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Methotrexate continues to be one of the most widely used systemic immunosuppressive agents in dermatology. We describe a case of low-dose methotrexate (MTX) toxicity in a patient with chronic plaque psoriasis occurring during long-standing methotrexate therapy. This case report emphasizes the fact that co-medications like NSAIDS may exacerbate MTX toxicity. This patient had a rare methotrexate-induced toxic epidermal necrolysis including cutaneous ulceration. Hence, careful consideration of concomitant medication is required to avoid drug interactions for safe long-term methotrexate treatment.

Background: In clinical practice, nonspecific antidiarrheals are most commonly used by clinicians along with routine treatment to hasten the recovery and to give psychological reassurance. This study was conducted to assess the effectiveness of nonspecific antidiarrheal agents in reducing the need for intravenous rehydration in children with acute diarrhea. Materials and Methods: This was a prospective, observational study done in clinical settings for a period of 3 years at two pediatric clinics and at a tertiary care hospital. Children were divided into 5 treatment groups (viz, control, racecadotril, Mebarid, Diarex and loperamide) at the discretion of the pediatrician. One questionnaire was provided to parents to record the details about the course of diarrhea. Parents were sensitized to report any episode of complication or need for intravenous fluids. Results: The unscheduled need for intravenous fluids due to dehydration was significantly higher in control group compared to other groups {Control: 7.37%, Racecadotril : 1.71% Mebarid: 2.4%, Diarex: 0%, Loperamide : 0%)}. Conclusion: Present study suggests that use of nonspecific antidiarrheals may decrease the need for admission for intravenous fluids in children with acute diarrhea.

Background: In clinical practice, nonspecific antidiarrheals are most commonly used by clinicians along with routine treatment to hasten the recovery and to give psychological reassurance. This study was conducted to assess the effectiveness of nonspecific antidiarrheal agents in reducing the need for intravenous rehydration in children with acute diarrhea. Materials and Methods: This was a prospective, observational study done in clinical settings for a period of 3 years at two pediatric clinics and at a tertiary care hospital. Children were divided into 5 treatment groups (viz, control, racecadotril, Mebarid, Diarex and loperamide) at the discretion of the pediatrician. One questionnaire was provided to parents to record the details about the course of diarrhea. Parents were sensitized to report any episode of complication or need for intravenous fluids. Results: The unscheduled need for intravenous fluids due to dehydration was significantly higher in control group compared to other groups {Control: 7.37%, Racecadotril : 1.71% Mebarid: 2.4%, Diarex: 0%, Loperamide : 0%)}. Conclusion: Present study suggests that use of nonspecific antidiarrheals may decrease the need for admission for intravenous fluids in children with acute diarrhea.