Topical corticosteroid therapy: clobetasol propionate 0.025%

Topical corticosteroids have been the cornerstone of treatment over the last six decades for various dermatoses characterized by dry, scaly, crusted, or erythematous skin as well as those associated with inflammation and pruritus. The potency of a topical steroid depends on the specific molecule, the amount of drug reaching the target, absorption through the skin (0.25%–3%), and the formulation. Clobetasol propionate (CP) 0.025% cream formulation is a potent, fifth-generation topical corticosteroid. It is approved by the United States Food and Drug Administration to be applied twice daily for the treatment of moderate-to–severe psoriasis in adults. This case series covers the clinical experience of various dermatologists, including their expert opinion on the safety and efficacy of ImpoyzTM (CP) cream 0.025% in different skin disorders.

Do joint national committee VII criteria also need to take non pharmacological measures into consideration? – Empirical evidence from slum resettlement colony from Delhi.

Background: Currently Joint National Committee (JNC) VII criteria are used worldwide to diagnose hypertension but it does not take non pharmacological measures into consideration. Also, it does not consider Indian system of medicine. Objectives: To assess whether JNC VII in its present form is valid to diagnose hypertension correctly or revision is required especially for Indian communities where such practices are prevalent. Material and methods: The present community based cross-sectional study was carried out in nand nagri, a slum resettlement of East Delhi which comes under field practice area of the Department of Community Medicine, UCMS, Delhi from August 2010 to February 2012. Total 310 subjects aged 20- 59 years were selected through multistage systematic random sample. Though the blood pressure cut-offs considered in our criteria was similar to the JNC VII cut-offs (SBP ³140 mmHg and or DBP ³90 mmHg), the difference was in the last part of JNC VII definition of hypertension i.e. treatment by anti hypertensive medicines; our criteria comprised of this statement as “any anti hypertensive measure”. Chi-square (χ²) test was applied for analysis. Results: Overall 54 were found to have hypertension by JNC VII criteria whereas 61 by our criteria. Seven patients who were not hypertensive by JNC VII but hypertensive by our criteria and the difference was found to be statistically highly significant (p<0.001). Exercise was the most common non pharmacological measure adopted by male gender where as in females, salt restriction was the most common measure adopted Conclusion: Our study emphasized inclusion of non-drug therapy measures into consideration while making diagnosis of hypertension in our setup.

Prevalence and predictors of hypertension among residents aged 20–59 years of a slum‑resettlement colony in Delhi, India.

Background: Slum‑resettlement communities are increasingly adopting urban lifestyles. The aim of this study was to assess the prevalence and identify correlates of hypertension among residents aged 20–59 years of a slum‑resettlement colony. Materials and Methods: A community‑based cross‑sectional study was done from 2010 to 2012 in NandNagri, a slum‑resettlement area in east Delhi. 310 participants aged 20–59 years were enrolled through multistage systematic random sampling. Each study subject was interviewed and examined for raised blood pressure; data on risk factors including smoking, alcohol intake, physical activity and salt consumption were also collected. Data were analysed by use of univariate and multivariate regression. Results: The overall prevalence of hypertension was 17.4% and 35% participants were prehypertensive. On multiple logistic regression, age 40–49 years (P = 0.020) and 50–59 years (P = 0.012), clerical/professional occupation (P = 0.004), abnormal waist circumference (≥90 cm in males and ≥ 80 cm in females; P = 0.001), positive family history of hypertension in both parents (P = 0.013) and above‑average daily salt intake (P = 0.000) were significantly associated with hypertension. Conclusions: These findings indicate that hypertension is a significant health problem in the study population. Many study participants diagnosed with prehypertension are at risk of developing hypertension, thus immediate public‑health interventions are indicated.

Prevalence of stress among resident doctors working in Medical Colleges of Delhi.

The present cross-sectional study was conducted from November 2007 to December 2008 in four medical colleges and associated hospitals of Delhi. Study subjects comprised 930 resident doctors. The overall prevalence of stress was found to be 32.8% in resident doctors from all colleges. Out of 930 resident doctors, 165 (17.7%) had mild stress, 113 (12.2%) had moderate stress, and 27 (2.9%) were severely stressed. Important reasons of stress as perceived by the study subjects included long duty hours, departmental academic activities, financial constraints, family and emotional problems in the decreasing order of preference. Important factors significantly associated with stress-included existence of children, year of residency, type of department, and presence or absence of job satisfaction, having close friends, spending time with family/friends, and place of graduation. In the multivariate model, year of residency, giving time to family and or friends, having close friends during residency, job satisfaction, and state of graduation came out as predictors of stress.

Depression, anxiety and stress among adolescent students belonging to affluent families: A school-based study.

Objective. To study depression, anxiety and stress (DAS) among adolescent school students belonging to affluent families and the factors associated with high levels of DAS. Methods. 242 adolescent students belonging to class 9-12th selected for the study. DASS-21 questionnaire was used for assessing DAS. Results. The scores in the three domains (DAS) were found to be remarkably correlated. It was seen that depression was significantly more among the females (mean rank 132.5) than the males (mean rank 113.2), p=0.03. Depression (p=0.025), Anxiety (0.005) and Stress (p<0.001) were all significantly higher among the ‘board classes’ i.e., 10th and 12th as compared to the classes 9th and 11th. All the three (DAS) were found to have an inverse relationship with the academic performance of the students. Depression and Stress were found to be significantly associated with the number of adverse events in the student’s life that occurred in last one year. Conclusion. A significant proportion of the students were found to be having high levels of DAS and several important factors were found to be associated with them. Proactive steps at the school-level and community-level and steps for improved parent-adolescent communication are needed for amelioration of the problem.

Methods for estimating prevalence and incidence of senile cataract blindness in a district.

The problem of senile cataract blindness (SCB) is very acute in India, contributing to 80 per cent of total blindness. The national objective of reducing the prevalence of blindness from 1.49 per cent, during 1986-89 to 0.3 per cent by AD 2000 has necessitated the surgical correction of SCB to be the major activity. With the introduction of District Blindness Control Society (DBCS), there has been a substantial increase in the number of operations of SCB in those districts. However, in the absence of standard, feasible, simple and cost effective methods to estimate the prevalence and incidence of SCB, the DBCS may find it difficult to plan and execute its major activity in a realistic way. The paper suggests two such methods for the use by DBCS. Only five seemingly rational assumptions have been adopted for the purpose. The authors feel that proper field testing is required to be sure about the reliability and validity of these methods.

Acute respiratory infections in children: a study of knowledge and practices of mothers in rural Haryana.

In the present study, data were collected on knowledge and practices of mothers in two villages of Block Beri of district Rohtak for devising a standard management plan. In all 304 mothers were interviewed. About 23 per cent mothers recognised pneumonia by fast breathing and 11.2 per cent recognised severe pneumonia by chest indrawing. Only 1.3 per cent mothers knew infective origin of ARI. Although most of them were convinced about continuation of breast feeding, 70 per cent of them were advising food restriction. Use of herbal tea in ARI was widely prevalent and so was the practice of putting warm mustard oil in ear for curing ear pain. Primary Health Centre was the most frequented place for treatment of ARI and mother-in-law was the most important person in taking management decisions for the child.