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Background: Melasma is hyper-pigmentation of skin, usually seen in young female adults, and previous studies have established substantial psychosocial burden associated with this disease. Aim: To measure the frequency of depression in melasma patients and its correlation with severity of melasma Study Design: Descriptive cross-sectional study. Place and duration of study: Dermatology OPD, HIT Hospital Taxila from 1st January 2021 to 31st August 2021 Methods: One hundred consecutive patients of melasma diagnosed by a skin specialist were enrolled. Elderly patients aged >60 years, those with previous psychiatric disease or chronic illnesses and on long term streroids were not included. After getting written informed consent, enrolled patients were screened for depression using Patient Health Questionnaire 9 (PHQ-9) Results: There were 17 males and 83 females. The mean age was 41.5±8.14 years. On MASI scale for assessing severity of melasma, 38 patients scored mild, 51 scored moderate and 11 scored severe. Using Patient Health Questionnaire 9 (PHQ-9) in patients with melasma, 18 patients didn’t have depression, 38 had mild depression, 31 had moderate depression, 6 had moderately severe depression and 7 had severe depression. Conclusion: The frequency of depression is quite high in patients suffering from melasma. It indicates a need for prompt diagnosis, appropriate intervention at correct time to ensure patient’s compliance to therapy to improve his disease outcome. Keywords: Depression, Melasma, Frequency

Objective: To check the motivational factors behind the usage of skin lightening creams and users’ awareness in our setup by constructing a validated questionnaire. Study Design: Cross-sectional study. Place and Duration of Study: Outpatient Department of Dermatology, Combined Military Hospital Rawalpindi, from Oct to Nov 2020. Methodology: Two fifty patients who were using skin-lightening creams (SLC) were recruited after the informed consent. Questionnaire was made following seven steps as mentioned in AMEE (Association for Medical Education Europe) guide 87. Data was analyzed by SPSS version 21. Reliability was be checked by Cronbach@. Descriptive statistics of responses including frequencies and percentages were calculated. Exploratory factor analysis of questionnaire was made. Results: Skin lightening cream users had age range from 16-56 years, majority 190 (76%) were females. Out of 158 (63.2%) were married, 180 (72%) well educated and 146 (58.4%) had Fitzpatrick skin type 3-5 predominate. Cronbach alpha of our questionnaire was 0.802. The 5-point likert scale was used to record users’ perceptions in the domains i.e., motivational factors, awareness about product and intentions. Majority, 89 (35.6%) used the product on social media recommendation. Out of 201 (80.4%) developed side effects with telangiectasia and skin thinning being the commonest ones. Out of 88 (35.2%) were using other skin whitening practices besides these creams. Conclusion: False perceptions about fairness and lack of user’s awareness govern the skin lightening practices in our society resulting in increased usage and side effects experienced by users. A mass educational awareness program regarding “skin lightening.........

Objective: To review the available literature investigating effectiveness of flipped classroom (FC) in context to teaching of procedural skills in residency in various medical fields especially in dermatology. Study Design: Systematic review. Place and Duration of Study: Flipped classroom meeting out inclusion criteria published in 9 years from 2012 to 2020. Methodology: Flipped classroom meeting out inclusion criteria published in 9 years from 2012 to 2020 were reviewed by the authors and co-authors as per their feasibility and discussion done by video conferencing by mobile software apps. Results: To review of 25 full-text articles. Strategic organization of course material, wise choice of pre-class activities, usage of Virtual learning environment, class time utilization tailored to learners needs, adherence to timelines, proper training of staff and proper evaluation; are required for successful implementation of flipped classroom. Students had positive perceptions about this technique. Conclusion: Flipped classroom is an effective teaching method for procedural skills training in post graduate medical training.