达万热某三级医院麻风病畸形患病率调查

Mangala Hc, Madhan Jeyaraman, K. Chaudhari, Vishakha Dhorde, D. Likhith, Murugesh Sb
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引用次数: 4

摘要

简介:麻风病是一种影响周围神经系统、皮肤和某些其他组织的慢性肉芽肿性传染病。世卫组织宣布,麻风病的发病率为每10万人中0.1人,是一个公共卫生问题。世卫组织将麻风病的消除水平定义为每1万人中<1人。麻风自然过程的模式转变正在从常规抗麻风治疗转向处理麻风残疾和畸形的预防。目的:了解某三级医院麻风病致畸形的流行情况。材料与方法:对2015 - 2018年在达文热JJM医学院皮肤与骨科进行的113例麻风患者进行前瞻性研究。所有病例均接受了全面的临床检查、基线实验室检查、神经诊断和受影响关节的放射学分析。病例被分类为稀少性和多菌性麻风,活检AFB染色。所有病例均根据菌群分类给予多药治疗。监测疾病自然过程的进展并绘制图表进行统计分析。结果:在113例研究人群中,社会经济地位较低的残疾人群居多。本组已报道37.16%的营养性溃疡、33.62%的手指和脚趾自动截肢、32.74%的爪手、10.61%的足下垂、7.96%的角膜混浊、6.19%的狮子相、4.42%的类人猿拇指畸形、2.65%的眼lagophthalmos和1.76%的骨质疏松。结论:由于麻风病在低社会经济地位人群中的流行,麻风病仍然是一个公共卫生问题。麻风病畸形的管理是一个多学科模式,并培训所有卫生相关工作人员识别麻风病。康复是预防畸形和改善麻风患者生活质量的主要治疗手段。
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A Study on Prevalence of Deformities in Leprosy in a Tertiary Care Hospital at Davangere
Introduction: Leprosy is a chronic granulomatous infectious disease affecting the peripheral nervous system, the skin and certain other tissues. WHO announced the level of leprosy >1 per 10,000 population as a public health problem. WHO defined the elimination level of leprosy was <1 per 10,000 population. The paradigm shift in natural course of leprosy is shifting from regular antileprotic treatment to deal with the prevention of disabilities and deformities of leprosy. Objective: To evaluate the prevalence of deformities due to leprosy in a tertiary care hospital. Materials & methods: Prospective studies with 113 cases of leprosy were conducted from 2015 to 2018 in department of Dermatology and Orthopaedics, JJM Medical College, Davangere. All the cases were subjected for thorough clinical examination, baseline laboratory investigations, neuro-diagnostics and radiographic analysis of affected joints. The cases were classified as pauci and multibacillary leprosy with AFB staining of biopsies. All cases were treated with a multi drug treatment according to the bacillary classification. The progress of natural course of disease was monitored and charted for statistical analysis. Results: In our study population of 113 cases, the disabilities were found more from low socioeconomic status. In our study, 37.16% of trophic ulcers, 33.62% of autoamputation of fingers and toes, 32.74% of claw hand, 10.61% of foot drop, 7.96% of corneal opacity, 6.19% of leonine facies, 4.42% of ape thumb deformity, 2.65% of lagophthalmos and 1.76% of madarosis have been reported. Conclusion: Leprosy still continues to be a public health problem due to prevalence of disease in low socioeconomic status people. The management of leprotic deformities is a multi-disciplinary model and to train all health related workers to identify leprosy. Rehabilitation is the mainstay of treatment in deformity prevention and to improve the quality of life of leprotic patients.
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