more as compared to females (p<0.05). Moreover, no association was noted between the level of education attained and the use of topical corticosteroids (p=0.91). Only 25 (12%) patients were either using correct or no topical medications during the time of consultation with the dermatologist. Among the patients using topical corticosteroids, 155 (88.6%) patients were using them on recommendation of the local pharmacist and only 2 (1.2%) patients were prescribed by a physician. Conclusions: In short, use of topical steroids was rampant among patients with tinea whilst 77.5% patients procured steroid topicals over-the-counter. Hence, a tougher law and strict regulatory guidelines deemed necessary to curb the unauthorized and rampant sale of these medicines.Keywords: Dermatophytes; over-the-counter; steroid misuse; self-medications; tinea; topical corticosteroid

scholarly journals Topical steroid abuse on face: a prospective study from a tertiary care centre of north India

2017 ◽  
Vol 3 (3) ◽  
pp. 433
Author(s):  
Asha Nyati ◽  
Anil Kumar Singhal ◽  
Devendra Yadav ◽  
Manoj Kumar Sharma
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Topical Steroid ◽  
North India ◽  
Topical Steroids ◽  
Tertiary Care Centre ◽  
Dermatology Department ◽  
Steroid Abuse ◽  
Topical Corticosteroids

<p class="abstract"><strong>Background:</strong> Topical corticosteroids (TCS) are widely misused on face which is associated with significant adverse effects and poor awareness of these effects. The aim of this study was to assess the frequency of misuse of topical corticosteroids, the causes behind it and the most common adverse events resulting from it and to make aware the people about it</p><p class="abstract"><strong>Methods:</strong> This study was conducted at Dermatology Department of Govt. Medical College, Kota during period of one year from July 2015 to June 2016. A total of 670 patients using topical steroids over face were enrolled in the study. Details about the usage of topical corticosteroids and their side effects were recorded.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of the patients were females (72.68%). The most common reason for misuse was melasma (57. 91%) followed by use as a fairness cream (22.38%). Most of the patient used topical steroid cream for duration of 3-6 months (33.13%). Most common age group was 21-30 years (48.20%). Acne form eruption (38.05%) and rebound erythema (28.20%) were the most common adverse effects noted. Patients were ignorant of the ingredients and their side effects.</p><p class="Default"><strong>Conclusions:</strong> Steroids have been misused by patients on their own or by pharmacist and non-dermatologist physicians for various reasons. Topical steroid should not be used on the face unless it is under strict dermatological supervision. </p>

scholarly journals A study on the clinical profile of dermatoses induced by topical corticosteroids

2021 ◽  
Vol 7 (2) ◽  
pp. 177
Author(s):  
Vontela Rohit ◽  
S. Rajesh Reddy ◽  
Narendar Gajula ◽  
Karing Deepthi
Keyword(s):  
Side Effects ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Topical Steroid ◽  
Age Group ◽  
Over The Counter ◽  
Study Region ◽  
Topical Corticosteroids ◽  
Wide Range ◽  
Tinea Incognito

<p class="abstract"><strong>Background:</strong> Topical corticosteroids (TC), commonly used for a wide range of skin disorders, are associated with many side effects with their overuse, abuse and over-the-counter use as a cosmetic. This article aims to study clinical presentation of various dermatoses induced by abuse of TC in order to bring awareness among patients and practitioners to use topical corticosteroids with utmost caution.</p><p class="abstract"><strong>Methods:</strong> This study was conducted at DVL department of a tertiary care teaching hospital over 23 consecutive months. A total of 200 consecutive patients of all ages and both genders with topical steroid induced dermatoses were included in the study. A detailed clinical evaluation was undertaken, data was then recorded and analysed.</p><p class="abstract"><strong>Results:</strong> Majority of the patients were females (56%). Most common age group was 20-29 years (42%). Majority used TC as a remedy for dermatophytosis (38%), followed by use as a fairness/cosmetic cream (20%). Most of patients (29.5%) used TC for 6 months duration. Most commonly used TC formulation was 0.05% clobetasol propionate (37.5%). Majority patients (62%) did not have a valid prescription of which 47% used TC on Quacks’s advice. The most common side effects encountered were tinea incognito (33%), steroid-induced acne (20.5%), hyperpigmentation (14.5%), and hypopigmentation in 22 (11%).</p><p class="abstract"><strong>Conclusions:</strong> Present study highlights irrational prescription of TC by non-dermatologists for dermatophytosis which are very common in this particular study region and emphasizes the need to educate patients about serious adverse effects of TC abuse.</p>

scholarly journals Use of over-the-counter topical medications in dermatophytosis: A cross-sectional, single-center, pilot study from a tertiary care hospital

2018 ◽  
Vol 4 (1) ◽  
pp. 13
Author(s):  
ManasaShettisara Janney ◽  
Rajeshwari Dabas ◽  
Radhakrishnan Subramaniyan ◽  
Sandeep Arora ◽  
VSandeep Lal ◽  
...  
Keyword(s):  
Pilot Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Single Center ◽  
Cross Sectional ◽  
Over The Counter ◽  
Topical Medications

scholarly journals Outcome and complications of self-administration of over-the-counter abortion pills: an observational study in a tertiary care hospital of a medical college in New Delhi

2021 ◽  
Vol 10 (8) ◽  
pp. 3148
Author(s):  
Anjali Singh ◽  
Sruthi Bhaskaran ◽  
Anshuja Singla
Keyword(s):  
Observational Study ◽  
Health Care Providers ◽  
Tertiary Care ◽  
New Delhi ◽  
Care Hospital ◽  
Care Providers ◽  
Self Administration ◽  
Over The Counter ◽  
Gynecology And Obstetrics ◽  
Medical Termination

Background: Due to unrestricted free availability of abortion pills, despite of national policies, guidelines and medical termination of pregnancy (MTP) act, unsafe abortions by self-administration of these drugs for termination of unwanted pregnancies without prescription are becoming common in our country, leading to associated morbidity and mortality.Methods: A prospective Observational study was done at Guru Teg Bahadur hospital, university college of medical sciences, New Delhi, from November 2019 to April 2020, in the department of gynecology and obstetrics, on women visiting the outpatient department and casualty department with the history of self-administration of medical termination pills without prescription. This study was done to study the outcome and complications occurring due to self-administration of over-the-counter abortion pills that are freely available in the market. 95 women were included in study and data was collected regarding age, education level, parity, presenting complaints, complications and their management. Descriptive analysis of the collected data was done.Results: In this study 95 women were included 71.6% took pills before 8 weeks of gestation, 1% took in second trimester. 46.3% landed up in incomplete abortion and 33.68% needed surgical evacuation, 8.42% had ectopic out, 2.1% had scar site pregnancy and 7.36% needed laparotomy, 1.05% had rupture uterus followed by abortion pill intake while 1.05% suffered from acute kidney injury (AKI). There was no ICU admission nor any mortality.Conclusions: There is urgent need of strict legislation to curtail this bad practice and free availability of over-the-counter abortion pills which leads to unexpected morbidity and mortality, such drugs should be given only by health care providers under supervision, there is need of community level awareness so as to impart knowledge regarding this problem. 

INCIDENCE OF CATARACT IN DERMATOLOGICAL PATIENTS USING STEROID CREAMS

2021 ◽  
pp. 65-66
Author(s):  
(Lt Col) Rajnish Kumar ◽  
(Lt Col) Vaka Raja Sekhar Reddy ◽  
(Lt Col) Sumit Kumar Singh ◽  
Debarshi jana
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Population Based ◽  
Topical Steroids ◽  
Study Group ◽  
Care Hospital ◽  
Ocular Side ◽  
Wide Range ◽  
The Face

Background/ Context: Corticosteroids, despite being a very effective line of treatment for various disorders is known to have a wide range of adverse effects. The use of systemic and topical steroids has been associated with cataract formation, however the ophthalmic side effects of application of steroid on skin away from the face has not been studied in depth. With increasing use of corticosteroids as rst line of therapy in treatment of various dermatological conditions, the ocular side effects, if any, of these preparations, cannot be overlooked. Aim: To study the incidence of cataract in patients using skin preparations of corticosteroids away from the face and also to correlate the dose and duration of steroid therapy to incidence of cataract. Materials & Methods: 50 patients with dermatological disorders who were being treated with dermatological steroids, on sites other than the face and periorbital region, for a period of more than six months consisted of the study group. The study group consisted of patients in the age group of 20 – 60 years. The study was conducted over a period of two years at a tertiary care hospital. Visual acuity, Slit lamp biomicroscopy, applanation tonometryand detailed fundus examination using 90D lens were carried out. Results: The incidence of cataract was signicantly higher in patients using dermatological steroids away from the face. Prolonged duration of use of these steroids also indicated a signicantly higher incidence of cataract. However, a larger population based study needs to be carried out to study the relationship between potency of steroid and incidence of cataract, although preliminary studies indicate a denite correlation between the two. Conclusions: Despite, steroids being used away from the face, there was a denite increase in the incidence of cataract. Before coming to any rm conclusions it would be advisable to reproduce the study in a larger population. However from the present pilot study it is prudent to advocate judicious use of innocuous looking steroid creams as they can cause signicant adverse effects

Clinico-epidemiological study and microbiological correlation of tinea incognito at a tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 212-216
Author(s):  
Monisha K ◽  
Jagannath Kumar V
Keyword(s):  
Tertiary Care ◽  
Fungal Culture ◽  
Care Hospital ◽  
Diagnostic Dilemma ◽  
Steroid Abuse ◽  
Systemic Corticosteroids ◽  
Study Population ◽  
Tinea Incognito ◽  
General Physical ◽  
Systemic Examination

Tinea incognito also known as steroid-modified tinea are dermatophytic infections modified by the use of topical or systemic corticosteroids. Dermatophytic infection being very common and very simple to diagnose, is a diagnostic dilemma due to steroid abuse. Hence making a simple curable infection into a chronic persistent dermatological condition. As a treating doctor it’s important to recognize and educate the patients regarding the tinea infections and steroid abuse. To study the various morphological presentations, epidemiology and etiological agent of tinea incognito. An observational study was performed with 100 cases from 2017 to 2019 in the department of Dermatology & Venerology, SS Institute of Medical Sciences and Research, Davangere, Karnataka, India. The baseline data, thorough general physical, local, and systemic examination were done with reference to clinical features of tinea incognito. Skin scraping were collected and subjected to potassium hydroxide (KOH) preparation. The part of the sample was inoculated into Sabouraud’s Dextrose Agar (SDA) media for fungal culture. Later the fungus was identified by standard techniques. The mean age of study population was 32.83 years. The males outnumbered females in our study. Almost 29% cases remain asymptomatic followed by 34% itching and 37% burning sensation. The source of drug responsible for tinea incognito were highly suggested by friends (29%) with the combination use of drugs account for 35% of study population. 77% cases showed erythema followed by 48% of hypopigmentation. The scraping of lesion showed positive KOH mount in 71% and T.mentagrophytes were the most common dermatophyte grown in SDA medium. Misuse of steroid formulations in dermatophytic infections may lead to adverse effect as well as chronicity. Awareness of this problem is needed for prevention of steroid modified dermatophytosis, which is a rising menace.

scholarly journals Knowledge, attitude, and practices about contraceptive in Western Rajasthan, India

2018 ◽  
Vol 7 (7) ◽  
pp. 2786
Author(s):  
Gayatri Aseri ◽  
Sudesh Agrawal
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sources Of Information ◽  
Cross Sectional ◽  
Over The Counter ◽  
Medical College ◽  
Study Population ◽  
Knowledge Attitude And Practice ◽  
Structured Questionnaire

Background: This study was carried out to assess the knowledge, attitude, and practice of contraceptive methods among women attending a tertiary care hospital in Western Rajasthan.Methods: This cross-sectional study was conducted in the department of obstetrics and gynecology, PBM and the associated group of hospitals, attached to Sardar Patel Medical College, Bikaner, Rajasthan, India. Total 500 married women between age group 15-49 yrs were included. These all women interviewed using a structured questionnaire after approval of the hospital’s ethical committee.Results: Total 500 women interviewed for their knowledge, attitude, and practices about contraception. Out of which, 402 (80.4%) women had some knowledge of at least one contraception method at the time of the study.  The most common sources of information about contraception were husband and family member. Amongst the various contraceptives most commonly known was condom (78.4%). Only 265 (53%) women were practicing contraception at present. Most commonly used contraceptive was condom (40.8%). The most common reason for the non-practice of contraception was need of more child or male child in 34.8% families followed by opposition from in-laws (12.4%).Conclusions: Literacy was positively associated with family planning related knowledge and practices. Preconception knowledge and practices about contraception are poor in our study population. Many of the women were getting MTP pills over the counter without consulting to health care persons and then later presents with complications.

scholarly journals Prescribing practices of topical corticosteroids in the outpatient dermatology department of a rural tertiary care teaching hospital

2013 ◽  
Vol 58 (5) ◽  
pp. 342 ◽  
Author(s):  
VinodS Deshmukh ◽  
ChetanrajG Bhamare ◽  
SuvarnaS Rathod ◽  
VijayM Motghare ◽  
RushikeshP Deshpande ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Prescribing Practices ◽  
Dermatology Department ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Topical Corticosteroids

scholarly journals A retrospective analysis of adverse drug reaction reported in a tertiary care hospital

2017 ◽  
Vol 6 (5) ◽  
pp. 1146
Author(s):  
Kirti Saxena ◽  
Chaitali Tailor ◽  
Chaitali Mehta ◽  
Paresh Gajera ◽  
S. K. Srivastava
Keyword(s):  
Tertiary Care Hospital ◽  
Diclofenac Sodium ◽  
Tertiary Care ◽  
Pharmacovigilance Centre ◽  
Pulmonary Medicine ◽  
Care Hospital ◽  
Dermatology Department ◽  
Medicine Department ◽  
Causative Drug ◽  
Male Patients

Background: The adverse drug reactions (ADRs) reported to pharmacovigilance centre in tertiary care hospital was analysed to find out the incidence and causality.Methods: This was a retrospective study to analyse the ADR reported at pharmacovigilance centre after ethical clearance from Institutional Ethic Committee (IEC). ADR data were analysed and ADRs were categorized as department-wise, system affected and causative drug. The causality of each ADR was assessed by WHO-UMC scale.Results: The majority of patients who had suffered from ADRs were between 19-64 years of age (94.2%) and male patients (58.6%) were affected more than female (41.4%). Pulmonary medicine department has reported highest number of ADR followed by dermatology department. Skin (46.5%) was most affected system followed by gastrointestinal (30.45%), CNS (21.26%), respiratory (9.0%) and remaining systems. Rifampicin (13.79%) shows the largest numbers of ADR followed by zidovudine (13.21%), nevirapine (12.64%) and diclofenac sodium (8.0%). The maximum ADRs reported were probable (94.8%) followed by possible (5.2%).Conclusions: In conclusion, the skin was most affected system followed by gastrointestinal, central nervous and respiratory system. Rifampicin has caused maximum ADRs followed by zidovudine, nevirapine and diclofenac sodium. The causality analyses showed that majority of ADRs were probable (94.8%) while remaining falls in possible (5.2%) category.

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