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Background: Primary care physicians play a crucial role in managing patients with common skin disorders who form around one-third of outpatient attendees. Aim: This study aimed to assess the need for dermatology training among primary care physicians by assessing their knowledge, self-perception of ability to diagnose and manage skin disorders, and their difficulties in managing these patients. Methods: A descriptive, cross-sectional, needs assessment study was done among primary care physicians (n = 61) of rural (n = 34) and urban (n = 27) areas of Vadodara district. A pre-validated semi-structured questionnaire (for self-rating of the ability to diagnose/manage skin disorders and difficulties faced in managing patients) was used along with a photo-quiz (for knowledge assessment) while approaching primary care physicians during their monthly review meeting with prior permission. Data were analyzed by Epi InfoTM software and manual content analysis. Results: The mean score on the photo-quiz was 4.1/10. Forty-three (70.5%) participants rated their ability to diagnose/manage skin disorders as 'average' on a five-point Likert scale. Various difficulties (n = 89) narrated by participants were related to their knowledge/skill, disease factors, patients and administrative aspects. Three-fourths of the participants managed difficulties by referring patients to dermatologists. One-third suggested conducting training in common skin disorders. Limitations: The study population included primary care physicians from the government healthcare setup only. Knowledge assessment was done using a short ten-item photo-quiz instead of actual patients. Conclusions: Primary care physicians had poor knowledge of skin disorders, and a majority overrated their own ability for clinical management of these disorders. Most common difficulties faced were related to clinical management. There is a need for training on common skin disorders.
RESUMO
Abstracts: Background: Methotrexate, in low dose, has been widely used therapy in psoriasis patients. It has a good safety profile if used with proper monitoring. It helps to achieve quick remission and delays relapse. This study was done to evaluate safety and efficacy of methotrexate in terms of adverse drug reaction as well as relapse and remission. This was an observational prospective study performed in dermatology department of a tertiary care government hospital. Methodology: : Total 43 patients with psoriasis were given methotrexate and were evaluated for remission, relapse and adverse drug reactions. Statistical analysis used: MedCalc stastical software was used to evaluate the data. Results: Out of 43 patients, 42 patients achieved remission within 2-24 weeks. (Median - 4 weeks) 28 patients out of 33 showed relapse within the span of 2-24 weeks; while five patients did not show the signs of relapse till six months after stoppage of MTX. Minor adverse reactions were seen in 21% of patients amongst which, only two cases with hepatitis needed withdrawal of methotrexate. Conclusion : Methotrexate is still a near to gold standard therapy for psoriasis. It induces quick remission and delays relapse significantly. Methotrexate, if given with proper monitoring, will have significantly low risk of adverse effects.
RESUMO
Ectrodactyly, ectodermal dysplasia and cleft palate/lip syndrome (EEC) is a rare autosomal dominant syndrome with varied presentation and is actually a multiple congenital anomaly syndrome leading to intra- and interfamilial differences in severity because of its variable expression and reduced penetrance. The cardinal features include ectrodactyly, sparse, wiry, hypopigmented hair, peg-shaped teeth with defective enamel and cleft palate/lip. A family comprising father, daughter and son presented to us with split hand-split foot deformity (ectrodactyly), epiphora, hair changes and deafness with variable involvement in each family member.