Impact of Short-Term Topical Steroid Therapy on Selective Laser Trabeculoplasty Efficacy

Background: To evaluate whether short-term use of topical steroid therapy affected the efficacy of selective laser trabeculoplasty (SLT) for primary open-glaucoma (POAG). Methods: 25 eyes of 25 patients, who used a drop of dexamethasone 0.1% 4 times a day for 7 days as post-laser therapy, formed the Steroid SLT group and 24 eyes of 24 patients, where no topical steroids or nonsteroidal anti-inflammatory agents as post-laser therapy were used, formed the No-steroid SLT group. Success was defined as an intraocular pressure (IOP) lowering exceeding 20% of pretreatment IOP. Results: The mean follow-up time was 21.24 months for the Steroid SLT group and 20.25 months for the No-steroid SLT group (p = 0.990). No significant difference was found between the two groups for mean pretreatment IOP (22.20 mmHg vs. 22.33 mmHg), and for mean IOP reductions during whole follow-up period. At all follow-up visits, the mean IOP reductions were smaller in the Steroid SLT group than in the No-steroid SLT group. At all follow-up visits, the mean percent IOP reduction was smaller in the Steroid SLT group than in the No-steroid SLT group, and such a difference was significant at 12 months (25.4% vs. 29.6%, p = 0.047) and 24 months (25.3% vs. 29.7%, p = 0.024). According to the Kaplan–Meier survival analysis, the 24-month success rate was 84% in the Steroid SLT group and 79.2% in the No-steroid SLT group, with no differences between the groups (p = 0.675). Conclusion: Short-term use of topical steroid therapy had no impact on the efficacy of SLT for POAG.

A study on effectiveness of topical steroid therapy in boys with phimosis in the age group of 5 to 10 years

Background: Phimosis defined as the inability to retract the prepuce over the glans of penis is a common condition affecting boys. Objective was to study the effectiveness of topical steroid therapy (0.05% clobetasol propionate cream) in boys with phimosis in the age group of 5 to 10 years. Methods: This retrospective observational study was conducted at the Department of Pediatrics and Department of Surgery at Arunai Medical College and Hospital, Thiruvannamalai, Tamilnadu, India among 74 boys in the age group of 5 to 10 years with phimosis. The effect of twice daily application of 0.05% clobetasol propionate cream for six weeks on phimosis was studied. Results: out of the 74 boys, 25 (33.78%) were in the age group of 5 to 6 years, 20 (27.02%) in the age group of 7 to 8 years and 29 (39.19%) in the age group of 9 to 10 years. As per Kikiros et al system of grading of retraction of foreskin, majority of the boys 30 (40.54%) were grade 4, followed by grade 2 (24 boys, 32.43%), grade 3 (14 boys, 18.93%) and grade 5 (6 boys, 8.1%). Out of the 74 boys with phimosis, 53 boys (71.62%) had associated complications. After 6 weeks of topical steroid therapy, 39 (52.71%) boys showed complete response, 24 (32.43%) boys showed partial response and 11 (14.86%) boys showed no response to the treatment regimen. There was no significant correlation between age of boys and grade of phimosis with treatment response. Significant correlation was noted between history of urinary tract infection and treatment response. None of the other complications showed significant correlation with treatment response. None of the boys had any side effects to topical steroid therapy. Conclusions: Topical steroid application can be tried as an effective treatment modality in boys with phimosis in the age group of 5 to 10 years.

Comparative assessment of psoriasis area and severity index and fasting blood sugar levels in psoriatic patients with diabetes mellitus

<p class="abstract"><strong>Background:</strong> Present study was done with objectives to study the co-relation between PASI and Fasting blood sugar (FBS) levels in psoriatic patients with diabetes mellitus and to study the association between duration of topical steroid therapy and Fasting blood sugar (FBS) levels.</p><p class="abstract"><strong>Methods:</strong> Present study was conducted in the 26 patients at the Department of Dermatology at a tertiary care centre in Bhuj, Gujarat. A detailed history on the type of psoriasis, duration, associated co-morbid conditions and details of topical steroid therapy was obtained from all patients. They were examined in detail and assigned a PASI score to assess the severity of psoriasis. Patients with nail involvement were scored using N NAIL tool. Fasting blood sugar levels were noted in patients with Diabetes.<strong></strong></p><p class="abstract"><strong>Results:</strong> Age of patients ranged from 15 years to 72 years. The different types of psoriasis observed were palmoplantar psoriasis-14 (50%), and chronic plaque psoriasis - 11. The joint was involved in 7 patients while 19 did not have joint involvement. The Pearson co-relation coefficient between PASI and FBS was 0.60 and p value was 0.001. The Pearson co-relation coefficient between duration of topical steroid therapy and FBS was 0.15, and p value was 0.50.</p><p><strong>Conclusions:</strong> A statistically significant positive correlation between PASI and FBS was noted in this study. The duration of topical steroid therapy was not associated with significant changes in FBS in psoriatic patients with diabetes mellitus. </p>