Topical corticosteroids in dermatology.

Since their introduction, topical corticosteroids have become indispensable in the treatment of various dermatoses. Hydrocortisone was the fi rst compound. Modifi cations in the basic structure generated in vivo activity and thus different topically active compounds were discovered. Apart from the Stoughton vasoconstrictor assay, various other methods are used for potency assessment of topical corticosteroids. Topical corticosteroides are classifi ed based upon potency and action of these molecules. Mechanism of action at the cellular level and indications of topical corticosteroid use have been discussed. Various adverse effects often occur as an extension of their activity combined with inappropriate usage. Tachyphylaxis and contact allergy are potential problems in clinical practice. Newer compounds with improved risk-benefit ratio are available.

Multi Disciplinary Rehabilitation of a Patient With Altered Passive Eruption and Hypodontia-- Case Report.

Patients who clinically display excessive gingival and short teeth require a thorough diagnosis and treatment plan to provide a predictable aesthetic outcome. This article illustrates multi-disciplinary approach in the treatment of a patient with altered passive eruption.

Autologous serum skin test in chronic idiopathic urticaria.

BACKGROUND AND AIMS: Chronic urticaria has a spectrum of clinical presentations and causes. About 25%-45% of patients have histamine releasing autoantibodies in their blood. The term autoimmune urticaria is increasingly being accepted for this subgroup of patients. The term autoimmune urticaria is used to reflect advances in knowledge about functional autoantibodies that activate mast cells and basophils through cross linking high affinity IgE receptors to secrete histamine. This study was started to find out incidence of autoimmune urticaria in Indian patients. METHODS: The autologous serum skin test was done in 45 patients with chronic urticaria of more than six weeks duration. Physical urticaria patients were not included in the study. RESULTS: Twelve patients had positive autologous serum skin test suggestive of autoimmune urticaria. CONCLUSIONS: Positive autologous serum skin test was seen in 26.67% of patients which is less than reports from Western literature. This is a useful screening test for autoimmune urticaria.

Hepatitis-B vaccine introduction into the routine immunization schedule--Andhra Pradesh experience.

Hepatitis B is a viral infection of the liver and is serious global public health problem with a high risk of death from cirrhosis of the liver and liver cancer, diseases that kill about one million persons each year globally. Globally, of the 2 billion people who have been infected with the hepatitis B virus (HBV), more than 350 million have chronic (lifelong) infections. It is preventable with safe and effective vaccines that have been available since 1982. Although the vaccine will not cure chronic hepatitis, it is 95% effective in preventing chronic infections from developing, and is the first vaccine against a major human cancer. More than 160 countries have already added this vaccine to their routine immunization programmes. Available epidemiologic studies in India and AP indicate that India is in intermediate endemic status (with a prevalence of 2 to 7%) and the best way to reduce the prevalence as per the strategies outlined by WHO is to introduce Hep-B vaccine into routine immunization. AP is the first State in India to introduce Hep-B vaccine in the routine immunization in a phased manner. In-spite of the initial apprehensions and slow take up, the program is proven to be successful and Govt. of India has made budgetary provisions in the 10th plan for introduction in rest of India.

Survey to validate neonatal tetanus elimination in Andhra Pradesh, India.

Neonatal Tetanus (NNT) elimination has been defined as an annual incidence of <1 case of NNT per 1,000 live births in each district of a province, state, or country. Reported incidence of NNT does not always reflect the true dimension of the problem. Thus, NNT mortality survey was planned during November 2003 to validate NNT elimination in the state of Andhra Pradesh. Firstly, based on review of records and recommended standard algorithm, two highest risk districts, namely Kurnool and Mahbubnagar were identified. In the second stage, NNT mortality survey was conducted in these two districts using lot quality assurance-cluster sampling (LQA-CS) methodology. In each of the two districts, 62 neonatal deaths were detected with no deaths due to NN, indicating incidence of NNT below 1/1000 LB. Thus, validation of NNT elimination may be concluded.