Corticosteroids are widely used compounds for allergic reactions, autoimmune diseases, inflammatory conditions, hormone replacement therapy etc. Hence, with widespread use and actions, these have several interactions with drugs and diseases. The purpose of this study was to obtain information about Corticosteroids prescribing and utilization pattern, to understand the prescribing behaviour of physicians and to identify drug interactions. A retrospective observational study was conducted in the department of dermatology and general medicine in a tertiary care hospital for 6 months. All the patients receiving any category of steroid therapy were included, and the prescribing and tapering pattern of steroids were reviewed. Drug utilization pattern (DUR) was observed and analysed among 150 patients during the study period. The results revealed that steroids were prescribed for various respiratory illnesses (66%) and skin-related conditions (34%). The steroid utilization was found to be more in elderly patients, particularly in males. Intravenous administration was common in 33% of cases. Budesonide was the most commonly prescribed steroid (36%), followed by Hydrocortisone (24%) and Dexamethasone (14%). The most frequent drug-drug interaction was between Hydrocortisone and Theophylline as well as Hydrocortisone and Hypoglycaemic agents. Most drugs were prescribed rationally, although some factors like prescribing drugs in the brand name, without mentioning route of administration, frequency and dose were deviating away from rationality. Not much variation was found in the pattern of prescription amongst healthcare professionals. Although most of the drugs were prescribed rationally, the involvement of a clinical pharmacist in patient care can help in more rational prescribing along with prevention and early detection of ADRs which can directly promote drug safety and better patient outcomes.

Background: Ceftriaxone is a commonly used antibiotic in a wide range of local and systemic infections. Encephalopathy is a rare complication of ceftriaxone, often seen in older adults and those with renal insufficiency. Case Description: A 73-year-old lady with prior history of hypertension and dyslipidemia presented with the complaints of slurred speech, gait imbalance, nocturnal vomiting, and progressively worsening headache. A magnetic resonance imaging of the brain revealed two intracerebral lesions involving the right frontal and temporal lobes, suggestive of multicentric glioma. She underwent craniotomy and excision of these lesions. The biopsy was reported as intra-axial tumors with features suggestive of the WHO Grade IV glioma. Postoperatively, she did not wake up. An electroencephalogram demonstrated triphasic waves suggestive of encephalopathy. The probable diagnosis of ceftriaxone-induced encephalopathy was made after ruling out other causes of delayed awakening after surgery. Ceftriaxone was discontinued and the patient improved within 2 days of withdrawal of ceftriaxone. Conclusion: Drug-induced encephalopathy should be considered in the differential diagnosis of patients with delayed awakening after surgery. Discontinuation of the drug leads to the recovery of these patients.

Several studies validate the role of various supportive interventions including loosening exercises, neck exercises and yogasanas in conventional management of cervical spondylosis. The present cross-sectional study proposes that religious meditation and prayers including namaz could also be beneficial in improving the overall health and wellbeing of patients with cervical spondylosis.

While Leptospira are known to cause multi-system dysfunction, cardiac involvement is uncommon. We present a case febrile myocarditis diagnosed to have leptospirosis. The patient also had pancreatitis, jaundice and renal failure but recovered well with timely management.