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Suggestions for Preparing a Keratolytic Ointment for Symptomatic Treatment of Discomfort & Cracking Associated With Keratosis in Arsenic Patients. 

Anonymous, 2003.

[The following suggestions are provided for thought and discussion. This is not medical advice and no claim is made by ACIC/ACN, nor by the authors (whom I have left unindentified intentionally) for the ointment described here. Before using this or any other treatment or medicine, you or your organization should get your own medical advice on your specific situation. In any case, this ointment only helps to manage the discomfort and cracking associated with keratosis. It does nothing to treat the cause of the keratosis - arsenic ingestion - for which provision of arsenic-free water and food are essential. - Ed.]

Patients suffering from arsenicosis often have keratosis (hardening) of the palms and / or soles. If cracking occurs, then infection can get in. Also, hard hands or feet can make it difficult for someone to work. For these reasons, applying an ointment to make the hands and feet softer can be very helpful.

During the training course "Arsenic in Bangladesh" at ITN / BUET on the 19th of May 2002, Dr. Abul Hasnat Milton of the NGO Forum and Dr. Quamruzzaman of Dhaka Community Hospital each presented a paper on the health effects of arsenic. They mentioned a keratolytic ointment of 20% urea and 10 - 20% salicylic acid in cream or Vaseline.

When we tried to make some for ourselves, we experienced difficulty in finding out exactly how to go about it. These suggestions are offered to help others who are not medical professionals in case they also would like to make some of this ointment.

We decided to make the following mixture:

Urea 20% 500 grams Salicylic acid 10% 250 grams Vaseline 70% 1,750 grams Total weight 100% 2,500 grams

We purchased the urea and salicylic acid in bulk in the Tikatoly section of Dhaka. There are a number of scientific suppliers in that area. It is good to "shop around" to see who has the most recent stock and best prices. We purchased 500 grams of urea (in granular form) for Taka 400 ex Loba Chemie (Mumbai). We purchased 500 grams of urea (in powder form) for Taka 350 ex Loba Chemie (Mumbai).

The minimum quantity available was 500 grams. European brands were also available, but they were double the price. We were told that the quality of the Indian product was just as good.

We later purchased the Vaseline in bulk from a wholesale market in the district town near where we were working. It cost only a few hundred taka. Packaged Vaseline ex the Middle East or Europe in Dhaka would have been much more expensive. In purchasing Vaseline locally in bulk supply, it is important to ensure that the Vaseline is pure.

We then mixed the urea and salicylic acid into the Vaseline in a clean plastic bucket using a stainless steel spoon. Finally, we transferred approximately 100 grams of the ointment into 24 small plastic containers to give to the patients at a village clinic. We found that the urea did not dissolve totally in the Vaseline. It is suggested that the urea be ground into powder beforehand for smoother mixing.

Alternatively, there is a company in Dhaka that probably can both supply the ingredients and mix them professionally.

BHAM & CO, Chemists & Druggists, bhamco @ hotmail.com, 7, BangaBandhu Avenue, Dhaka - 1000. Tel 955-3354


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