Bhardwaj, A. Bhardwaj, M. Bharti, N. Bhasin, K. Bhaskar, C. Bhat, Satish S. Bhat, Manoj K. Bhat, Akshay U. Bhat, Sujata V. Bhat, Monita Bhat, S. Bhat, Udaya K. Bhat, Santoshkumar D. Bhat, Tejasvinee Bhat, Sachin A. Bhatia, Varsha Bhatkhande, Dhananjay S. Bhatnagar, A Bhatnagar, A. Bhatt, Kandarp Bhatt, Harshad B. Bhatt, Chandra S. Bhatt, Pramod Bhatta, Umananda M.
Bhattacharjee, Chira R. Bhattacharya, Asish K. Bhattacharya, Rahul Bhattacharya, S. Bhattacharya, A. Bhattacharyya, Arnab S Bhattacharyya, D. Bhavnani, Varsha Bhavnani, V. Bhavsar, Rupesh S. Bhavsar, Kavita P. Bhavsar, Ritesh A. Bhavsar, Ghanashyam A. Bhavsar, Kavita Bhavsar, K.
Bhelkar, Yugandhar Bhide, Amey J. Bhide, Rajesh Bhide, Sunil R. Bhirud, Ashwini Bhise, Ankushkumar D. Bhise, Ashok B. Bhogade, Ravindra B. Bhoite, Shubhangi P. Bhoite, Nitin Bhoite, Ashwini S. Bhonde, Ramesh R. Bhonsle, Hemangi S. Bhopale, Somnath R.
Bhor, Renuka Bhoraskar, Vasant N. Bhoraskar, S. Bhoraskar, Y. Bhoraskar, V. Bhoraskar, Sudha V. Bhorde, Ajinkya Bhosale, Siddharth H. Bhosale, Manik E. Bhosale, Reshma Bhosale, Shivaji V. Bhosale, R. Bhosale, Vikas K. Bhosale, Reshma K. Bhosale, Shrikar M. Bhosale, Santosh D. Bhosale, Popatrao N. Bhosale, Jitendra D. Bhosale, Dattatry S. Bhosale, Sidhanath V. Bhosale, P. Bhosale, Raghunath Bhosale, Manik E.
Bhosale, Rahul R. Bhosale, Sumedha Bhosekar, Gaurav V. Bhosle, Govind S. Bhosle, Sonali Madhavrao Bhosle, S. Bhosle, Manisha R. Bhosle, S. Bhosle, G. Bhoware, Shrikant S. Bhowmick, Ananya Bhowmick, R. Bhoyare, Vivek W.
Bhujbal, Swapnil V. Bhukya, Hussain Bhuma, N. Bhunia, A. Bhuniya, Debnath Bhure, Mahesh H. Bhusare, Bhushan Bhusare, B. Bhusari, Vidhya K. Bhuse, V. Bhute, Shrikant S. Bielenberg, Diane R. Biju, S. Biju, A. Biradar, Ankush V. Biradar, Narayan S. Biradar, Pradeep S.
Biradar, Satish C. Biradar, Santoshkumar S. Biradar, A. Biradar, N. Biradha, Kumar Birajdar, Shobha N. Birajdar, Mallinath S. Birajdar, Rajkumar S. Biring, Sajal Biring, S. Birjiniuk, Alona Birnie, Dunbar P. Biswal, Mandakini Biswal, B. Blackburn, William H. Blake, Alexander J. Blanchard, P. Blanco, Ignazio Blumich, B. Blundell, Tom L. Bock, Martin Bocobza, S. Bodake, Anita J. Bodas, Dhananjay S. Bodas, Mandar S. Bogush, A. Bohara, R. Bohara, Raghvendra A. Bohlmann, W.
Bohringer, Walter Boidot, R. Bojja, Sreedhar Bokade, Vijay V. Bokade, Vijay Bokade, Vijay V. Bokade, V. Bokare, Alok D. Bora, Mayuri Borade, P. Borade, Balasaheb R. Borade, Nandkumar A. Borhan, Babak Boricha, Vinod P. Borikar, Sanjay P. Borkar, Vivek Borkar, V. Borole, O. Bouckaert, Julie Boudon, J. Bougouma, Moussa Boukheddaden, K. Boukherroub, Rabah Boukherroub, R. Boyd, D. Boyd, Kevin J. Branquinho, R. Brans, Toon Bratcher, Matthew S.
Braun, H. Briggs, Michael E. Briggs, Michel E. Bright, John R. Brindha, Velappan Britto, Virginia D. Brocord, E. Brookhart, Maurice Brougham, Dermot F. Browning, Nigel D. Bruckner, Angelika Brulet, A. Bruneau, C. Bulakh, Neelima N. Bulakhe, Ravindra N. Bulani, Dinesh Bulbule, Vivek J. Bulsara, B. Bundale, Sunita Burade, S. Burade, Sachin S. Burade, Sachin Burange, Anand S. Burate, Pralhad A.
Burdman, Saul Buriak, Jillian M. Burman, Anand C. Burnus, T. Butcher, Raymond J. Buwa, V. Campet, Guy Campos, Luiza C. Campos, L. Candeias, Nuno R. Cao, Wudi Caperaa, N. Cardenas, P. Carle, Reinhold Carmona, Santiago J. Carreon, Moises A. Carvalho, Thais C. Casale, S. Cassidy-Hanley, Donna M. Cejka, J Cejka, J. Chae, K. Chahande, Anurag M. Chaitanya, K. Chakkarambath, Aswathy Chakor, N. Chakrabarti, A. Chakrabarti, Ranjan Chakrabarti, Swarup K. Chakrabarti, S. Chakrovorty, Debamitra Chamachi, Neharika G.
Chamachi, N. Champness, Neil R. Chamundeswari, V. Chanale, Jyoti Chand, Hemender R. Chanda, B. Chanda, N. Chanda, Bhanu M. Chanda, Anupama Chandak, Hemant S. Chandgude, Macchindra G. Chandra, S. Chandra, Tilak Chandrachood, Pranav S. Chandrakar, P.
Chandrakesan, Muralidharan Chandrakumar, K. Chandrakumar, Narayanan Chandralekha, A. Chandramohanadas, Rajesh Chandran, Jima N. Chandran, Nikhil M. Chang, J. Charate, Shrinivas P.
Charpe, Vaibhav P. Chary, K. Chary, Kandala V. Chaskar, Manohar G. Chate, P. Chatterjee, S. Chaturvedi, Hema T. Chaudhari, Nilima S. Chaudhari, Nilima Chaudhari, Harshal D. Chaudhari, Priti N. Chaudhari, Shivani Chaudhari, Hemantkumar S. Chaudhari, N. Chaudhari, Chandan S.
Chaudhari, Amit S. Chaudhari, Sudeshna Chaudhari, Sopan T. Chaudhari, P. Chaudhari, Nitin K. Chaudhari, Vinod D. Chaudhari, R. Chaudhari, Sanjeev Chaudhari, Bhushan P. Chaudhari, Vrushali Chaudhari, V. Chaudhari, Vijay R. Chaudhari, Vijay Raman Chaudhari, H. Chaudhari, Bhushan Chaudhari, B. Chaudhari, Ravindra D. Chaudhary, Preeti M. Chaudhury, S. Chauhan, A. Chauhan, Nar Singh Chauhan, R. Chauhan, C. Chaure, Nandu B. Chaure, N. Chavan, Nayaku Chavan, Subhash P.
Chavan, Santosh S. Chavan, Pramod V. Chavan, Prakash N. Chavan, Prakash D. Chavan, Pradnya S. Chavan, Padmakar G. Chavan, P. Chavan, Pooja Chavan, Rank N. Chavan, S. Chavan, Sanjay T. Chavan, Vilas B. Chavan, Pradnya Chavan, Santosh B. Chavan, Sayalee R. Chavan, V. Chavan, Sachin G. Chavan, Sanjay Chavan, Hemant V.
Chavan, N. Chavan, Abhijit P. Chavan, Sakalya Chavan, P. Chavan, Rahul B. Chavan, Sandeep Chavan, Prakash V. Chavan, Nayaku N. Chavan, G. B Chavan, S. Chawla, Amit Chaya, Patil S. Cheekuramelli, N. Cheh, Albert M. Chen, C. Chen, J Chen, J. Cheney, Miranda L. Chevrier, S. Chhabda, Pavan J. Chhatbar, Mahesh U. Chhatre, Shraddha Chhatre, Shraddha Y. Chherawalla, Batul M. Chidambaram, Hariharakrishnan Chidley, Hemangi G. Chidley, Hemangi Chidley, H. Chien, J. Chiessi, Ester Chikate, Yojana R.
Chikate, Rajeev C. Chikate, Y. Chikate, Rajeev Chikate, R. Chikhalikar, Kalyani Chikkala, Suresh K. Chikkali, Samir H. Chikkali, S. Chilka, A. Chilka, Amarvir G. Chilukur, Satyanarayana Chilukuri, Satyanarayana V. Chilukuri, Harsha Chilukuri, V. Satayan Chilukuri, Satyanarayana Chilukuri, H. Chimote, Geetanjali Chimote, M. Chinchansure, Ashish A. Chincholkar, Pinak M. Chinnathambi, Arunachalam Chintawar, Chetan C. Chirgadze, Dimitri Chirmade, T.
Chithiravel, Sundaresan Chithiravel, S. Chithra, P. Chitikeshi, Harshavardhan Chitre, T. Chitre, Trupti S. Chittiboyina, A. Chkraborty, B. Chopade, Anil U. Chopade, Manojkumar U. Chopade, Balu A. Chopade, M.
Chopra, Deepak Chopra, S. Chopra, Sidharth Chorghade, Mukund S. Chorghade, V. Chou, S. Choubey, A. Choudhari, P. Choudhari, Prafulla B. Choudhari, Amit S. Choudhari, Amit Choudhari, A. Choudhary, S. Choudhary, Ram J. Choudhary, Arindam Choudhary, R. Chougale, Sanket Chougale, A. Chougule, Nanasaheb P. Chougule, B. Chougule, Rahul R. Chougule, S. Chowdhury, P. Chowdhury, D. R Chowdhury, S.
Chu, Zhen T. Chu, Trang T. Chulliyil, Ramya Chumbhale, Vilas R. Chunchu, Venkatrao Chundawat, Shishir P. Chundawat, T. Clapham, D. Clark, Theodore G. Co, A. Codjovi, E. Coffinier, Yannick Coffinier, Y. Coimbra, Joao T. Collin, B. Collins, Terrence J. Cooper, Andrew I. Coq, Bernard Corbin, David R. Counsell, Jonathan Coutinho, Evans C. Cowling, Stephen J. Coyne, Robert S.
Creton, Costantino Cristol, S. Cronin, Nora B. Crowther, Gregory J. Cutignano, Adele Cygnet, Choorapoikayil T. Da Silva, J. Dabhi, Raju Dacks, Joel B. Dacquin, J. Dadwal, Arun Dadwal, A. Dadwal, Arun H. Dahiwale, S.
Dahiya, Sumit Daima, Hemant K. Dairi, Tohru Dakshinamoorthy, D. Dalai, Sayli Dalai, P. The PB cases showed maximum chromosomal abnormalities. Among the 30 patients. They come under the age group of years.
The occupation of many of the patients were agriculture. The genetic disorder seen in the patients may also be influenced by environmental factors. Sixty two paucibacillary cases were randomly selected within the age group of years, and put on two different multidrug regimen for 6 months. Regimen I was according to WHO recommendations consisting of Dapsone daily and six once a month rifampicin. In regimen II in addition to above two constituents, clofazamine was added 50mg per day in adults and doses according to body weight in children.
The efficacy, acceptability and side effects of MOT were observed for a period of one year. Clinical and histopathological assessment was dene, on completion of MDT and there after every 3 months up to end of one year in all cases.
A comparative evaluation of effects of two multidrug regimen in paucibaciUary leprosy patients is reported. Addition of clofazimine over WHO reccrnmended regimen appears to have marginal benefit with regard to period of inactivation, disease regression and incidence of reactions.
A study performed on tuberculous patients prcv lously treated with several courses of chemotherapy but remain sputum positive, draw the attention of using other drugs. Marked improvement in vivo of mam of the chronic cases was noticed and sumo became sputum negative. The significance of the results and effects of die aminoglycosides on Mycoba.
Leprea will be reported and discussed. Oliveira MLW. Gomes HM. Gallo MEN. Nery JAC. Cunha MGS. Leprosy Unit. In order lo evaluate the magnitude of relapses and their risk factors associated, a study both current and retrospective was undertaken. Although the fall in BI average showed some differences according to high BI, clinic form, and treatment scheme, the follow-up evaluation 49,62 to 58,17 months didn't show any significant differences.
The relapse result was 0. Both groups present less reactions during and alter treatment A prospective study is need in order to confirm this association. In view of these reports a pilot experimental study has been undertaken to demonstrate the effect of hydnocarpus in experimentalis inflicted wounds on male Wistar rats. The wound healing effect of hydnocarpus is studied with reference to the collagenation.
Detection of viable M. Leprae by sensitive laboratory techniques in patients who have completed MOT is generally interpreted as an indication for re-treatment with MDT or administration of even newer drugs.
In , BI: 4. Biopsy of skin and nerve in April showed regressing LL. Bl of 4. Skin and nerve biopsies ai RFT revealed growth of M. Leprae in the mouse foot pad. Patient has not relapsed so far. In after 8 years absence 81 was 4. Biopsy of skin and nerve at this stage showed regressing BL. Bl was negative in and growth of M. Leprae was reported in the mouse foot pad. In both these cases, we are presumably dealing with dormant "persisters" which have not multiplied leading to clinical and bacteriological relapse.
However, in view of stray reports of late relapses in patients with high Bl, we advocate observation of such patients for a longer period. Leprosy like any other myco-bacterial disease cannot be devoid of relapses. Initial BI of relapsed cases was 1 to 4. Skin smears were negative at RFT except one case. All the cases remained clinically inactive and bacteriologically negative during surveillance. Relapses were observed after a period of 4 to 13 years after RFT.
Relapses were confirmed by clinical, bacteriological and histopathological investigations. All were HIV negative. In 6 cases mouse foot pad studies showed growth of viable bacilli.
These relapses, we consider, are due to the 'persister' bacilli rather than to development of drug resistant strains to all the drugs employed, which is a very rare phenomenon.
Relapse in leprosy is generally considered to be due to multiple drug resistance and clinicians often resort to newer drugs or arbitrary regimens. We believe that the relapses after MDT should be managed with the same course of treatment. In this paper the authors analysed the efficacy of the regimen with which MB caces were treated. Out ol the leprosy cases, were newly diagnosed or relapsed cases without previous treatment or only treated less than 6 months before MDT group A , and cases were same cases mentioned but previously treated with DDS monotherapy for a certain period of time before MDT group B.
The average BI value in group A was 2. The average BI value in group B was 2. The average time needed to reach the negativity of skin smear was There was no statistical significance regardiing the time needed to reach skin smear negativity among mentioned 4 categories of patients. Relapses were also monitored annually after completion of MDT and no relapse was delected in a total of person years of follow up.
The authors believed that the regimen were very effective in treatment of MD cases with a very low relapse rate, although they understand that not all MB cases should be treated until skin smear became negative. Single dose treatment of single lesion PB leprosy with a combination of nfampicin R , ofloxacin O and minocycline M is being practised gradually by the leprosy programmes.
The following table summarises the events relating to a 45 years old female patient with a raised single lesion PB leprosy on left forearm. In December , she reported with reaction of old lesion along with a erythematous and raised new lesion on dorsum of left foot She was treated with chloroquine. Skin biopsy of both lesions showed tuberculoid granuloma negative for AFB.
In November , 40 mg steroid was started to differentiate between type-1 reaction and relapse. The old lesion on forearm showed regression. However, the new lesion did not show any change except slight change in erythema. The patient is under steroid to decide about possible relapse. The results of Ofloxacin containing combined drug regimens in the treatment of 60 multibacillary leprosy cases from January to February are reported.
The objective of the trial is to compare the antileprotic property of ofloxacin and ripampicin in multbacillary leprosy patients and to study the killing rate of M. The complications and side-effects of ofloxacin and rifampicin were of a mild nature and both drugs were well tolorated. Moderate to marked clinical improvement was noticed in a short period with Ofloxacin containing regimens in multibacillary Leprosy patients.
No persisters were detected in any of the 33 specimens of mouse footpads that had been obtained after treatment for 6 months.
The results were evaluated on the basis of the clinical conditions mycobactericidal effectiveness, sings of drug toxicity and side effects. The paper reported the activity of minocycline on agaisnt M. The results showed that using the kinetic method, the growth delay of M. The clilical improvements such as softening and flattening of the nodules and plaques in the patients were found as early as 1 week after starting treatment.
At the end of trial, significant clinical improvement was found in all patients. The average MI decreased from 8. Of 8 cases tested by mouse foot-pad one month after starting treatment, viable M. Mild ENL and one mild skin reversal reaction developed in 2 and 1 cases respectively during the trial. All patients had slight brownish pigmentation on exposed skin lesions, but the patients tolerated the drug well during the trial.
The results suggested that minocycline was proved effective and safe against leprosy and could be used in leprosy chemotherapy. Department of Internal Medicine. Fourteen cases, 7 men and 7 women aged 16 to 64 years, nine of them murtibacillary and five paucibaciliary, were observed.
Symptoms characteristically started 35 minutes to 3. We observed more than one organ or system were frequently involved. Eleven patients were cured, two developed mild to moderate chronic renal failure, and one patient died. We emphasize the frequency of the combined involvement of various organs and the importance of the early recognition of adverse reactions to rifampin. Ajeet Sodhi, Dr. Chaturvedi, Dr. Mishra, Miss, Anchal, Dr. Hering Homoeopathic Hospital.
Leprosy is a Chronic granulomatous disease caused by Mycobactrium leprae. The immune system is not confined to single site in the body : rather governed by central motor nervous system, immunocytes and their secreted molecules traffic within and among lymphoid organs and various body compartments.
Hence a highly complex system of communication has developed among the various cell types in the immune system. Homoeopathic medicines determine the pattern of chemical transformation in biological system, catalysed by specific proteinaceous macromolecules called 'enzymes'. The antigen combining regions of most of the high affinity anti bodies are encoded by immunoglobulin genes which acquire somatic mu tations.
Serum levels of the immunoglobulins generally are normal in tuberculoid leprosy patient, whereas polyclonal hypergammaglobulinemia is a common feature Of lepramatous leprosy. The homeopathic medicines like Hura brazilienses and Hepersulf have been found to cause reduction in lymphoid swelling and levels of gamma globulins. These medicines irreversebly bind to collagens and are, therefore, are targeted to the infected cells. Hura braziliensis and Hepersulf proposed to be new antileprae drugs, having recently met first phase of clinical trials.
The initial results are promising, however, further studies are still awaited. The control period, after the MB patient was released from treatment, was 5 years; and for the PB patient, years. The observation is that the relapses by MB is presented between years after release of MDT , and none during the conventional control period. The relapse rate in this period is, therefore, globally 1.
All the patients were exam meted clinically and bacteriologically once a year for five years. At the end of the study, relapse rales in three groups were compared. The results showed that in the first scar of monitoring, the positive rate of PGL-IgM antibody gradually increased in patients at the pole of tuberculoid leprosy towards the pole of lepromatous leprosy, and the shorter the time after cure, the higher the positive rate was.
In the period of 5 years, 20 relapsed cases were detected 16 Four hundred and eighty seven of them were males and were fermales Their age ranged from 17 to 70 years and disease duration ranged from 1 month to 39 years.
Cured individuals not re-treated were used as control for this trail. This treatment was continued for 12 months and was completed within a period of 15 months.
Six hundred and twenty cases Exclusive of 2 who died and 1 migrated out of Shanghai after completion of re-treatment, the remaining were followed uo for a period of years cases for more than 12 years and the total follow up period was 8 person years, no relapses occurred. But there were 23 identified as relapses among the control individuals, giving an overall relapse rate of The authors suggested that for a more reliable conclusion, these cases should and will be followed up until 20 years after completion of re-treatment.
Serum samples were taken before reaction, at reaction and during antireactional treatment in a prospective study. Four patients with reversal reaction RR and one patient with several episodes of ENL and one episode of neuritis were studied. Levels decreased or normalized during antireactional treatment with prednisone. In general, patients in reaction showed elevation of markers investigated. Laboratory markers may be helpful to support the diagnosis of reaction in leprosy patients.
Duncan 1, 2. Hungnaw 3. Selassie 2. Melaku 4. Kazen 3 , A. Challis 5. Addis Ababa; 4 Dept Neurology. Faculty of Medicine. Strachur, Argyll. In The aim of this study was to investigate if early nerve enlargement was a prodromal sign of leprosy.
Subjects: A9 cohort children: 85 51 females and 34 males ; distribution according to leprosy status of the mother mulubacillary leprosy MBK , paucibacillary leprosy PBK and non-leprosy NLK Male:female ratio for nerve enlargement was , except in MBK The ulnar nerve was the most frequently enlarged. Nerve Conduction Velocity: measurements in 30 children who had evidence of neurodyjfunction were all within limits of normal for the reference laboratory.
Kazen 3. Hansen 5. Julu 5. Ward 6. Challis 7. Institute of Neurological Sciences. The aim of this study was to see whether neurodysfunction could be detected before ineversible nerve damage had occurred in the A9 cohort and healthy controls. Hansen 5 , G. Jamal 5 , P.
Julu 5 , A. Challis 6. Addis Ababa. These findings from a well documented cohon are indicative of a significant level of as yet undiagnosed subclinical leprosy among teenagers and young adults in the "leprosy villages", potentially explosive and crippling in the event of widespread immunosuppression. Hypothesis: Abnormal thermal thresholds, in effective measure of early small nerve fibre damage, arc the first evidence of subclinical leprosy which at present is not treated.
Application: Thermal Threshold Tester ii simple to use. There is a strong case for using the A9 cohort with numbers augmented from surrounding villages, to carry out a controlled drug trial with appropriate MDT against placebos in both affected and unaffected populations to see whether treatment i restores thermal thresholds to normal, and ii prevents development of new cases and especially the nerve damage which causes disfiguration.
Facial skin is so richly supplied with sensory nerves, chiefly Vth [Trigeminal] nerve, that even new active tuberculoid lesions may lack sensory loss. Three leprosy textbooks omit Vih nerve sensory loss, except conjunctival. For most leprologists this nerve escapes attention. Nine other self-referring A9 women 7BL.
Conclusion: Facial burning sensation requires urgent investigation with STG especially in "menopausal" women. Forty forearm of human cadavers were dissected and studied. A , two on the right side and three on the left side. From the total of five cases, two of this anastomosis occurred among the branches reserved to the flexor digitorum profundus muscle, one from the branch of the anterior interosseous nerve, and two directed from the median to the ulnar nerve.
From this 20 forearms of 15 subjects, 5 It is therefore apparent from this study that 5 years after stepping MDT, most HIV positive cases ao succumb to death. However, the effect of treatment with MDT in terms of regression of the lesions appears to be similar for both HIV positive leprosy cases as well as HIV -ve leprosy cases. Andhra Pradesh. The Bacteriological Positivity of patients is analysed year wise and also population wise at Risk. The study showed thai there is reduction of infective patients every year during Multi Drug Therapy implementation minimising the nsk to the Community under study.
The sensations and motor functions in hands of 52 MB pts. The results of examination done initially and after every three months were ex pressed in numeric a1 scores. Out of 15 MB pts. Follow up of motor function scores did not show worsening in any of the patients.
The simple method of quantifying sensations using Nylon Monofilaments and motor functions by standard methods are useful even in the fieid conditions. In Arabian Peninsula, leprosy is considered more as a social problem connected with strange imaginary stories. According to WHO reports. Yemen is considered as the mostly affected area in the Middle East.
To obtain a general idea about the social aspect and epidemiological and clinical pattern of the disease in the country, the files of leprosy patients registered for MDT during will be analysed with a leprosy profile and community beliefs in Yemen. Leprosy patients in Bangladesh are not spared the usual dental problems in developing countries. This study is an attempt to further delineate the various dental problems and their prevalence among the leprosy patients in Gaibandha and Jaypurhat.
These two districts, located in the Rajshahi division of the country, have a combined population of 3 million. The study consists of a survey of the patienls attending the leprosy clinics of the Gaibandha-Jaypurhat leprosy Control Project.
Patients are categorized with regards to their sex, marital status, PB-MB status, disability grade and which particular organ is involved , and their particular dental problems: dental caries, periodontitis, pyorrhea, gingivitis, etc.
Other oral problems like candidiasis, oral cancer, osteomyelitis, etc. Particular relationships to common habits like brushing teeth with neein twigs, chewing of betel nut and supari local food items , oral hygiene, etc.
Comparisons are made with a control group of general patients seeking treatment at the Dental Clinic in the Bogra Mission Hospital The incorporation of basic dental health education materials into the conventional messages of leprosy workers is explored. Annamma S. John , Dr. Rajan Babu, Dr. Vijaykumar, Dr. Helen G. Roberts, Dr. Road, Calcutta , India. Out of patients only 2 pattents 1.
In both cases MDT has continued for 12 months. In the case of the female patient the neuritis developed after she became pregnant. A case of borderline tuberculoid leprosy of 2 years duration in a year-old male Is reported. The patient developed exacerbation of the lesions and inability to retract the prepuce for one month.
Skin biopsies were performed from 3 different skin lesions,and circumcision was also carried out. The skin biopsies showed florid tuberculoid granulomas. The excision biopsy of the prepuce showed granulomatous and round cell infiltrate almost replacing the dermis. The nerves were infiltrated or surrounded by infiltrate. The patient received multidrug therapy, including daily rifampicin, and the plagues gradually flattened. Repeat biopsies done one year later from 2 subsided skin lesions showed only mild to moderate periappendageal round cell infiltrate.
One large, unrecognisable nerve was seen infiltrated with epitheloid cells and round cells. Sequential clinical photographs during treatment will be shown, and also pre and post-treatment photomicrographs of this patient.
Observation: Mme M. Sur le plan biologique existait un syndrome inflammatoire. La biopsie d'un nodule montrait de nombreuses cellules de Virchow avec des bacilles de Hansen BH en globi. Pupil cycle time PCT was measured in 81 subjects eyes , all under 45 years of age.
This study included 9 tuberculoid TT. Some others functions of the autonomic nervous system were tested blood pressure and pulse response to standing, body temperature, lacrimal and pupillary responses and symptomatic involvement was also reported. City Guizhou Provine, China. In order to reduce ocular complications from leprosy, the authors suggested that the patients should be detected as early as possible, leprosy reactions should be timely managed, self care training should be given to patients and one of their family members at least and surgical corrections should be provided for those with paralytics lafophthalmos and ectropion if necessary.
Regular eye examinations are conducted MDT was started in late 5. Routine screening was done once in 6 months with Slit Lamp. Observations were recorded and anlysed. Eye complication did not occur in non Lepromatous patients except for lagophthalmos Eye complications in Lepromatous with short duration of diescase were fleeting in nature and minimal, subsided within six months of MDT and did not recur again.
Eye complications like During the past 7 years eye complications were not seen among new cases except for lagophthalmos and steroid induced ca An occasional Early detection of leprosy is very important in preventing eye complication Judicious use of steroid will minimice steroid induced eye complication like cataract.
Treated patients will require surgers for cataract lagophthalmos care should be a part of the care-after Institute of Dermatology. In order to find out the prevalence, the causes as well as the distributions of blindness and low vision in leprosy, an epidemiological survey of blindness and low vision caused by leprosy among cases of leprosy was 7.
The prevalence of eye complications in different groups of patients was quite different, it was higher in fermales than in males, multibacillary patients higher than paucibacillary patients, in-patients higher than out-patients. Corneal disease was the commonest cause of blindnes in this group, to the second was iritie disease and cataract. The main cause of low vision was cataract. The main cause of low vision then normal and iritie diseases.
Treatable blindness acconted for Cebu, Philippines. Regular clinical, bacteriological and eye examinations were done before, during and after treatment.
The study is now in progress for 9 years. Two BL patients developed lagophthalmos during treatment. Clofazimine deposits appeared about 6 months of treatment and disappeared aboul 12 months after treatment was stopped. No increase in intra-ocular pressure was noted. The clinical characteristics of the patients in the study, their demographic aspects and possible risk factors associated with the development of ocular complications will he discussed. In ten of Guangdong Province's leprosy villages, over an 18 months period, cured cases of leprosy with, clinical symptoms of lacrimal deficiency were tested by using Schirmir test on all, while 80 were examined with slit-lamp.
Findinqs suqgest that a high incidence of dry eye maybe caused by leprae drugs which restricts and damages lacrimal glands function, VII nerve damage affects secretion, damaged conjunctiva destroys conjunctival goblet cells, Vitamin A deficiency and presence of eye lid deformity effects tear film. Because of drying of the corneal epithelium, visual acuity is diminished and resistance of the cornea to withstand mild impact and infection occur.
Based on findings of dry eye in Guangdong, use of protective eye devices, tear substitutes, long term use of Vitamin A, and corrective surgery of eyelid deformity is recommended. Although corneal ulcer continues to be a serious ocular problem occurring in leprosy patients, it has not been studied extensively in leprosy. In 5 patients there was blockage of the naso - lacrimal duct.
The most common organism cultured from the ulcers was pneumococcus. No anaerobic organisms were cultured. Mycotic filaments were found in 5 ulcers. The majority of ulcers were located in the central cornea and in the inferior temporal quadrants. Vis ion improved after treatment in 2 patients, remained static in 35 and deteriorated in 21 patients. The importance of identifying risk factors that can give rise to corneal ulcers, early recognition of ulcers and appropriate treatment to be given are discussed.
The changes in the manifestations of Lepromatous Leprosy over a period of 20 years, to is presented. Leprosy has not only declined in numbers but also in the severity especially after the introduction of MDT. With the introduction of MDT in , we have noted the changes from multiple nodules to few nodules and then to single nodule and no nodule. Diffuse infiltration all over the body to symmetrical patches then to localised infiltration. The case histories of 4 of our patients manifesting with single lesion which proved positive for skin smear are presented.
This paper intends to alert field workers regarding mono lesion cases that may be "Localised Lepromatous Leprosy". EI-Minia Faculty of Medicine.
The present work was dsigned for screening the hormonal profile of the suprarenal gland in leprosy, namely, cortisol, dehidreniandrostcrone- sulfate DHEA-S deltaandros-tenedione and testosterone. In addition, the concomitant clinico-endocrinological manifestations, if any, associating those of the disease were also studied. This was carried out by the recruitment of 60 male leprotics 21, paucibacillary and 39 multibacillary and 16 healthy males as control group.
The values of cortisol in both paucibacillaty and multibacillary groups were insignificantly higher than that of controls and the value of paucibacillary group was insignificantly higher than that of multibacillary group. No statistically significant difference between both paucibacillary and multibacillary groups. On the other hand, the value of paucibacillary group was insignificantly higher than that of the multibacillary group. The results of this screening study have provided an argument for further studies to he held for thorough investigation and assessment of the adrenal function in leprotics.
Mexico City. Mild incipient damage was found in the remaining leprosy patients. The testicular ultrasound and the testicular reserve tests reported high sensitivity to disclose progression of functional damage We suggest that hormone replacement therapy should be considered for selected cases with long term treated leprosy.
The association between different body builds and several diseases known to occur. However, no such study seems to exist to understand the morphological changes of leprosy patients despite having evident bony changes and deformities of body of leprosy patients. The present study is an attempt in this direction. The ages of leprosy in normal adults vary between years. This age group has been selected purposely as changes due to senescence more or less static in this age group.
The comparative morphological changes thus observed between leprosy afflicted and normal adults may probably be on account of leprosy only.
These measurements are being taken using standard methodology and instruments. The various indices wil l be formulated to observe proportionate changes.
The findings of this study will be discussed in detail. Jane Tomimori-Yamashita 1 , Marcos C. Floriano 1. Helio K. Yamashita 2. The facial or seventh cranial nerve is responsible for eye closure.
In leprosy, the damage of facial nerve causes lagophthalmos, particularly affecting the lower lid. The MR1 is a technique, which is able to identify the affected segment of facial nerve, especially the infratemporal canal tract. It has been used for analysis of this nerve lesion in Bell's palsy. The diagnosis of facial nerve lesion could help the patients to prevent ocular sequelae.
In the future, the MRJ could be an important method to detect an early lesion, indicating the segment lo be submitted to a surgical decompression.
The authors studied 8 patients 1 LL, 5 BL, 2BT with and without leprosy reaction, one patient presented clinical signs of facial nerve lesion.
By the MRI, we could observe some irregular thickness of facial nerve in different segments, particularly in the mastoid bone intracanalicular tract The patient with lagophtalmos and reversal reaction presented a thick nerve and an enhancement of ganglionar segment after the paramagnetic contrast injection.
The same aspect had been demonstrated in Bell's palsy. We conclude: 1 the etiopathogenesis of the contrast enhancement in the symptomatic acute facial palsy in leprosy could be due to a neuro-vascular mechanism as it had been described in Bell's palsy 2 the presence of the contrast enhancement is not a specific signal of acute lesion, but indicates the nerve lesion 3 MRI could detect early lesion in facial nerve in patients without clinical symptoms.
Blood levels of total lipids, cholesterol, triglycerides, and low density lipoprotein were studied in leprosy patients. Blood samples from patients and controls were taken in spring-summer season at strictly determined time intervals: - At the same time in these patients low density lipoprotein level was significantly decreased as compared to controls.
It was found out that patient's lymphocyte ability of spontaneous incorporation of 3 H-thymidine in vitro was inversely related to ratio of total blood cholesterol to triglycerides. This finding supports the view of Memon el al. Leprosy Besides, in patients with inactive lepromatous leprosy given DDS therapy blood levels of intermediate and final products of lipid peroxidation were estimated with using ultraviolet spectro photometry methods.
The results obtained showed thai intensity of lipid peroxidation in the patients mentioned above was significantly decreased. This might be either ihe result of antioxidant effect of DDS or decreased contents of low density lipoproteins which are ihe most liable to oxidation among lipid-protein structures of blood. The possibility of interrelation between above factors cannot be ruled out.
Using intra-operativc spinal root stimu lation, the most proximal site of a leprosy induced neuropathology of the tibial nerve was foun d. Patients with leprosy affecting the posterior tibial nerve behind the medial malleolus causing significant anaesthesia of the foot were investigated by spinal root stimu lation of mixed comp oun d nerve action potentials MCNAP which were then recorded from the exposed tibial nerve.
In nearly all cases the MCNAP amp litudes were reduced or disappear at or before the bifurcation of the sciatic nerve in the mid thigh. This was always the case even though the nerve macroscopically looked normal. Epineurotomy within these app arently una tlected segm ents revealed mild fibrosis of the intra fascicular epineurium in 9 of the 10 cases.
There was macroscopic and histological evidence ofdiscontinu ity from distal to proximal skip lesion , in that there was less fibrosis deep in the proximal calf. Evidence for such a proximal leprosy nerve lesion w as corroborated by the finding of mild wasting of the proximal calf mu sculature, Gastrocnemius an d soleous , mu scles not normally thought to be involved by leprosy nerve damage.
Recently we reported successlul management of Mitsuda negative borderline and lepromatous leprosy patients with MDT plus active immunotherapy by low dose Convit vaccine. There was quick clinical cure, reversal reaction, early bactenal negativity and Mitsuda conversion.
It is recognised that there are few leprosy patients with repeated episodes of ENL, who cannot be controlled by large doses of steroids. We observed that this method of chemoimmunolherapy could reverse the downhill course of the disease, reduce the bacterial load and interrupt the painful episodes of ENL. Rakesh Matumdhar. Anandaban Leprosy Hospital. PO Box A retrospective study of a large cohort of previously untreated bordeline lepromatous BL and lepromatous LL patients presenting at Anandaban Hospital between and was performed to measure the prevalence of erythema nodosum leprosum ENL , the time of onset and the contribution of 9 clinical and laboratory factors to the risk of developing ENL.
The identification of clinical features at presentation associated with high risks of developing ENL will be valuable in patient management and in minimising leprosy disability. It is known that lesions in type I reaction may ulcer. However since times of Ryrie in Malasya, there are no studies about the occurence of this phenomenon in some leprosy cases. We will present 10 of such cases which were studied under clinical, bacteriological, histopathological and immunological aspects.
Patients were submitted to a clinical I and of neurological examination and pictures were taken from iheir lesions. Smears for determination of BI and MI were taken from six sites and two biopsies were collected for histopathological studies. In all of them a Mitsuda test was performed. The results obtained were variable probably because among these cases there is reactional bordehne cases and reactional tuberculoid cases, that is, cases with different grades of cellular immunity.
Theses results will be discussed as wel as the probable mechanisms involved in the occurance of the ulcerations. Early detection of leprosy is the prerequisite not only to prevent lasting disability in leprosy patients, but also to reach the proposed WHO goal of world-wide elimination of leprosy.
Tropicale e Pesca assolutamente terribile con acqua non ha niente a che vedere con i sapori indicati, sono stato costretto a mischiarlo con succo alla pesca per renderlo bevibile.
Prodotto ottimo,gusto banana-fragola e…. Sono proteine molto solubili. In quanto a risultati non saprei,prendo anche altri due tipi di proteine al giorno. Comunque hanno un alto livello di percentuale proteica e sono a rilascio immediato.
Credo sia un prodotto valido. Sie scheinen aus Deutschland zu kommen. Klicke hier. You can unsubscribe at any time Privacy Policy. Remember me. Nutrition information Chocotella.
Per daily dose 30 g.
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