Drug rash with eosinophilia and systemic symptoms syndrome (DRESS syndrome) is a potentially life-threatening, drug-induced, multi-organ system reaction, the most frequently involved organ is liver, followed by the kidneys and lungs. 1 Early detection and diagnosis followed by withdrawal of the offending agent is vital to minimise the associated morbidity and mortality. A detailed drug history is vital to identify the causative drugs. Although Spanish guidelines were developed by a panel of allergy specialists from the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC) and are available in literature from 2020, many clinicians are still unaware about the management of this syndrome. Framing national guidelines for the early diagnosis and Pharmaco-therapeutic management of DRESS will help the healthcare professionals to save the patients from unintended vulnerability. Leflunomide, a drug widely used in rheumatology and orthopaedics must be used with caution since it has the potential to cause DRESS syndrome. We report a case of a lady aged 32 years, presented to our hospital with a history of leflunomide intake and symptoms of DRESS.

Dadru is one among the Kushta described in the classical text books of Ayurveda which bears greater resemblance with Tinea or Ringworm Infection. It is the commonest single fungus group of infectious skin disorders found in unhygienic conditions of tropical and subtropical countries and most encountered in clinical practice. Unless properly treated they become chronic. Dadru is a disease where all the treatment modalities can be applied as per the requirement of the disease condition. Here in this study, patients diagnosed with Dadru were treated with Dadrughna Lepa externally and Pittaja Kustahara Kashaya internally for a period of 30 days and observations were recorded. Methods: 50 patients fulfilling the diagnostic and inclusion criteria were considered for this single group study of 30 days for each patient. Periodical assessment done during the course of treatment and observations recorded as per case proforma. The data collected during study were Statistical analysed and resultant overall effect of therapy is noted. Results: As a result, Out of 50 patients, highly significant results (p< 0.05) were obtained with respect to Kandu (Itching) (i.e. 75.61%), Raga (Redness)(79.61%), Daha (Burning sensation)(83.12%), Pidaka (Eruption) (84.21%), Rookshata (Dryness)(53.66%), Udgata Mandala (elevated lesion) (71.43%), Size and No. of Lesions (67.82%). Discussion: Out of 50 patients, 2 patients (4%) were getting No improvement, 4 patients (8%) observed to have Mild improvement, 16 patients (32%) were observed with Moderate improvement and 28 patients (56%) with Marked Improvement. Overall effect of the treatment observed is 75.25%.

BACKGROUND Pre-eclampsia is reported to occur in around 25% of primigravida and 12%-15% of subsequent pregnancies. Ocular involvement is common. Reversible cortical blindness and extraocular muscle palsy have also been documented in eclamptic patients. The ocular vascular changes have been said to correlate with the severity of hypertension and this has been used as an indica tor for termination of pregnancy. The aim of this study is to determine the retinal changes in pre-eclampsia and eclampsia, and its relationship with severity of hypertension. MATERIALS AND METHODS An observational study was conducted over the period of 9 months at Department of Ophthalmology, Madurai Medical College among 199 patients, who fit into the diagnostic criteria of pre-eclampsia and eclampsia. After obtaining a detailed history, a thorough ocular examination was conducted with necessary blood investigations. All subjects were reviewed again at Ophthalmology Department two weeks after delivery. RESULTS The information collected regarding all the cases were recorded in a Master Chart. The study subjects were segregated into three major groups-Group 1: Mild Pre-eclampsia-BP > 140/90 mmHg with proteinuria > 300 mg/mL; Group 2: Severe pre-eclampsia-BP > 160/110 mmHg with proteinuria > 500 mg/mL associated with elevated renal parameters/ pulmonary oedema/ HELLP syndrome/ foetal compromise; and Group 3: Eclampsia-any unexplained seizures/ coma. The eclampsia group had more number of aged mothers, primigravida with generalised and pedal oedema and also proteinuria, whereas mothers with severe preeclampsia and mild pre-eclampsia were in the lower age group with or without pedal oedema and proteinuria, and the visual acuity was found to improve in all the three groups after delivery.