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ADR patient bounces back from jaws of death

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Heena Khan before and after the severe drug reaction she suffered
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Until a week ago, it was uncertain whether Kalyan resident Heena Khan, 28, would survive the serious drug reaction that had gripped her. In a fortunate turn of events, the doctors deemed her fit for discharge on Friday. After spending a month in Saifee Hospital, hanging between life and death, she is now looking forward to going home.

What had happened to the patient?
Heena had developed a life-threatening reaction to antibiotics after taking penicillin-based antibiotic drug Mox 250, containing antibiotic ingredient amoxycillin, which a local doctor had prescribed for her cough and cold. "Within two days of popping the pills, her skin had started peeling off in huge layers. It seems like her flesh was on fire and her skin was burning from inside out," said Heena's husband Mustaqeem. Right now, she is too weak to talk to anyone, he added.

What reaction did she suffer?
Heena was suffering from Toxic Epidermal Necrolysis Syndrome (TENS), a condition where body adversely reacts to certain drugs. Close to 30-40% of the patients inflicted with TENS die, said Dr Hakim Pardawalla, a consulting physician at Saifee Hospital, said.

How did the doctors treat her?
"Her skin condition has miraculously abated. We had a tough time managing her. Close to a week ago, she was constantly running a fever. Nearly 70% antibiotics would not work as her body was allergic to those medicines. Because her blood culture reports were deceptively negative for any infection, we empirically treated her for fungal infection. To our great relief, the medication worked and she is on the road to recovery," Pardawalla said.

Recovering, but is she completely fine?
Heena's appearance has under gone a sea change now. Her face is disfigured due to all the skin shed. She has black pockmarks and scars all over her body. She has temporarily lost vision in her left eye. "For the next six months, it is difficult to say if her eye can be cured. She has developed pus in the eye, which is blocking her vision. We will prepare her for a corrective surgery after her infection stabilises," said Dr Quresh Maskati, opthalmologist, Saifee Hospital.

What does the family say?
Her two children Araviya, 7, and Zaid, 3, are desperate to meet her. But Mustaqeem is reluctant to let them as yet. "If they comment on her appearance, Heena may be traumatised. I am not even sure if they will recognise her. Heena will stay at her mother's place in Bhiwandi for a few more days," he said.
Mustaqeem, who runs a small repair shop of electronic equipment, has spent close to Rs6 lakh over the past month for Heena's treatment. "I have had a hard time arranging finances. I have sold my gold and have also borrowed from relatives and friends. I am under a huge debt. In spite of having lodged a police complaint against the doctor who prescribed those medicines to her, the investigation has not made much progress," he rued.

What is TENS?
Toxic Epidermal Necrolysis Syndrome is a severe allergic drug reaction with an incidence rate of one in a population of 1,00,000.
It causes painful blistering of skin and internal organs lined with mucous membrane to burn from inside out.
In many cases it is preceded with flu-like symptoms and high fever. As it evolves, the skin literally sloughs off.
Severe conjunctivitis and loss of vision can also occur as it affects the cornea adversely.
It is mostly caused due to adverse effect of paracetamols, anti-epileptic drugs or anti-convulsants, HIV drugs, penicillin and corticosteroids among others.

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