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• W2011529906 abstract "The Correspondence letter by Reto Krapf (Dec 7, p 1884)1Krapf R Development of Cushing's syndrome after use of a herbal remedy.Lancet. 2002; 360: 1884Summary Full Text Full Text PDF PubMed Scopus (13) Google Scholar highlights irrational drug use patterns in developed countries. The scenario regarding irrational use of drugs in India, and perhaps in many other developing countries, is different. We report a case of Cushing's syndrome in a 3-month-old infant due to irrational use of a steroid by a complementary and alternative medicine practioner. The infant was admitted to our hospital in September, 2001, with rapid breathing and chest indrawing. On physical examination she had cushingoid facies, truncal obesity, drumstick limbs, and paper-thin skin with striae. On enquiry, the mother showed us a small bottle of betamethasone, which was prescribed to the child at 15 days of life for upper respiratory tract infection. She had continued receiving this drug for the next 2 and a half months. We gave her ceftriaxone intravenously, and the steroid was gradually tapered off and stopped. The infant recovered and was discharged after 4 weeks in hospital. When last seen in August, 2002, there were no complaints. Guidelines for over-the-counter steroids in developing countries are lacking.2Hui JYH Woo PCY Lo SS Chan JCS Over the counter medication and its effects.Lancet. 2002; 359: 1120Summary Full Text Full Text PDF PubMed Scopus (8) Google Scholar Kshirsagar and colleagues estimate that more than 30% of prescriptions by medical practitioners are irrational.3Kshirsagar MJ Langade D Patil S Patki PS Prescribing patterns among medical practitioners in Pune, India.Bull World Health Organ. 1998; 76: 271-275PubMed Google Scholar Complementary and alternative medicine practitioners, who are untrained medically, prescribe allopathic medicines openly, and even prohibited drugs are available without prescription.4George R Abraham R Private health in India.Lancet. 2002; 359: 1528Summary Full Text Full Text PDF PubMed Scopus (8) Google Scholar The problem is further compounded by the symbiosis that exists between qualified professionals and complementary and alternative medicine practitioners. Such practitioners refer difficult and serious patients to qualified allopathic private practitioners, and get tipped for the service. Governments in developing countries must make more serious efforts to enforce the existing laws to improve health care, which presently looks elusive." @default.
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• W2011529906 date "2003-03-01" @default.
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• W2011529906 title "Iatrogenic Cushing's syndrome: a different story" @default.
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• W2011529906 doi "https://doi.org/10.1016/s0140-6736(03)12811-5" @default.
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