Frequency of serum cortisol suppression in patients using 0.05% clobetasol propionate as topical steroid for more than 3 weeks

Objective: To determine the frequency of serum cortisol suppression in patients using 0.05% clobetasol propionate as topical steroid for more than 3 weeks

Study Design: Cross sectional Study

Place and Duration of Study: Both outdoor and indoor patients of Dermatology Department, Military Hospital [MH] Rawalpindi for duration of 6 months i.e. from 18[th] April 2012 to 17[th] October 2012 were selected

Patients and Methods: A total of 189 patients were included in the study. Non-probability purposive sampling technique was used. Early morning [0800 hrs] serum for cortisol levels was taken before starting the treatment and same was repeated after 3 weeks at AFIP. Effect modifiers like age and gender were controlled through stratification. The data was analyzed using SPSS version 10. The quantitative variables like age, duration of illness were calculated by taking standard deviation and mean whereas the qualitative variables like gender, suppression of serum cortisol levels were calculated by taking percentages and frequency. Frequency of serum cortisol suppression was presented according to gender and age groups

Results: Majority of the patients selected were between 31-40 years i.e. 44.98% [n=85]. Gender distribution was 61.90% [n=117] males and 38.10% [n=72] females. Frequency of serum cortisol suppression in patients using 0.05% Clobetasol propionate as topical steroid for more than 3 weeks was seen in 33.33% [n=63]

Conclusion: The frequency of serum cortisol suppression was significantly higher amongst patients using clobetasol propionate 0.05%. Therefore patients prescribed clobetasol propionate 0.05% topically should be checked for serum cortisol suppression regularly if the application is intended to be used for more than 3 weeks

Clinical audit: Baseline investigations for intramuscular meglumine antimoniate in cases of cutaneous leishmaniasis

To see if the baseline investigations for intramuscular meglumine antimoniate in cases of cutaneous leishmaniasis were being carried out in accordance to our local guidelines. 30 case records of patients with cutaneous leishmaniasis were randomly selected from our dermatology ward. These records were reviewed to see if the pre-therapy investigations for meglumine antimoniate were carried out. The method of data collection was retrospective. The result showed 100% compliance with our local guidelines in the analyzed cases. Our audit showed 100% compliance

Frequency, etiology and characterstics of zygomatic complex fractures

Objective of this study was to find out the frequency, etiology and characteristics of zygomatic complex [ZMC] fractures. Forty patients with ZMC fracture visiting Oral and Maxillofacial Surgery Department, Ayub Teaching Hospital, Abbottabad from 27[th] January 2006 to 16[th] June 2006 were included in the study. A detailed history of patients was taken to find out the etiology, followed by clinical and radiographic examination to find out the characteristics of ZMC fractures. There were 31[77.5%] male and 9 [22.5%] female patients. The most common cause of ZMC fractures was Road Traffic Accident [RTA] 17[42.5%] followed by fall 8[20%], Firearm injury [FM] 5[12.5%], earthquake injury [EQI] 4[10%], interpersonal violence [IPV] 3 [7.5%], sports injury 2 [5%] and explosion [EXP] 1 [2.5%]. The most common characteristic of ZMC fracture in this study was periorbital ecchymosis 13 [32.5%] followed by paresthesia 8 [20%], flattening of cheek 6 [15%], subconjunctival ecchymosis 5 [12.5%], epistaxis 5 [12.5%], pain 5 [12.5%], step deformity of orbital margins 4 [10%], trismnus 3 [7.5%], diplopia 3 [7.5%] and buccal sulcus ecchymosis 2 [5%]

Frequency of unerupted mandibular third molar in mandibular angle fractures

Fractures of the mandibular angle are common and comprise 31% of all mandibular fractures. Multiple recent studies report a 2-3 fold increased risk for mandibular angle fractures when un-erupted mandibular third molars are present. The objective of this study was to assess the frequency of un-erupted mandibular third molar in mandibular angle fractures. This crosssectional study was conducted at the Department of Oral and Maxillofacial Surgery, Ayub Medical College, Abbottabad from April to October 2009. One hundred and two patients were included both from the outdoor and ward on consecutive non-probability sampling base. Data were recorded on a structured Performa and analysed using SPSS-16. A hemi-mandible containing un-erupted mandibular third molar was seen to have a 1.41 times the risk of mandibular angle fracture then a hemi-mandible containing an erupted mandibular third molar. The presence of unerupted mandibular third molar is associated with an increased risk for mandibular angle fracture.

Familial dysbetalipoproteinemia: a potentially fatal disorder

Familial dysbetalipoproteinemia is an inherited disorder in which both cholesterol and triglycerides are elevated in the plasma of the blood, which pre-disposes people to coronary artery disease and peripheral vascular disease. We report two young boys with multiple cutaneous xanthomas and grossly abnormal serum cholesterol and triglycerides. Two of the family members had died of cardiovascular accidents in young age and rest of the family members had deranged lipid profile. Patients were managed with lipid lowering drugs and fat restriction diet. All family members were counseled and advised regular exercise and follow-up