Indian journal of leprosy最新文献

Leprosy is a disease with different ratings due to the diversity of clinical manifestations. The most used classification by Reference Centers is the histopathological, which has been considered to have better specificity and sensitivity. Thus, the aim of this study was to determine the histopathological types of profile of Leprosy patients from different parts of Sergipe, Brazil, from 1985 to 2005. For this purpose, it was used histopathological diagnosis reports filed at Prof. Dr. Nestor Piva Memorial from 1985 to 2005. There were 2,102 reports with Leprosy diagnosis, from which 1,165 (55.4%) cases were women, 1,224 (58.2%) cases were of mixed race and 1,835 (87.3%) were from the metropolitan area of Aracaju/SE. The mean age was 36.62 year. The smear microscopy classified 1,669 (79.4%) lesions as paucibacillary and there was a predominance of tuberculoid and indeterminate forms. Men were more likely to be multibacillary, as well as being the lepromatous pole. The determination of histopathological forms and the knowledge about the association and the epidemiological profile are important tools to contribute to public health policies.

Unlabelled: Leprosy is a chronic communicable disease since age associated with stigma and suffering. India claims its elimination but in some districts it remains a public health problem. A cross sectional study was conducted and a total of 60 persons were interviewed with an objective to assess the knowledge and attitude about leprosy among sample of 30 adults each from leprosy colony dwellers and urban slum dwellers in South District of Delhi.

Result: Knowledge about the leprosy among leprosy colony dwellers was significantly lower than the slum dwellers. Both the groups still believed that leprosy could be due to curse of God, past misdeeds, and could spontaneously occur. Respondents of leprosy colony had significantly less adverse attitude such as leprosy patient should never get married (12% vs 57%), patient should be kept in leprosy colony (0 vs 30%) and should not be allowed to enter religious places (0 vs 23%). Surprisingly 73% of them had not heard about MDT and only (68%) knew that treatment is available free of cost in all Govt. hospitals. Only about half of the respondents knew that deformities could be corrected.

Conclusion: This study reflects the poor awareness and negative attitudes towards leprosy particularly among leprosy patients themselves, which could be one of the reasons for slow progress in Leprosy Elimination Program in Delhi.

Fifty seven leprosy patients having moderately collapsed nose were taken for nasal reconstruction. The bone graft was obtained from the second metatarsal of the foot. It was corticoperiosteal and placed in between lining and the nasal skin. 48 patients were reviewed periodically at 3 months, initially for 2 years and irregular visits at 3 to 5 year intervals in last 25 years. The nasal architecture and donor site problems were evaluated. 26 patients were completely satisfied, 14 patients were happy with shape of the nose along with some other problems. 6 cases showed the poor results. Two cases developed the deformity after seven years of correction. The details of the technique and the problems occurring during and long-term follow up have been discussed.

Tuberculosis is a major health problem throughout the world causing large number of deaths, more than that from any other single infectious disease. Estimates till date ascertain the fact that Tuberculosis (TB) is continuing to be the leading cause of death worldwide. The infection from single infectious agent Mycobacterium tuberculosis is killing about 3 million individuals every year and accounts for around 18.5% of all deaths in adults between the age group of 15 and 65. An average of 1.79 billion people, which constitutes roughly one-third of the world's population, is infected with the causative agent M. tuberculosis and is at risk of developing the disease. This situation highlights the relative shortcomings of the current treatment and diagnosis strategies for TB and the limited effectiveness of public health systems, particularly in resource-poor countries where the main TB burden lies. The timely identification of persons infected with Mycobacterium tuberculosis and rapid laboratory confirmation of tuberculosis are two key factors for the treatment and prevention of the disease. Novel molecular assays for diagnosis and drug susceptibility testing offer several potential advantages over the above methods including faster turnaround times, very sensitive and specific detection of nucleic acids, and minimal, or possibly no, prior culture. The need for new technologies for rapid diagnosis of tuberculosis is clear. Most studies of mycobacterial immunity attributes focus on proliferation of T cells, production of cytokines and cytolytic activity. A proper vaccine for tuberculosis can be developed by using a combination of antigens and adjuvants capable of inducing appropriate and long-lasting T cell immunity. Development of new vaccines against TB should include some important aspects learned from BCG use such as mucosal routes of immunization; revaccination of BCG immunized subjects, booster immunization and prime-boost strategy with wild-type BCG, and other vaccine candidates. Here, we review current and future strategies toward the rational design of novel vaccines against TB, as well as the progress made thus far, and the hurdles that need to be overcome in the near and distant future.

Leprosy is a unique infectious disease due to varied spectrum of clinical signs it exhibits. Pure neural leprosy (PNL) is an unusual form of leprosy and accounts for 4-8% of all leprosy cases. It can manifest as a simple tingling sensation to complex and tragic motor paralysis. Here we report a case of PNL involving isolated cutaneous radial nerve as multiple abscesses along the course of the nerve. To the best of our knowledge, this is rarest presentation of pure neural leprosy.

Secular trends in incidence of leprosy serve as a powerful tool in determining progress in reaching eradication. However, the interpretation of these trends must take into account both operational and epidemiological factors. A study was done to assess a time trend in the ratios of MB & PB from 2001 to 2010 based on the leprosy patients registered in a referral hospital in UP, India. Data were analyzed based on the gender, age and residence. Regardless of these factors, MB proportion shows no significant trends. These findings are discussed and it is concluded that we are no more close to eradication as compared to the status over a decade ago. Hence, much greater efforts will be required to promote early detections of MB cases, whether children or adults, male or female.

Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae. Predominantly involving skin and nerves and having classic clinical description, the diagnosis may be clear-cut in majority of patients but may be challenging in others. Non-pitting edema, ichthyosis and arthritis are uncommon in leprosy and very rare in tuberculoid type where the diagnosis may be challenging unlike relatively clear-cut clinical picture in lepromatous type. Musculoskeletal manifestation is seen in 1-5% of cases and usually associated with reactional states where again the diagnosis sometimes becomes evident. High index of suspicion is therefore recommended in patients with unexplained systemic illness especially in endemic areas. Herein we report a young male with non pitting edema and symmetric peripheral arthritis involving all four limbs, and ichthyosis as presenting manifestation of borderline leprosy where the neuro-cutaneous manifestation developed two months after the said presenting features and in absence of a reactional state.

Even though type 1 lepra reaction (TIR) is a commonly encountered clinical problem, its histology has not yet been clearly delineated. This study attempts to enumerate the most sensitive parameters for the histological diagnosis of TIR. Case records between March 2007 and September 2007 of patients with TIR were reviewed and the biopsies were evaluated by a pathologist blinded to the previous diagnoses. Twenty three patients were included in the study. The most sensitive parameters in our study were dermal edema, intra-granuloma edema and giant cell size. Though clinical findings should remain the mainstay of diagnosis of TIR, the above mentioned parameters should be evaluated in biopsies of leprosy to look for signs of reaction which might otherwise be missed.

28 yr old male presented with asymptomatic nodules and few well to ill defined papules on ears, asymmetrical nerve enlargement and evanescent tender nodules on the extremities without any infiltration of the skin and madarosis. Slit skin smear done from normal skin was BI 6+. Skin biopsy showed features of lepromatous leprosy.

Oxidative stress is a condition associated with an increased rate of cellular damage induced by the oxygen derived oxidants commonly known as reactive oxygen species (ROS). ROS are capable of damaging cellular constituents generated in excess during the chronic, inflammatory, neurodegenerative disease process of leprosy. Severe oxidative stress has been reported in leprosy patients because of malnutrition and poor immunity. The decreased levels of SOD, glutathione and total antioxidant status in leprosy patients may indicate a degradation of these antioxidant enzymes by free radicals during detoxification processes. The subjects for this study comprises of Normal human volunteers (NHV, n = 20) and treated MB patients (MB, n = 20). The levels of lipid peroxidation products are increased in MB Patients (*P < 0.001). SOD (**P < 0.0001) and glutathione levels (***P < 0.0001) decreased in MB Patients in comparision with normal human volunteers. The present study of estimation of antioxidants conclude that the free radical activity was increased and the total antioxidant status was decreased in all MB patients, indicating that there was an oxidative stress even after the treatment with MDT. The decreased levels of SOD, glutathione indicate a link between oxidative stress and leprosy. Since the MB patients are unable to produce sufficient amount of antioxidant to cope up with the increased oxidative stress in them. Providing nutritional supplementation may present a novel approach for fast recovery. Administration of exogenous antioxidants like vitamin C, tocopherols would prevent tissue damage and make the patient therapeutically benefited.