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Post by Martin Harvey on Dec 4, 2008 17:17:21 GMT
Entirely agree with Dave Smith in all respects and applaud his logical analysis of this thread. I too fail to see why a discussion should be 'dumbed down' when knowledge of various procedures can surely only be of benefit to anyone in any area of foot health. Also, such discussions perhaps allow the revisiting of area's of our science which have become overburdened with apocrypha allowing us to collectively discuss them in the light of modern science and evidence based medicine.
In respect of the above, in this current thread I would highlight the statements made about inflammation, which are - with respect - entirely at odds with the understanding of the immune system as believed by a few hundred thousand immunologists, anatomists and physiologists plus the statement made (by the poster who objected to this thread) about Salicylic acid being 'unlicensed' whom I can only refer to section 13.7 of edition 56 of the British National Formulary to view all the licensed applications of - yes, you have guessed it - Salicylic acid.
Cheers,
Martin
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Post by dtt on Dec 4, 2008 18:34:47 GMT
Hi Dave, Martin et al Couldn't agree more The fact the discussion is on this thread ( the reason the objection was raised) has ? been closed ( albeit FHP's as far as I'm aware can view any thread on this site and Pod Arena) flies in the face of common sense? BUT Perhaps a modification is required? Bel suggested there be a "Dermatology" Main thread started ( Davidh?) which I feel would appease the complainers and the WHOLE of the community on this site at whatever level. Anyone could then view and discuss as has been the way in the past. Just my thoughts Cheers D
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Post by Martin Harvey on Dec 4, 2008 19:02:48 GMT
Hi Dek, cant see the point of the move away from the OP myself, anyway, we have to cover electrodessication, topical cantharidin, dinitrochlorobenzene ointment, topical fluorouracil cream, tretinoin cream, ammonium lactate lotion, topical poison ivy extract and intralesional bleomycin yet. Oh and cimetadine, gunpowder cautery and the midnight dance referred to by Bel Cheers, M
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Post by dtt on Dec 4, 2008 19:18:32 GMT
Hi Martin Dont you EVER CHANGE mate ;D ;D ;D ;D ;D ;D ;D ;D ;D ;D ;D Be lucky Cu at T3 ( looking forward to it Cheers D
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10feet
Junior Member
Posts: 68
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Post by 10feet on Dec 4, 2008 21:52:58 GMT
Salicylic acid is on the Pharmacy only or general sales exemptions. This means the professions of Podiatry and Chiropody has exemptions and is therefore able to use salicylic acid up to concentrates of 70% legally either by sale, supply or administration. There is concern that these products do not have a product licence or marketing authorisation and despite the exemption, we may still be using them illegally. One for the legal beavers.
Martin, I fail to understand your point about the BNF. Anyone can buy licensed products containing salicylic over the counter but the legal responsibility changes when you are the practitioner selling, supplying or administering.
I think it was Bel who stated good, sound and practical advice to our FHP colleague. Others have advised the use of Salicylic acid as the keratolytic of preference.
I have no objection to any discussion surrounding application of caustics but urge caution to keep this within a perspective of the locality the discussion is taking place and temper it with the appropriate advice as Bel did right at the beginning of the thread. I am new to this forum and perhaps my caution is not appreciated.
Pete
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leon
New Member
Posts: 11
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Post by leon on Dec 4, 2008 22:29:02 GMT
Hello Mr Pete, I thank you for what you have said as it makes things more clear to me. I was becoming very confused with different ideas of the silver nitrate as it was not taught much when I trained, likewise the caustics use for VP. I think it is very complex area for me and in future will refer to pod. regards Leon
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Post by Martin Harvey on Dec 4, 2008 23:38:47 GMT
To clarify, this is an academic discussion only – or at least it is on my part, and with the good old statutory principle of mens rea clearly lays out my legal position.
....... hmmmm! suggest you talk to a 'legal beaver'
To clarify the position still further the 1968 medicines act exemptions to which you advert refer to currently registered podiatrists, not the ‘professions of chiropody and podiatry’.
when you are not so new you will perhaps observe that we are also particularly cautious, not to mention perceptive.
re:
Pete, really glad you raised that issue, it is always good to make a point about the BNF to those who fail to understand (and you may rest content, lest you were worried, that I do so at every opportunity). It contains much wisdom for those who wish to understand and discuss medicines and I wholeheartedly commend it to anyone who aspires to comprehend the subjects of pharmacokinetics and pharmacodynamics. I would counsel you to always have one at hand so that when you cautiously OSCE a new patient you can do so with the knowledge of this worthy tome supporting you.
Oh, and just to feed the Ignoratio Elenchi, I am sure that you are familiar with the subsection of the act which states :
In closing, re: its probably worth pointing out in the spirit of versimilitude that the original discussion was on AgNo3, which I am sure you will know is a protein coagulant not a caustic.
Toodle Pip,
M
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10feet
Junior Member
Posts: 68
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Post by 10feet on Dec 5, 2008 7:39:23 GMT
Martin
I still do not understand the points you are trying to make. It reads as point scoring and in my professional life this is something I do not subscribe to.
I am certain most of our FHP colleagues have access to the various suppliers of goods to the foot care profession and could quickly and easily obtain 70% salicylic acid. I still advocate caution.
You have highlighted the point that medical legislation does not specifically address the issue of administration of medicines excpet where the product is for injection. Again, this urges caution when administering any medicine. Is salicylic acid a medicine?
Martin advocates the use of the BNF. If you haven't a copy of the BNF handy, go to BNF.org - registration takes moments. Do a search for salicylic acid and scroll down to a product called Verrugon. This contains 50% salicylic acid with the instruction to apply daily.
Maybe at this point it would be appropriate to discuss the actions of 50% salycilic acid applied daily to a plantar verruca?
Pete
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Post by Martin Harvey on Dec 5, 2008 8:08:56 GMT
Pete,
.... perish the thought!
..... caution in all things temporal, spiritual and medical is to be warmly lauded, applauded, celebrated and highlighted.
..... is it?
...... do you think so?
Cheers,
M
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Post by Admin on Dec 5, 2008 8:51:47 GMT
Dave I don't get your rational as to closing the thread because its run its course, presumably because it appears to have gone off topic and or some people cannot follow the debate because of its hibrow, technical content.. Thats not unusual for any topic to evolve into something not quite resembling the OP. However reading back thru this thread it can be summarised like so. Some cut...... Its your site and you can lock any thread you wish but I feel that in this case you would be setting a precedent that will detrimentally skew future posting trends. Hi Dave, On re-reading entirely agree. Due to an oversight I didn't lock this thread down. Due to popular demand its been re-instated!Cheers,
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Post by Admin on Dec 5, 2008 8:53:30 GMT
The fact the discussion is on this thread ( the reason the objection was raised) has ? been closed ( albeit FHP's as far as I'm aware can view any thread on this site and Pod Arena) flies in the face of common sense? BUT Perhaps a modification is required? Bel suggested there be a "Dermatology" Main thread started ( Davidh?) which I feel would appease the complainers and the WHOLE of the community on this site at whatever level. Anyone could then view and discuss as has been the way in the past. Just my thoughts Happy to do this if people feel if would be useful. I'll put a Dermatology Board up over the weekend. Cheers,
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Post by davidsmith on Dec 5, 2008 9:12:13 GMT
David H
Bravo!
regards Dave S
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Post by dtt on Dec 5, 2008 10:13:49 GMT
Hello Leon Perhaps you could enlighten us where you got your FHP training and exactly what you were taught please ? Then we can adjust discussion to help you at you level of knowledge. Thank you and best wishes Derek
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Post by blinda on Dec 5, 2008 11:58:13 GMT
Indeed! Helpful for Pods, FHPs, FCAs and even`Clinical Reflexologists` , (cue Maria) Thanks for keeping the thread open David. Whilst i like the idea of a dedicated derm board, i would not want anyone who is not a pod to feel that they could not contribute to it. Cheers, Bel
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Post by Admin on Dec 5, 2008 12:27:03 GMT
Hello Leon Perhaps you could enlighten us where you got your FHP training and exactly what you were taught please ? Then we can adjust discussion to help you at you level of knowledge. Good point Derek. Leon, there are a few FHP trainers, each following different curriculae. SME FHPs should be up to speed with VP treatments, I don't know about either the Midlands School or Stonebridge, so any onfo would be useful. Regards,
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