Pharmaceutical preparations are currently significant contributors to liver illness, in which hepatotoxicity being the most common cause of Acute liver failure .The liver is a vital organ, its strategic location and multidimensional functions support almost every other organ in the body. It is the main organ for metabolism, elimination of metabolic products and hepatotoxicity is a potential adverse effect for most of the drugs particularly Anti-tubercular drugs, general anaesthetics, paracetamol and some Anti-cancer drugs. Liver sometimes can be damaged by some chemicals called hhepatotoxins such as galactosamine and chloroform. Moreover steroids, vaccines and anti-viral drugs which are used as treatment option for liver diseases, may produce adverse effects especially after chronic administration. The main objective of our study is to assess the frequency of drugs causing the severity of Hepatotoxicity in patients in a tertiary care hospitals. A prospective observational study was carried out in 3 different tertiary care hospitals at Andhra Pradesh, India. It was found that males are more prone to hepatotoxicity compared to females, as well as the age group 25-64 years (67%) are more hepatotoxic compared to above 65years (15%) age group. So there is a need of awareness in patients and physicians to consider the drug induced hepatotoxicity while giving the treatment, in which most of the cases it was being left unconsidered and finally leading to hepatotoxicity starting with mild and moderate stages.

Scleroderma is a rare heterogenous group of autoimmune fibrosing disorder that mainly exists in two forms; localized scleroderma (LS) and systemic sclerosis (SSc). It involves thickening of the skin at fingers region extending from proximal to metacarpophalangeal joints. The diagnostic criteria of scleroderma include past history of patient, symptoms of patient, serology, and skin biopsy. The morbidity and mortality are much worse for SSc with the patients are at risk for life threatening lung, heart and other visceral organ fibrosis and vasculopathy. There is no drug that can cure or stop scleroderma over fibrosis, but certain drugs regulate the symptoms associated with it and boost the patient's quality of life, particularly steroidal creams that help alleviate swelling, joint pain, loosen tight skin; blood pressure drugs that dilate blood vessels; immunosuppressive agents. If the disease is severe amputation is necessary.