New Delhi, Feb. 12: A large number of people across Bihar could be misusing easy-to-buy and inexpensive steroid drugs owing to irrational prescriptions by doctors or self-medication, a study by doctors at Raxaul has suggested.

The study, which sampled 334 households, found that nearly one in three patients prescribed any medication over a six-month period had taken steroids. And among 113 people who had consumed steroids, in 100 patients, their use was "totally inappropriate."

"What we found is alarming and indicates a widespread problem in the state," said Lois Armstrong, a public health specialist at Duncan Hospital in Raxaul, which shares its border with Nepal. The doctors observed even some grocery shops selling steroids.

"Medical professionals appear to be prescribing these drugs rampantly without thinking about long-term implications but many patients are also buying them on their own from retail chemists out of ignorance," she said.

While their study sampled only households in Raxaul during 2013, doctors say an earlier study in Punjab and anecdotal accounts of patients suffering from side effects of steroid abuse before and after this study, suggest the problem is not confined to Bihar.

The doctors from Duncan Hospital found that 45 per cent of patients they sampled had been prescribed steroids by doctors, the others had self-medicated themselves.

While glucocorticoids are important in the treatment of many inflammatory, allergic and immunological disorders, their use needs good supervision to prevent various severe side effects such as diabetes, hypertension, cataract, osteoporotic fractures, Cushing's syndrome, characterised by obesity, diabetes and edema.

Doctors suspect that "quick-fix medicines" offered by quacks could also be contributing to the menace, though they could not confirm this.

The survey also indicated that one in 15 people in Raxaul is likely to have suppressed hypothalamo-pitiuitary adrenal axis, resulting in reduced function by three key glands in the body that lead to various complications.

"The main reason for this is unethical prescriptions by doctors and the cheap and easy access to steroids over the counter," Armstrong stressed. "Except in the Indian subcontinent, steroids are not available without doctors' prescriptions anywhere else."

The study published by the doctors in an international medical journal in January this year, noted that while the largest use of glucocorticoids was for respiratory problems and joint pains in people over 40 years of age, 18 children below nine years had also used the steroids for reasons ranging from simple cases of fever to acute illness.

Among those consuming glucocorticoids, 78 per cent had taken them for over a month and in the rural areas, various brands of the medicine were sold without questions even in grocery shops.

An earlier scrutiny of 92 randomly selected prescriptions in Jalandhar, Punjab, by doctors of the Lala Lajpat Rai Memorial Medical College, Meerut, had also detected widespread irrational prescriptions written out by allopathic medical practitioners for their patients.

"We found that steroids were being prescribed without valid reasons in 75 per cent of the cases apart from vitamins, tonics, and minerals in 58 per cent of the samples and these are harming patients more than helping them," said Dr Pinki Vishwakarma of the Lala Lajpat Rai Memorial Medical College.

A senior faculty member at the National Institute Mental Health and Neurosciences, Bangalore, Sasi Chandra, recalled how she had treated one of the severest cases of steroid abuse last year.

"He was a 50-year-old college professor suffering from muscle degeneration who had been referred to us from Odisha. He had been taking glucocorticoid every day for the past 20 years on his own," Chandra said.

The patient had been a chronic sufferer of asthma and had been taking a steroid drug ever since a doctor had prescribed him the medicine once for quick relief.