My experiences with Betnovate

Betnovate is a famous brand of topical steroid Betamethasone valerate.

Recently we saw many acne patients with monomorphic lesions ( all lesions have same morphology). This particular type of acne is frequently seen in patients who are on steroids, topical or oral. Over a period of time we have found Betnovate to be most common culprit. We were surprised by this rampant " cosmetic" use of betnovate and decided to find more. And man what we found!! People specially young guys and girls were using it to lighten the skin color. God!! thats hypopigmentation and thats a side effect. There are other side effects too like thinning of skin and permanent blood vessel dilatation( this will cause redness- people like Fair and redness combo), increased fragility of skin etc. People are using this cream to get "desired side effect" and are ignoring all other side effects.

I will narrate 2 incidents to highlight the issue of widespread cosmetic use of Betnovate. One incident involves a newly married woman. Apparently she started using Betnovate before her marriage. After marriage she shifted to her in-laws place and here Betnovate was not available. So soon her "fairness and redness" was gone. She attended hospital on her husband's insistence and asked for an alternative for Betnovate!! so that she can continue to look fairer. The other incident involves a medicine shop owner. One patient proudly narrates a story where how the local people threatened a medicine shop owner to keep a constant supply of Betnovate!

I am surprised to learn what marketing and promotion can do!! And, " intelligent"-among-local people have contributed their bit, i am sure of it.

Is there anything like P- diagnosis?

Before coming to my point i want to highlight the concept of P-drug that we read in pharmacology during our undergraduate days. The P-drug concept includes the name of a drug, dosage form, dosage schedule and duration of treatment for a specified condition. This thing helps a physician to handle pharmacological concepts and drug-related data in an effective manner by developing one's own set of P-drugs. so instead of prescribing different drugs in same group, physician sticks to one particular drug from the group. This helps in better understanding of that particular drug.

While doing my post graduation i have got chance to sit with different teachers and learn from them. And over time i have realized one particular guy makes diagnosis from a list of say 50-200 conditions ( No. of entries in list depends on competency of that doctor... More entries..better Clinician!!) And interestingly this list differs for different clinicians. I have noticed that a certain diagnosis is made by a particular doctor only- other guys almost never make this particular diagnosis. This should not be a problem where a diagnostic tests is available. But this becomes an issue in dermatology where most of the conditions are diagnosed clinically. Diagnostic tests are either not confirmatory, not easily available or not affordable. So the problem!! Its confusing for beginners like us.

I have always believed one tends to follow one particular teacher while learning medicine. Medicine is not learned from the books, but from the teacher. Its like creating a intellectual clone- Both the doctor and the " intellectual cloning process'' can be good or bad. So our clinical acumen definitely depends on who we decide to follow. And this is where concept of "P- diagnosis" matters- at least to me. It helps me in deciding whose "intellectual clone" i wanna be!!

Nostalgia

Found it somewhere...sharing here with you guys

Gone are the days!!!My Friend..

When

The school reopened in June,

And we settled in our new desks and

benches!

When

we queued up in book depot,

And got our new books

and notes!

When

we wanted two Sundays and no Mondays, yet

managed to line up daily for the morning prayers.

We learnt writing with

slates and pencils, and

Progressed To fountain pens and ball pens and then Micro tips!

When

we had lunch in classrooms, corridors,

Playgrounds,under the trees and even in cycle sheds!

When

a single P.T. period in the week's Time Table,Was awaited more eagerly than the monsoons!

Gone are the days

Of Sports Day,

and the annual School Day ,

And the month long preparations for them.

Gone are the days

When we used to talk wid frends now we dont have time to say hi.

when we used to chat for hours now we chat in chat rooms.

gone r those days,but their memories will linger in my heart!!!