Background A severe cutaneous adverse reaction (SCAR) is a rare, clinically heterogeneous, life‐threatening phenomenon that results in serious skin damage, systemic complications, and significant morbidity or mortality comprising of Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), or SJS‐TEN overlap, acute generalized exanthematous pustulosis (AGEP), exfoliative dermatitis, and drug rash with eosinophilia and systemic symptoms (DRESS). Materials and methods A retrospective study was conducted on all cases of SCARs admitted in a tertiary care referral hospital from January 2015 to December 2019. Clinical and epidemiological details were retrieved from the records of patients as per predesigned proforma. The data collected were analyzed and statistically evaluated. Results and analysis A total of 142 patients (67 males, 75 females) with SCARs, constituting 0.08% of total hospital admission and 0.027% of total dermatology outpatient department (OPD), were studied. Age group ranged from 2 to 61 years, with the mean age of 33.6 years (SD = 17.43). Most patients belonged to SJS‐TEN complex (75 cases; SJS 48, SJS‐TEN 18, TEN nine) followed by exfoliative dermatitis (27 cases/19%), AGEP (26 cases/18.3%), and DRESS (14 cases/9.8%). Anticonvulsants were most commonly implicated (22%) followed by antibiotics (20%), nonsteroidal anti‐inflammatory drugs (NSAIDs) (17%), and ayurvedic (7%). There was only single mortality in a DRESS patient. Conclusion SCAR has considerable disease burden with marginal female preponderance in SJS/TEN and exfoliative dermatitis and can involve even the pediatric population. Anticonvulsants followed by antibiotics, NSAIDs, and ayurvedic medicines are common groups known to cause SCARs. To date, there are no definitive recommendations regarding their optimal treatment regimen, hence early diagnosis, prompt withdrawal of culprit drug, high standard of nursing care, and interdisciplinary consultations are vital steps to avoid disease progression and restore health.

Context: Bronchial asthma is a chronic respiratory disorder which affects over 300 million people worldwide. Inhalation pharmacotherapy is the cornerstone in treatment of asthma, which is administered using inhaler devices. Studies show high prevalence of incorrect technique while inhaler usage, which renders to compromised disease control and increased healthcare cost. Aims: This study was aimed to monitor errors in use of inhalers and explore their relationship with patient characteristics and training given by healthcare providers, in patients suffering from mild to moderate bronchial asthma. Settings and Design: This was an observational cross-sectional study conducted after approval of Institutional ethics committee in a tertiary care hospital. Methods and Material: A total of 207 patients were recruited after they met the inclusion criteria and their informed consent was taken. Data regarding the patients’ socio-demographic information, education status and history of illness were logged on a case record form. Their inhalation techniques were assessed according to the checklist, errors were noted and patients were educated regarding correct technique using ‘teach-back training’ method. Statistical analysis used: Chi-square test, SPSS software. Results: Among the inhalers used, pMDI was most commonly prescribed (58%), followed by DPI (37.7%) and pMDI with spacer (4.3%). Irrespective of the type of inhaler used, overall 75.36% patients included in the study, showed errors in use of inhaler. Prevalence of errors in DPI, pMDI and pMDI with spacers was 78.2 %,77.8% and 22.2% respectively. Our study showed that education status of patient, training by healthcare provider and duration of inhaler use have statistically significant association (p< 0.05) with the prevalence of errors in inhaler usage. Conclusion: It is emphasized that dedicated and trained staff should be available for instructing patients and reinforcing by follow up checks should be considered.

Background: Drug promotional literature (DPL) forms a major marketing technique of pharmaceutical companies for propagating information regarding a drug. Many a times, it is the only source on which treating physicians depend for updating their knowledge about the existing and novel drugs. Aims and Objectives: This study was conducted to understand the clinicians’ perceptions about DPL and its critical appraisal so that relevant interventions can be made. Materials and Methods: It was a cross-sectional questionnaire based study. A self-administered validated questionnaire was administered to 125 clinicians working in a medical college, which sought responses on their perception of various aspects including interpretation, analysis, evaluation, inference and decision making based on the DPL which they encounter in their day-to-day practices. The data was analyzed using descriptive statistics. Results: A total of 100 clinicians reciprocated with complete questionnaire. 99% of the clinicians were exposed to pharmaceutical promotional activities and around 79% clinicians accepted that drug promotion has a considerable bearing on their prescribing practices. Majority (79%) of the clinicians felt that the accuracy of the claims in the various forms of DPL was between 50-75%. Amongst the various forms of DPL, brochures were adjudged as the most useful followed by interactions with medical representatives, advertisements in medical journals and direct mailers. a majority of the clinicians (69%) felt that, though the claims in the DPL are balanced but are supported by poor evidence. Around 75% clinicians perceived the primary intention of drug promotional literature was to boost company sales. Around 84% clinicians felt that doctors’ integrity can be compromised by accepting gifts from medical representatives. Over 75% of clinicians believed that training in interacting with medical representatives and assessing other forms of drug promotional literature should be imparted to undergraduates in medical colleges. Conclusion: Physicians need to be aware that the pharmaceutical industry may use drug advertisements to influence prescription patterns even when this results in distortion of scientific facts. The pharmaceutical industry should be more responsible and more meticulous in making sure that pharmaceutical claims referring to scientific studies are quoted accurately.

Drug Abuse has become a major challenging problem for the society. It effects people of all countries economical strata's and all ages. According. Monetary loss all over the world regarding drug abuse is in million dollars, it not only has an impact on human productivity and healthcare cost but also on cost of crimes conducted by these drugs and alcohol abuse. Therapeutic vaccine has come as new approach to deal with this problem, after failures in search for a pharmaceutical agent to deal with drug of abuse and alcohol. Research in field of nicotine abuse has gone a way ahead with number of vaccines being tried clinically followed by cocaine, opioids, methamphetamine, phencyclidine and alcohol. All of them have a common mechanism of action by antibody production whereas alcohol acts by genetic intervention. None have being approved yet due to poor results in phase II trials, possibly due to not able to trigger an adequate immunological response. But still quest is on for cracking the ice by developing first successful vaccine against drug of abuse, that would follow for other drugs too. It would be great step in field of therapeutic vaccines for drug abuse after similar successful vaccines being approved for other diseases like cancer.

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