PDF of Trial CTRI Website URL -
|
|
- Gavin Rose
- 5 years ago
- Views:
Transcription
1 Clinical Trial Details (PDF Generation Date :- Tue, 02 Oct :40:33 GMT) CTRI Nuber Last Modified On 24/02/2012 Post Graduate Thesis Type of Trial Type of Study Study Design Public Title of Study Scientific Title of Study CTRI/2011/04/ [Registered on: 21/04/2011] - Trial Registered Prospectively No Interventional Drug Randoized, Parallel Group Trial A Clinical trial intended to copare Clindaycin & Benzoyl Peroxide cobination topical gel to Duac of Stiefel Labs, in patients with ild to oderate acne vulgaris. A Randoized, Double-blind, Multi-center, Parallel-group, Pilot clinical study to copare the efficacy and evaluate safety of Clindaycin 1% / Benzoyl Peroxide 5% Topical Gel (Cadila Healthcare Liited, ) with Duac Topical Gel (Stiefel Laboratories, USA) in Patients with Acne Vulgaris. Secondary IDs if Any Secondary ID Identifier Details of Principal Investigator or overall Trial Coordinator (ulti-center study) Details Contact Person (Scientific Query) Details Contact Person (Public Query) CRL/CT/02/10-11 Designation Affiliation Protocol Nuber Details of Principal Investigator Dr Ranjan Rawal Head Of Departent Phone Fax Eail Designation Affiliation Dept of Deratology, V.S. Hospital, Skin OPD, 1st Floor, Ellis Bridge, ranjancraval@gail.co Details Contact Person (Scientific Query) Dr Charu Gauta Director Clinical Operations Phone Fax Eail Designation Affiliation BA Research Liited Opp. Pushparaj Towers, Bodakdev, charu@baresearchindia.co Details Contact Person (Public Query) Mr Chirag Shah Head Clinical Trials BA Research Liited Opp. Pushparaj Towers, Bodakdev, page 1 / 6
2 Source of Monetary or Material Support Priary Sponsor Details of Secondary Sponsor Countries of Recruitent Sites of Study Phone Fax Eail Source of Monetary or Material Support > Cadila Healthcare Liited Sarkhej Bavla N.H. No.8A, Moraiya, Tal: Sanand, Dist: , Gujarat,. Tel# Fax# Type of Sponsor BA Research Liited List of Countries of Principal Investigator Dr Bela Shah Dr Chitra Nayak Priary Sponsor Details Cadila Healthcare Liited Sarkhej Bavla N.H. No.8A, Moraiya, Tal: Sanand, Dist: , Gujarat,. Pharaceutical industry-n BA Research Liited Opp. Pushparaj Towers, Bodakdev, Gujarat, of Site Site Phone/Fax/Eail BJ Medical College, Civil Hospital BYL Niar Hospital and TN edical college Dept of Deratology, ST and Leprosy, Roo-139, 1st floor, OPD Building, BJ Medical College, Civil Hospital, Asarwa, Dept of Deratology, OPD No 14, BYL Niar Hospital and TN edical college, Dr AL Nair Rd, Central, Dr Prachi Matte Dera Lesar Clinic Dera Lesar Clinic, B-Wing, 8th Floor, Lokat Building, Radaspeth, Nagpur Nagpur Dr Vikrant Saoji Dr. Saojis Clinic Dr Saojis Clinic, Navprabhat Chaber, Opp Tarun Bharat, Central Bazaar Road, 27, Radaspeth, Nagpur Nagpur shah.drbela@gail.co chitra1202@yahoo.co.i n dr.prachiatte@sify.co vikrantsaoji@hotail.co Dr D G Saple Dr. Saples Clinic Dr Saples Clinic, page 2 / 6
3 Details of Ethics Coittee Dr B Leelavathy Dr A S Kuar Dr Deepa Bhatt Dr Sandesh Gupta Dr Ranjan Rawal MS Diabetes and Shirdi Skin Care Centre Owaisi Hospital & Research Center SCL Muncipal Hospital, Skin & Laser Centre, Delhi V.S. Hospital, Hindu Colony, 3rd Lane, Near Bhagini Saaj, Dadar, MS Diabetes and Shirdi Skin Care Centre, No 6/1, Opp Hotel Krishnasagar, 80 ft Road, Indiranagar, Bangalore Bangalore KARNATAKA Dept of Deratology, Owaisi Hospital & Research Center, Kanchan Baug, Hyderabad Hyderabad ANDHRA PRADESH clinic@drsaple.co drleelaskincare@gail. co dr_askuar@yahoo.co. in Dept of Deratology, SCL Muncipal Hospital, Saraspur, - deepabhatt_ahd@yaho o.co Skin & Laser Centre, F-12/10, Krishna Nagar, Delhi drsandeshg@rediffail. North East co DELHI Dept of Deratology, V.S. Hospital, Skin OPD, 1st Floor,Ellis Bridge, ranjancraval@gail.co of Coittee Approval Status Date of Approval Is Independent Ethics Coittee? Clinical Ethics Foru, Approved 25/02/2011 Yes CLINICOM, Bangalore Approved 17/02/2011 Yes IEC- Nagpur Approved 31/01/2011 Yes Independent Ethics Coittee, Nagpur Independent Ethics Coittee-Clinico Institutional Ethics Coittee, Institutional Ethics Coittee, Hyderabad Nair Golden Jubilee Research Foundation, Approved 31/01/2011 Yes Approved 17/02/2011 Yes Approved 07/04/2011 No Approved 26/02/2011 No Approved 09/04/2011 No page 3 / 6
4 Regulatory Clearance Status fro DCGI Health Condition / Probles Studied Intervention / Coparator Agent Inclusion Criteria NHL-IEC, Approved 22/02/2011 No Rogi Kalyan Saiti, Status Approved 28/02/2011 No Date Approved/Obtained 30/03/2011 Health Type Patients Condition Mild to Moderate Acne Vulgaris Type Details Coparator Agent Intervention Age Fro Age To Gender Duac Topical Gel (Stiefel Laboratories, USA)Clindaycin 1% + Benzoyl Peroxide 5% Topical Gel Clindaycin 1% / Benzoyl Peroxide 5% Topical Gel (Cadila Healthcare Liited, ) Year(s) Year(s) Both Inclusion Criteria Once Daily on the affected area for 11 Weeks Once Daily on the affected area for 11 Weeks Details 1. Be Healthy ale or non-pregnant non-lactating feale subjects 13 to 40 years of age; 2. Be able to provide signed infored consent. Subjects of 18 years or older ust provide IEC/IRB approved written infored consent. Subjects of less than 18 years age ust have IEC/IRB approved written infored consent fro a parent or legal guardian. Subjects of 13 C 17 years age ust coplete an IEC/IRB approved assent for for inors. 3. Have clinical diagnosis of Acne Vulgaris and on the face, 25 non- inflaatory lesions (i.e. open and closed coedones) AND 0 inflaatory lesions (i.e. papules and pustules) AND 2 nodulocystic lesions (i.e. nodules and cysts). 4. Local Tolerance grading 0, 1 or Investigators Global Evaluation (IGE) of acne severity grade 2 or Willing to refrain fro use of all other topical acne edications or antibiotics during the 11 week treatent period. 7. All subjects will be evaluated by the principal or sub-investigator physician during a pre-study edical evaluation perfored within 15 days of the initial dose of study edication which will include: 8. a noral or non-clinically significant physical exaination, including vital signs (blood pressure, heart rate, respiratory rate and teperature); 9. within noral liits or non-clinically significant laboratory evaluation results for the clinical laboratory tests. 10. Willing and able to understand the requireents of the study, abide by the restrictions, apply the edication as instructed, and return for the required study visits. 11. Be in good health and free fro any clinically significant disease, other than acne vulgaris, that ight interfere with the study evaluations. 12. Have used the sae brand of ake-up for a iniu period of 2 weeks prior to randoization, for subjects who use ake-up, and agree to not change ake-up brands or types during the study. Exclusion Criteria Exclusion Criteria page 4 / 6
5 Details 1. Be pregnant or breast feeding. 2. Have presence of any skin condition that would interfere with the diagnosis or assessent of acne vulgaris; which includes, on the face: 2 nodulocystic lesions, rococo, deratitis, psoriasis, squaous cell carcinoa, eczea, acnefor eruptions caused by edications, steroid acne, steroid folliculitis, or bacterial folliculitis. 3. Excessive facial hair (e.g. beards, sideburns, oustaches, etc) that would interfere with the diagnosis or assessent of acne vulgaris 4. Have a history of hypersensitivity to clindaycin, lincoycin, benzoyl peroxide, or any coponent of the study edication forulations. 5. Use within 6 onths prior to randoization of oral retinoids or therapeutic Vitain A suppleents of greater than 10,000 units/day 6. Have received treatent with systeic antibiotics or steroids within 4 weeks of study start or topical antibiotics or steroids within 2 weeks of study start 7. Use on the face within one onth prior to randoization or during the study of: a) cryodestruction or cheodestruction, b) derabrasion, c) photodynaic therapy, d) acne surgery, e) intra lesional steroids, f) x-ray therapy 8. Use within one onth prior to randoization of, a) spironolactone, b) systeic steroids, c) systeic antibiotics, d) systeic treatent for acne vulgaris or e) Systeic Anti inflaatory agents. 9. Have received treatent with topical anti-acne edications within the 2 weeks prior to the study (topical steroids, topical retinoids, topical acne treatents including over the counter preparations, topical anti inflaatory agents, edicated cleansers or topical antibiotics 10. Have any systeic or deratologic disease that ay effect the evaluation of study results. 11. Have a history of regional enteritis, ulcerative colitis, pseudoebranous colitis or antibiotic-associated colitis. 12. Subjects with clinically significant unstable edical disorders, life-threatening disease, or current alignancies. 13. Subjects who engage in activities that involve excessive or prolonged exposure to sunlight. 14. Subjects who consue excessive aounts of alcohol (ore than 3-4 drinks per day), abuse drugs, or have any condition that would coproise copliance with this protocol. 15. Subjects who have been treated with an investigational drug or investigational device within a period of 30 days prior to study entry Method of Generating Rando Sequence Method of Concealent Blinding/Masking Other Other Participant, Investigator and Outcoe Assessor Blinded Priary Outcoe Outcoe Tiepoints Mean percent reduction fro baseline to Day 77 in the nuber of inflaatory acne lesions Mean percent reduction fro baseline to Day 77 in the nuber of inflaatory acne lesions Secondary Outcoe Outcoe Tiepoints Target Saple Size ean percent change in no. of non-inflaatory lesions, ean percent change in no. of total lesion count and change in Investigator Assessent Total Saple Size=60 Saple Size fro =60 Fro Baseline to End of Study Visit page 5 / 6
6 Powered by TCPDF ( PDF of Trial Phase of Trial Phase 3/ Phase 4 Date of First Enrollent () Date of First Enrollent (Global) Estiated Duration of Trial Recruitent Status of Trial (Global) Recruitent Status of Trial () Publication Details Brief Suary 25/04/2011 No Date Specified Years=0 Months=2 Days=0 Not Applicable Copleted Not Applicable presently A Randoized, Double-blind, Multi-center, Parallel-group, Pilot clinical study to copare the efficacy and evaluate safety of Clindaycin 1% / Benzoyl Peroxide 5% Topical Gel (Cadila Healthcare Liited, ) with Duac Topical Gel (Stiefel Laboratories, USA) in Patients with Acne Vulgaris. The study duration is of 60 days and will be conducted in 10 study centers in. The priary efficacy easures are (1) Mean percent reduction fro baseline to Day 77 in the nuber of inflaatory acne lesions, and (2) ean percent change in no. of non-inflaatory lesions, (3) ean percent change in no. of total lesion count page 6 / 6
PDF of Trial CTRI Website URL -
Clinical Trial Details (PDF Generation Date :- Tue, 02 Oct 2018 21:40:33 GMT) CTRI Number Last Modified On 26/12/2012 Post Graduate Thesis Type of Trial Type of Study Study Design Public Title of Study
More informationPDF of Trial CTRI Website URL -
Clinical Trial Details (PDF Generation Date :- Fri, 21 Dec 2018 19:27:12 GMT) CTRI Number Last Modified On 06/01/2014 Post Graduate Thesis Type of Trial Type of Study Study Design Public Title of Study
More informationPharmacy Coverage Guidelines are subject to change as new information becomes available.
TOPICAL RETINOID AND COMBINATION PRODUCTS: ATRALIN (tretinoin) gel AVITA (tretinoin) cream and gel DIFFERIN (adapalene) cream, gel, lotion (Over-the-Counter Differin is a plan exclusion) EPIDUO (adapalene-benzoyl
More informationPharmacy Coverage Guidelines are subject to change as new information becomes available.
TOPICAL CLINDAMYCIN PRODUCTS: ACANYA (clindamycin phosphate-benzoyl peroxide) gel BENZACLIN (clindamycin phosphate-benzoyl peroxide) gel CLEOCIN-T (clindamycin phosphate) gel, lotion, solution, swab CLINDAGEL
More informationGSK Clinical Study Register
In February 2013, GlaxoSmithKline (GSK) announced a commitment to further clinical transparency through the public disclosure of GSK Clinical Study Reports (CSRs) on the GSK Clinical Study Register. The
More informationTolerance of a Low-Level Blue and Red Light Therapy Acne Mask in Acne Patients with Sensitive Skin
Poster 7098 Tolerance of a Low-Level Blue and Red Light Therapy Acne Mask in Acne Patients with Sensitive Skin Dara Miller 1, Michael J. Cohen 1, Adegboyega Adenaike 1, Julie Biron 2, Michael H. Gold,
More informationThe secondary objective was to evaluate the cosmetic properties and its efficacy after 28 days.
P0090 CLINICAL EVALUATION OF CUTANEOUS SAFETY AND EFFICACY OF A FACE EMULSION CONTAINING MYRTACIN EXTRACT, PP VITAMIN ANS SABAL EXTRACT ON ACNE PRONE SKIN SUBJECTS TREATED BY TOPICAL ANTI ACNE DRUG THERAPY.
More informationChildren s Hospital Of Wisconsin
Children s Hospital Of Wisconsin Co-Management Guidelines To support collaborative care, we have developed guidelines for our community providers to utilize when referring to, and managing patients with,
More informationManagement of acne requires proper application
DRUG THERAPY TOPICS A Qualitative and Quantitative Assessment of the Application and Use of Topical Acne Medication by Patients James Q. Del Rosso, DO Management of acne requires proper application of
More informationJDDonline.com. Introduction. Methods Study Design Twenty-three patients enrolled in a 4-week, multicenter, investigator-blinded,
534 Emil Tanghetti MD, a Leon Kircik MD, b David Wilson MD, c Sunil Dhawan MD d a. Center for Dermatology and Laser Surgery, Sacramento, CA b. Physicians Skin Care PLLC, Louisville, KY c. Education and
More informationEFFECTIVE PRIMARY CARE MANAGEMENT OF ACNE VULGARIS
EFFECTIVE PRIMARY CARE MANAGEMENT OF ACNE VULGARIS WHY ACNE? EXCESS OIL PRODUCTION BY OVERACTIVE SEBACEOUS GLANDS. IMPROPER CELL TURNOVER/EXFOLIATION CLOGS PORES. DISRUPTED OXYGEN SUPPLY ALLOWS P. ACNE
More informationPOLYTAR Plus Liquid PRODUCT INFORMATION. Polytar Plus Liquid medicated scalp cleanser, contains coal tar solution.
NAME OF THE MEDICINE POLYTAR Plus Liquid PRODUCT INFORMATION Polytar Plus Liquid medicated scalp cleanser, contains coal tar solution. DESCRIPTION Polytar Plus Liquid contains coal tar solution 4% w/w.
More informationCLINICAL EVALUATION OF REVIVOGEN TOPICAL FORMULA FOR TREATMENT OF MEN AND WOMEN WITH ANDROGENETIC ALOPECIA. A PILOT STUDY
CLINICAL EVALUATION OF REVIVOGEN TOPICAL FORMULA FOR TREATMENT OF MEN AND WOMEN WITH ANDROGENETIC ALOPECIA. A PILOT STUDY Alex Khadavi, MD, et al,. Los Angeles, CA USA 2004 Abstract: This study was done
More informationFor the use only of Registered Medical Practitioners or a Hospital or a Laboratory BREVOXYL CREAMY WASH. Benzoyl Peroxide Creamy Wash 4%
For the use only of Registered Medical Practitioners or a Hospital or a Laboratory BREVOXYL CREAMY WASH Benzoyl Peroxide Creamy Wash 4% QUALITATIVE AND QUANTITATIVE COMPOSITION Hydrous Benzoyl Peroxide
More informationNIGHTTIME ANTIOXIDANT
NIGHTTIME ANTIOXIDANT CLINICAL RESULTS: RESVERATROL B E 12 WEEKS RESVERATROL B E IMPROVEMENT IN FIRMNESS, SMOOTHNESS, AND OVERALL RADIANCE 12-week clinical study conducted on 55 females ages 45-60 years
More informationMaterial Safety Data Sheet
1. MATERIAL AND COMPANY IDENTIFICATION Material Nae : Uses : Autootive and industrial grease. Manufacturer/Supplier : SOPUS Products PO Box 4427 Houston, TX 77210-4427 USA MSDS Request : 877-276-7285 Eergency
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT Epiduo 0.3% / 2.5% gel 2. QUALITATIVE AND QUANTITATIVE COMPOSITION One gram of gel contains: adapalene 3 mg (0.3%) benzoyl peroxide 25
More informationHair loss checklist. 1. Hair loss patient history from received and completed
Hair loss checklist 1. Hair loss patient history from received and completed 2. Complete the attached medical release form: include all doctors that have checked lab work, performed biopsy or evaluated
More informationClient Intake Form. Name: Date: Address: City: ST: Zip: Phone:
Client Intake Form Name: Date: Last First Address: City: ST: Zip: Email: Phone: How did you hear about Skin Renew Day Spa? What are your main concerns? How long have you been experiencing your current
More informationMaya Med Spa 6330 Broadway Blvd. Suite B, Garland, TX Name: Date of birth: Address: Pharmacy of your choice:
Client Consultation Name: Date of birth: Address: Home Phone: Cell Phone: Business Phone: E-mail address: Married: Yes No If yes, anniversary date: Employer: Occupation: Pharmacy of your choice: Does your
More informationContact Information. Idaho Falls. Idaho Falls, ID (208) (307) NAME. City / state / zip
Contact Information NAME physical street address City / state / zip Home phone cell phone email address want monthly specials? date of birth Age gender Male female How did you hear about us? WHICH AREAS
More information4.3. Contraindications Hypersensitivity to the active substances or to any of the excipients listed in section 6.1.
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT Tactuo 0.1% / 2.5% gel 2. QUALITATIVE AND QUANTITATIVE COMPOSITION 1 g of gel contains: Adapalene 1 mg (0.1 %) Benzoyl Peroxide 25 mg
More informationLaser Skin Resurfacing what to expect
Laser Skin Resurfacing what to expect Laser skin resurfacing is a treatment to reduce facial wrinkles and skin irregularities, such as blemishes or acne scars. The technique directs short, concentrated
More informationPRODUCT INFORMATION BREVOXYL CREAM
NAME F THE MEDICINE Brevoxyl contains benzoyl peroxide. PRDUCT INFRMATIN BREVXYL CREAM DESCRIPTIN Benzoyl peroxide is a white powder with the following chemical structure: The compound has anti-bacterial
More informationForename Surname... SOPRANO ICE SHR LASER CONSULTATION FORM
Forename Surname... SOPRANO ICE SHR LASER CONSULTATION FORM 1 SOPRANO ICE SHR PERSONAL INFORMATION Gender: Male/Female Date of birth.age. Home address..postcode.. Telephone..Mobile.. Email address.. GP
More informationREF Rev. 4
REF 0800-8273 Rev. 4 Presentation Outline Medical Heritage Our Products Mild Moderate Acne Treatments Science and Clinical Studies Protocols Wrinkle Treatments Science and Clinical Studies Protocols Summary
More informationFor the use only of Registered Medical Practitioners or a Hospital or a Laboratory BREVOXYL HYDROPHASE. Benzoyl Peroxide Cream IP
For the use only of Registered Medical Practitioners or a Hospital or a Laboratory BREVOXYL HYDROPHASE Benzoyl Peroxide Cream IP QUALITATIVE AND QUANTITATIVE COMPOSITION Hydrous Benzoyl Peroxide IP equivalent
More informationSPECIAL TOPIC. Virginia Clinical Research, Inc., Norfolk, VA b. Oregon Dermatology and Research Center, Portland, OR c
September 2014 611 Volume 13 Issue 9 Copyright 2014 ORIGINAL ARTICLES Journal of Drugs in Dermatology SPECIAL TOPIC An Aqueous Gel Fixed Combination of Clindamycin Phosphate 1.2% and Benzoyl Peroxide 3.75%
More informationCOMMON CONTRAINDICATIONS FOR FACIALS
COMMON CONTRAINDICATIONS FOR FACIALS Ms. Wade Cosmetology Department Fullerton College PREVENTION The following conditions cannot receive a facial treatment: Viruses Bacterial Infections Fungal Infections
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Duac Once Daily 10 mg/g + 50 mg/g Gel 2 QUALITATIVE AND QUANTITATIVE COMPOSITION 1 g of gel contains: 10 mg clindamycin as clindamycin
More informationCOLORADO AESTHETIC CENTER
COLORADO AESTHETIC CENTER 9320 Grand Cordera Parkway, Suite #250 Colorado Springs, CO 719.387.7800 Skin and Health Questionnaire Please answer the following questions thoroughly, as this provides a better
More informationA novel daily moisturizing cream for effective management of mild to moderate Atopic Dermatitis in infants and children
TM Weber PhD 1, F Samarin MD 3, M Babcock MD 2, A Filbry PhD 4, C Arrowitz 1, F Rippke MD 4 1 Beiersdorf Inc., Wilton CT, USA 2 Mountaintop Dermatology, Colorado Springs CO, USA 3 Colorado Springs Dermatology
More informationEPIDUO GEL PRODUCT INFORMATION
EPIDUO GEL PRODUCT INFORMATION NAME OF THE MEDICINE EPIDUO Topical gel: 0.1% adapalene + 2.5% benzoyl peroxide Common Names: Adapalene and benzoyl peroxide Chemical Name : - Adapalene: 6-[3-(1-adamantyl)-4-methoxyphenyl]-2-naphthoic
More informationNew Zealand Datasheet
New Zealand Datasheet 1 PRODUCT NAME Epiduo 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Adapalene 0.1% / benzoyl peroxide 2.5% gel 3 PHARMACEUTICAL FORM Epiduo is a white to very pale yellow opaque gel
More informationHair Loss/Hair thinning/alopecia Patient History Form
Hair Loss/Hair thinning/alopecia Patient History Form We take hair loss very seriously due to the large impact it has on a patients quality of life. We therefore devote an alopecia clinic appointment for
More informationPatients should be given information about skin reactions and self-care strategies. A recent UK survey found that:
Summary of Interventions for Acute Radiotherapy-Induced Skin Reactions in Cancer Patients: A Clinical Guideline recommended for use by The Society and; College of Radiographers Responsible person: Rachel
More informationHOW TO USE. and make the most out of your CTCL treatment
HOW TO USE and make the most out of your CTCL treatment TARGRETIN Gel should not be used by women who are pregnant, believe they may be pregnant, or are planning to become pregnant. Please see Important
More informationThe CARI Guidelines Caring for Australians with Renal Impairment. 12. Prophylaxis for exit site/tunnel infections using mupirocin
12. Prophylaxis for exit site/tunnel infections using mupirocin Date written: February 2003 Final submission: July 2004 Guidelines (Include recommendations based on level I or II evidence) Prophylactic
More informationPackage leaflet: Information for the user. ZORAC 0.05% gel ZORAC 0.1% gel. Tazarotene
Package leaflet: Information for the user ZORAC 0.05% gel ZORAC 0.1% gel Tazarotene Read all of this leaflet carefully before you start using this medicine because it contains important information for
More informationEast Hill Medical Group
Name: of Birth: Address: City: State: Zip: Home Tel. #: Cell #: Employer: Occupation: Emergency Contact: Relationship: Phone: Email: How Referred: Parents Ethnic Background: Previous Treatments Year: Area(s):
More informationPatient Information. M.I. Address: DOB: Sex: M F City: State: Zip: Social Security Number: / / Whom may we thank for referring you?
Today's : First Name M.I. Address: DOB: Sex: M F City: State: Zip: Social Security Number: / / Home Phone: ( ) Work Phone: ( ) Cell Phone: ( ) Patient Information Last Name Email: Primary Care Physican:
More informationNEWS RELEASE. CONTACTS: Investors: Lisa DeFrancesco (862) Media: Mark Marmur (862) Ember Garrett (714)
NEWS RELEASE CONTACTS: Investors: Lisa DeFrancesco (862) 261-7152 Media: Mark Marmur (862) 261-7558 Ember Garrett (714) 246-3525 JUVÉDERM VOLBELLA XC APPROVED BY U.S. FDA FOR USE IN LIPS AND PERIORAL RHYTIDS
More informationNew Patient Registration
New Patient Registration Today s Date: Social Security Number: Name: Last First MIddle How do you like to be addressed: Date of Birth: Address: Street City State Zip Email Address: Preferred Contact Number:
More informationClient Questionnaire Skin & Health
Client Questionnaire Skin & Health Please answer the following questions thoroughly and completely, as this provides a better understanding of your general health, lifestyle and skin care concerns; thereby
More information513 Maple Ave West, Vienna, VA
CLIENT INFORMATION AND CONSENT FORM: SKIN CARE Name Date of Consultation Address City State Zip Home phone ( ) Cellular phone ( ) E-mail Date of birth Emergency contact and telephone number How did you
More informationDON T LET HAIR LOSS TANGLE YOU UP: DERMATOLOGISTS CAN IDENTIFY COMMON HAIR DISORDERS AND OFFER SOLUTIONS
Jennifer Allyn Scott Carl Allison Sit (847) 240-1730 (847) 240-1701 (847) 240-1746 jallyn@aad.org scarl@aad.org asit@aad.org FOR IMMEDIATE RELEASE DON T LET HAIR LOSS TANGLE YOU UP: DERMATOLOGISTS CAN
More informationHOW TO USE. and make the most out of your cutaneous T-cell lymphoma (CTCL) treatment
HOW TO USE and make the most out of your cutaneous T-cell lymphoma (CTCL) treatment TARGRETIN gel should not be used by women who are pregnant, believe they may be pregnant, or are planning to become pregnant.
More informationSALIBIAN MOSSI. Name Last First Middle. Address Apt. City State Zip. Home Phone Cell Phone Work Phone. Address
Name Last First Middle Address Apt. City State Zip Home Phone Cell Phone Work Phone Email Address Age Date of Birth Sex Height Weight Marital Status Drivers License # Social Security # Employer Occupation
More informationMassey Medical. Medical History (Dermal Filler) MEDICAL INFORMATION: I am interested in the following services: Juvederm: Botox:
Medical History (Dermal Filler) Name: Date: _ Date of Birth: Phone: _ MEDICAL INFORMATION: I am interested in the following services: Juvederm: Botox: NO YES Allergies history of severe allergy or anaphylaxis.
More informationWHERE HEALING HAPPENS TWO-STEP HOSPITAL-GRADE SYSTEM RADIATION SKIN CARE
AT HOME WHERE HEALING HAPPENS TWO-STEP HOSPITAL-GRADE SYSTEM RADIATION SKIN CARE Cleanses, moisturizes and protects red, irritated skin Helps protect against redness, drying and peeling Radiation Dermatitis
More informationHair Restoration Gel
Hair Restoration Gel CLINICAL STUDY Cosmetic hair tonics have been peddled for the better part of the last century, mostly in the form of inert tonics and pigmented creams that promised to restore hair
More informationTACTUPUMP. TACTUPUMP FORTE adapalene and benzoyl peroxide topical gel, 0.3%/2.5% w/w
PRODUCT MONOGRAPH Pr TACTUPUMP adapalene and benzoyl peroxide topical gel, 0.1%/2.5% w/w TACTUPUMP FORTE adapalene and benzoyl peroxide topical gel, 0.3%/2.5% w/w Acne Therapy GALDERMA CANADA INC. 55 Commerce
More informationPearl Fusion Technique
Pearl Fusion Technique Combined Treatment Advanced Technique General Considerations The Pearl Fusion Technique is an advanced procedure intended for operators with previous knowledge and experience with
More informationFor Acne Vulgaris, A Topical Gel Treatment For Dermatologic Use
For Acne Vulgaris, A Topical Gel Treatment For Dermatologic Use ERYGEL (Erythromycin) Topical Gel USP, 2% Please see Important Safety Information on back page and accompanying Full Prescribing Information.
More informationImbue Aesthetics & Wellness PATIENT REGISTRATION FORM
Today's Date Legal Name Marital Status Sex DOB Age Mailing Address Preferred Phone Number Email Do we have your permission to add you to our email list to receive newsletters and promotions? YES NO Emergency
More informationStiefel Canada. Inc. The Leader in Canadian Dermatology. Talking with Richard MacKay, President, Stiefel Canada Inc.
Stiefel Canada Inc. The Leader in Canadian Dermatology Talking with Richard MacKay, President, Stiefel Canada Inc. Please review your career path leading to your present position as President of Stiefel
More informationChemical Inspection and Regulation Service (CIRS)
Guidance on Exporting Cosmetics to China April Guo, Regulatory Affairs Specialist for Cosmetics and Cosmetic Ingredient, april.guo@cirs-reach.com Chemical Inspection and Regulation Service (CIRS) 27 June
More informationThe hair follicle is preserved. Therefore, hair regrowth is always possible.
WHAT ARE THE DIFFERENT TYPES OF HAIR THINNING? NON-SCARRING types of hair thinning are due to changes in your hair cycle, hair follicle size, hair breakage, or a combination of these changes. The hair
More informationAreas of Concern. Patient s Name Last First Date
Areas of Concern What are your main concerns for today s visit? Please check the problem areas that concern you. Include anything you wish to discuss, even if it is not the main reason for your visit.
More informationENERPEEL SPECIALIST IN PEELS. Advanced Chemical Peel Systems for younger, healthier looking skin
ENERPEEL SPECIALIST IN PEELS Advanced Chemical Peel Systems for younger, healthier looking skin PROFESSIONAL Modern Approach to Exfoliation MAXIMIZE RESULTS MINIMIZE DOWNTIME STRONG EFFICACY BETTER TOLERABILITY
More informationVTCT Level 3 NVQ Award in Airbrush Make-Up
VTCT Level 3 NVQ Award in Airbrush Make-Up Operational start date: 1 November 2011 Credit value: 8 Total Qualification Time (TQT): 80 Guided learning hours (GLH): 62 Qualification number: 600/3448/8 Statement
More informationROSACEA. Marie Piantino
ROSACEA Marie Piantino WHAT IS ROSACEA? Rosacea is disorder involving chronic inflammation of the cheeks, nose, chin, forehead, or eyelids; it may cause redness, vascularity (increased prominence of the
More informationClinical Policy: Lindane Shampoo Reference Number: CP.PMN.09 Effective Date: Last Review Date: Line of Business: Oregon Health Plan
Clinical Policy: Lindane Shampoo Reference Number: CP.PMN.09 Effective Date: 10.01.18 Last Review Date: 07.13.18 Line of Business: Oregon Health Plan Revision Log See Important Reminder at the end of this
More informationTHE SCIENCE WHITE PAPER SERIES OF IMAGE SKINCARE: by Marc A. Ronert MD PhD, Clinical Director Image Skincare
THE SCIENCE WHITE PAPER SERIES OF IMAGE SKINCARE: Clear Cell Line containing Benzoyl Peroxide by Marc A. Ronert MD PhD, Clinical Director Image Skincare ABSTRACT Image Skincare offers products with many
More informationDate: Date of Birth: Gender: Male Female. City: State: Zip: Caucasion a African-American Hispanic Asian East Indian American Indian
Contact Information: Date: Date of Birth: Gender: Male Female Name: Address: City: State: Zip: Home Phone: Work/Day Phone: Cell: Email: Emergency Contact: Emergency Contact Phone: Medical Background Ethnic
More informationMULTICENTER CLINICAL AND INSTRUMENTAL STUDY FOR THE EVALUATION OF EFFICACY AND TOLERANCE OF AN INTRADERMAL INJECTABLE PRODUCT AS A FILLER AND A
MULTICENTER CLINICAL AND INSTRUMENTAL STUDY FOR THE EVALUATION OF EFFICACY AND TOLERANCE OF AN INTRADERMAL INJECTABLE PRODUCT AS A FILLER AND A BIOREVITALIZER FOR THE AGING FACE PURPOSE Aim of the study
More informationCLIENT QUESTIONNAIRE
CLIENT QUESTIONNAIRE YOUR INFORMATION Name Age DOB Address City State Zip Home Phone Cell Phone Email MEDICATIONS Medication When How Long Medication When How Long Antibiotics Androstendione Accutane Testosterone
More informationDUAL ACTION LOGO. Quinoderm 10% / 0.5% w/w Cream Benzoyl Peroxide, hydrous / Potassium Hydroxyquinoline Sulfate
DUAL ACTION LOGO Quinoderm 10% / 0.5% w/w Cream Benzoyl Peroxide, hydrous / Potassium Hydroxyquinoline Sulfate Read all of this leaflet carefully before you start using this medicine because it contains
More informationISOTREX GEL Isotretinoin 0.05% w/w
ISOTREX GEL Isotretinoin 0.05% w/w Consumer Medicine Information What is in this leaflet Please read this leaflet carefully before you use Isotrex Gel. This leaflet answers some common questions about
More informationLisa Chipps, MD, MS, FAAD Assistant Clinical Professor David Geffen School of Medicine at UCLA
Lisa Chipps, MD, MS, FAAD Assistant Clinical Professor David Geffen School of Medicine at UCLA Presented at The American Academy of Facial Plastic and Reconstructive Surgery Meeting, September, 2011 Provided
More informationCTEC School of Beauty Prospectus
Excellence in Training 2011 A thing of beauty is a joy for ever: Its loveliness increases; it will never pass into nothingness. John Keats (1795-1821) CTEC, Norse Gate House, St. Peter s Square, Wexford
More informationAntiaging Treatments. Natalia Jiménez. Hospital Universitario Ramón y Cajal Grupo de Dermatología Pedro Jaén
Antiaging Treatments Natalia Jiménez. Hospital Universitario Ramón y Cajal Grupo de Dermatología Pedro Jaén Background A statistically significant increase in the epidermis and papillary dermis thickness
More informationTea tree oil gel for mild to moderate acne; a 12 week uncontrolled, open-label phase II pilot study
Australasian Journal of Dermatology (2017) 58, 205 210 doi: 10.1111/ajd.12465 ORIGINAL RESEARCH Tea tree oil gel for mild to moderate acne; a 12 week uncontrolled, open-label phase II pilot study Harsimran
More informationACCUTANE SKIN RASH HANDS
ACCUTANE SKIN RASH HANDS Accutane Skin Rash Hands Accutane of doses small Accutane drink can i on wine while Accutane and irritable bowel disease Accutane itchy ears and Depression effect tests newsletter
More informationFor the use only of a Registered Medical Practitioner or a Hospital or a Laboratory OILATUM EMOLLIENT. Light Liquid Paraffin Emollient
For the use only of a Registered Medical Practitioner or a Hospital or a Laboratory OILATUM EMOLLIENT Light Liquid Paraffin Emollient QUALITATIVE AND QUANTITATIVE COMPOSITION Light Liquid Paraffin IP Base
More informationConsultation Form: AHA Chemical Peel
Consultation Form: AHA Chemical Peel NAME: ADDRESS: TELEPHONE NUMBER: DATE OF BIRTH: EMERGENCY CONTACT: EMAIL ADDRESS: OCCUPATION: DOCTORS NAME/SURGERY: We aim to ensure clients have the best possible
More informationPackage leaflet: Information for the patient. Epiduo 0.3% / 2.5% gel adapalene / benzoyl peroxide
Package leaflet: Information for the patient Epiduo 0.3% / 2.5% gel adapalene / benzoyl peroxide Read all of this leaflet carefully before you start using this medicine because it contains important information
More informationWe understand that a competitor has raised the following issues which we will address in this letter.
March 01, 2010 Dear Customer, Thank you for your recent inquiry into PURELL Waterless Surgical Scrub. PURELL is an effective surgical scrub formulation that meets the requirements of the surgical scrub
More informationArbonne Intelligence Genius Ultra
Arbonne Intelligence Genius Ultra Arbonne Intelligence Genius Ultra Arbonne skincare products are formulated with the best of science and nature to deliver youthful and luminous-looking skin. Our clinically
More informationClear Proof Acne System
Clear Proof Acne System What You Should Know About Clear Proof Acne System: What products are in the regimen. What is the regimen Power Statement. What results did people see. What did people have to say
More informationEpiCeram Topical therapeutic Skin Barrier Emulsion
EpiCeram Topical therapeutic Skin Barrier Emulsion PEDIAPHARM INC. Date of preparation: August 31, 2010 Summary Product Information: EpiCeram Skin Barrier Emulsion is a steroid-free, fragrance - free,
More informationResults Clinical Photography
A High-Strength Retinol Serum Enhanced with N-Acetyl Glucosamine Provides Significant Anti-Aging Effects in Combination with a Comprehensive Skincare Regimen Joel Schlessinger, MD ; Brenda L. Edison, BA
More informationThe Natrelle ConfidencePlus Warranty Program
WARRANTY The Natrelle ConfidencePlus Warranty Program Offering you more coverage for your peace of mind Nikki Natrelle INSPIRA Responsive Style SRF-415 Individual results may vary. Please see inside for
More informationPlan and provide airbrush make-up
Plan and provide airbrush make-up T/600/8755 Learner name: Learner number: VTCT is the specialist awarding body for the Hairdressing, Beauty Therapy, Complementary Therapy and Sport and Active Leisure
More informationComplete Dermal Integration. Proven Duration.
Complete Dermal Integration. Proven Duration. Introducing BELOTERO BALANCE Dermal Filler. BELOTERO BALANCE Dermal Filler is uniquely manufactured with CPM Technology to give you precision to treat a wide
More informationChemical Peels Corporate Medical Policy
Chemical Peels Corporate Medical Policy File Name: Chemical Peels File Code: UM.SURG.13 Origination: 08/2016 Last Review: 10/2018 Next Review: 10/2019 Effective Date: 01/01/2019 Description/Summary A chemical
More informationDr. Abbasi Hair Clinic
Dr. Abbasi Hair Clinic Surgical Treatments 1. Scalp flaps: Transferring a hair bearing part of scalps to the bald area. 2. Reducing the extension of the bald area by surgical methods. 3. Planting artificial
More informationRodan + Fields Dermatologists Skincare Changing skin and changing lives. The Perfect Partnership
Rodan + Fields Dermatologists Skincare Changing skin and changing lives The Perfect Partnership Why partnering with Rodan + Fields is the right choice Services currently provides: Hair Services Hair Removal
More informationPRODUCT INFORMATION DALACIN T TOPICAL LOTION NAME OF THE MEDICINE DESCRIPTION PHARMACOLOGY. DALACIN T clindamycin 1% (10 mg/ml) (as phosphate) lotion.
PRODUCT INFORMATION DALACIN T TOPICAL LOTION NAME OF TE MEDICINE DALACIN T clindamycin 1% (10 mg/ml) (as phosphate) lotion. The chemical name for clindamycin phosphate is methyl 7-chloro-6,7,8-trideoxy-6-(1-methyl-
More information(Injection of collagen, hyaluronic acid or other filler materials) INFORMED CONSENT FOR DERMAL FILLER
INFORMED CONSENT FOR DERMAL FILLER (Injection of collagen, hyaluronic acid or other filler materials) INTRODUCTION Dermal fillers are injected just under the skin s surface in order to temporarily correct
More informationTATTOOING, BODY PIERCING, PERMANENT COSMETICS & BRANDING APPLICATION FOR REGISTRATION
TATTOOING, BODY PIERCING, PERMANENT COSMETICS & BRANDING APPLICATION FOR REGISTRATION 1. GENERAL PRACTITIONER INFORMATION New Registration Annual Registration Updated Registration FULL LEGAL NAME (Give
More informationConsultation Form: Coffeeberry Peel
Consultation Form: Coffeeberry Peel NAME: ADDRESS: TELEPHONE NUMBER: DATE OF BIRTH: EMERGENCY CONTACT: EMAIL ADDRESS: OCCUPATION: DOCTORS NAME/SURGERY: We aim to ensure clients have the best possible advice
More informationReference ID: CONTRAINDICATIONS None. (4)
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use EPIDUO Gel safely and effectively. See full prescribing information for EPIDUO Gel. EPIDUO (adapalene
More informationCOURSE #: COS 3101 TITLE: Manicurist SEMESTER: Varies INSTRUCTOR: M. Cole
COURSE #: COS 3101 TITLE: Manicurist SEMESTER: Varies INSTRUCTOR: M. Cole COURSE DESCRIPTION This course provides the necessary training for students wishing to enter the field of manicuring. Upon completion
More informationVTCT Level 2 NVQ Award in Providing Pedicure Services
VTCT Level 2 NVQ Award in Providing Pedicure Services Operational start date: 1 December 2011 Credit value: 6 Total Qualification Time (TQT): 60 Guided learning hours (GLH): 53 Qualification number: 600/3926/7
More informationAREA OF BODY TATTOO IS SITUATED?
CLIENT CONSULTATION LASER TATTOO REMOVAL FORM Address: Date of Birth: Suburb: State: Postcode: Telephone: Work: Mobile Home: Other: Email Address: How did you hear about us? Tattoo Removal Colours in tattoo
More informationThe solution contains isopropyl alcohol 50% v/v, propylene glycol, and water.
Cleocin T (clindamycin phosphate topical solution, USP) (clindamycin phosphate topical gel) (clindamycin phosphate topical lotion) For External Use DESCRIPTION CLEOCIN T Topical Solution and CLEOCIN T
More informationType of Application (Check One) New Protocol Revised Protocol Project Duration Start Date: End Date:
Page 1 of 11 INSTITUTIONAL BIOSAFETY COMMITTEE Winston-Salem State University Application for the Use of Biohazardous Materials, Recombinant DNA and Infectious Agents 1. APPLICANT INFORMATION Assigned
More informationPackage leaflet: Information for the patient. Duac Once Daily 10mg/g + 50mg/g Gel clindamycin + anhydrous benzoyl peroxide
Package leaflet: Information for the patient Duac Once Daily 10mg/g + 50mg/g Gel clindamycin + anhydrous benzoyl peroxide Read all of this leaflet carefully before you start using this medicine because
More informationAlthough clindamycin phosphate is inactive in vitro, rapid in vivo hydrolysis converts this compound to the
APPROVED PACKAGE INSERT SCHEDULING STATUS:S4 PROPRIETARY NAME AND DOSAGE FORM: DALACIN T ( Solution) DALACIN T (Lotion) COMPOSITION: DALACIN T Solution contains the following per ml : Clindamycin phosphate
More information