Lymphatic filariasis is an eradicable disease. It can cause disability which causes a lot of discomfort to the patients but the treatment given at the right time is very beneficial. Here we report a case of pleural filariasis with shortness of breath and cough in a 52-year-old male patient from Uttar Pradesh. The pleural fluid showed the presence of microfilaria. The patient responded to DEC and improved clinically. So it is essential to look for the presence of microfilaria both in the peripheral blood smear and the other body fluids depending on the clinical symptoms and signs. Proper treatment leads to improvement in the patient’s condition most of the time.
DRESS syndrome is a severe drug hypersensitivity reaction with an estimated incidence ranging from 1 in 1000 to 1 in 10,000 drug exposures with Carbamazepine being the most commonly implicated drug. We present the case of a 25-year-old male who was being managed for bipolar affective disorder with carbamazepine. He developed multiple maculopapular rashes, facial puffiness, fever, lymphadenopathy with leucocytosis and eosinophilia about four weeks after commencing carbamazepine. He was managed with prednisolone with a very good outcome. Naranjo’s algorithm was used to confirm the possible involvement of Carbamazepine in this case and diagnosis of DRESS syndrome was confirmed using Regis CAR criteria.
This syndrome is a severe and life-threatening condition that requires a high index of suspicion in patients who are taking Carbamazepine. The consensus on the management is immediate stoppage of the drug and commencement of systemic corticosteroids. Awareness of this rare side effect of Carbamazepine by Clinicians will help in reducing the mortality associated with this drug reaction.
There is currently no consensus on specific pharmacological treatments for COVID-19 and there is debate about the efficacy and safety of antiviral drugs. The aim of this study is to show the effect of the reduced form of Methylene blue (MB) as the last option of treatment to rescue patients who did not respond to Remdesivir, Interferon-β, and Favipiravir therapies. Ten hospitalized severe COVID-19 patients (who failed to respond to Remdesivir, Interferon-β, and Favipiravir) were administered oral MB (1 mg/kg every 8 hours for two days, followed by 1mg/kg every 12 hours for the next days). These patients recovered completely. MB can be used in the treatment of COVID-19 patients. For the treatment of COVID-19 patients, in addition to fluid therapy and oxygen support, different types of drugs are required simultaneously, such as anti-viral agents, antibiotics, anticoagulants, immunomodulatory drugs, and antioxidants. MB possesses all of these properties along with anti-hypoxemia and anti-respiratory distress features and can therefore be included in the clinical management of COVID-19.
Drugs manufactured by licenced manufacturers have been determined to be “not of standard quality” (NSQ) owing to deficiencies caused by minor variations in the drug. Defects that arise as a result of insufficient pre-formulation checks, in-process controls performed by the supplier, or hazardous conditions. Counterfeit or fake drug products are formulations manufactured to conceal the product's true identity. Spurious drugs are made to imitate another drug, particularly any famous brand. Spurious products are typically developed by unlicensed anti-social elements. Adulterated medicines are those medicines that are found to contain an adulterant or substituted medicines. The Central Drugs Standard Control Organization (CDSCO) has issued notification about 49 products, including eye drops, pain relievers, vitamins, and even antibiotics. Out of the 1,336 samples tested, 1,286 were deemed to be of good quality, 49 were deemed NSQ, and one was deemed spurious. This study analyses the implications of violating the laws and regulations stated in the D&C Act by taking the example of a case brought against a pharmaceutical company that involved in manufacturing of NSQ drugs. The study stresses the need to follow the rules to ensure that the pharmaceutical or cosmetic product is made available to the individuals in the country with acceptable standards of quality, protection and efficacy.