Dapsone induced photosensitivity in Indian women: a rare case

Dapsone, a potent antileprotic anti-inflammatory drug is used in treatment and prophylaxis of many dermatological and non dermatological conditions. Cutaneous adverse reactions to dapsone are uncommon ranging from mild maculopapular rash to fatal toxic epidermal necrolysis. We report here a case of 40-year-old, housewife treated for leprosy with paucibacillary multi drug therapy who presented with red itchy skin lesions over exposed areas of skin which worsened on exposure to sunlight. The patient was diagnosed as a case of dapsone-induced photosensitive dermatitis which was confirmed by improvement of symptoms on withdrawal of dapsone and recurrence of similar lesions on rechallenge with dapsone in reduced dose. Photosensitivity as adverse drug reaction to dapsone is rare and very few reports are available in the literature.

National hospital costing systems matter for universal healthcare: the India PM-JAY experience

India envisions achieving universal health coverage to provide its people with access to affordable quality health services. A breakthrough effort in this direction has been the launch of the world's largest health assurance scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, the implementation of which resides with the National Health Authority. Appropriate provider payment systems and reimbursement rates are an important element for the success of PM-JAY, which in turn relies on robust cost evidence to support pricing decisions. Since the launch of PM-JAY, the health benefits package and provider payment rates have undergone a series of revisions. At the outset, there was a relative lack of cost data. Later revisions relied on health facility costing studies, and now there is an initiative to establish a national hospital costing system relying on provider-generated data. Lessons from PM-JAY experience show that the success of such cost systems to ensure regular and routine generation of evidence is contingent on integrating with existing billing or patient information systems or management information systems, which digitise similar information on resource consumption without any additional data entry effort. Therefore, there is a need to focus on building sustainable mechanisms for setting up systems for generating accurate cost data rather than relying on resource-intensive studies for cost data collection