Self-care programme to prevent leprosy-related problems in a leprosy colony in Champa, Chattisgarh.

A self-care programme aimed at preventing leprosy-related physical disabilities in a leprosy colony in Champa, Chattisgarh, India, is described. Once the initial resistance was overcome through persistent and caring attitudes, the residents accepted the challenges for self-care. The outcome at the end of one year showed significant decline (41%) in ulcer rates, significant use of MCR footwear (43%), and significant proportion (over 90%) of patients and their families practising and helping in self-care activities.

[Simplification and codification of treatment for leprous plantar ulcers]. / Simplification et codification des soins aux maux perforants plantaires lépreux.

Practically leprous plantar ulcers (PU) are difficult to treat and heal under field condition. Considering the important number of patients showing a PU, the directors of national leprosy control programmes are determined, within the programmes on prevention of disabilities (POD), to treat the PU in the field. Therefore it appears to be essential to codify and simplify their treatment thus enabling it to be effective. The healing of PU being the only criteria of effectiveness of the technique. Four clinical stages were defined, each corresponding to a precise way of treatment using only essential and basic products at low cost. During the trainings about the treatment techniques and attitudes much emphasize is given on the discharge of the PU, on the trimming of the wound and on the products to use according to PU's evolutionary stage.

Ulcera perforante plantare negli hanseniani: trattamento medico e nuovo e semplice trattamento chirurgico

L`auteur, au cours d`une description rapide des ulcères perforants plantaires que L´on rencontre chez les hanséniens, fait remarques les associations possibles, avec les > ou mieux avec les > et étude les différents aspects, causes et mécanismes des sièges d`élection et de développement cliniques de ces ulcères. En mentionnant les bons effects d`un traitement aux enzymes pancréatiques des cas initiels, il décrit une méthode nouvelle et simple d´intervention chirurgicale qui s`est rèvélée, dans une prémiére série de cas, utile pour le traitment des cas avancés. Il souhaite que la méthode soit pratiquée sur une plus grande échelle pour mieux étudier et si possible confirmer les résultats

Plantar ulcers in leprosy / ?

In two papers an attempt has been made to present a concept of the natural history of plantar ulcers in leprosy with the main stress on factors dependent on anaesthesia of the foot. A rational therapy based on these findings has been described

The place of reconstructive surgery in the prevention of foot ulceration in leprosy

1- Paralysis of the lateral popliteal nerve in relation to lateral border ulceration is discussed, and three operations used for its correction are described. 2- Paralysis of the posterior tibial nerve in relation to metatarsal-head ulceration is discussed. An operation for the correction of the claw toe deformity is described. 3- Trophic ulceration can only be prevented by careful attention to several factors, namely, (a) reduction of walking and standing to the minimum, (b) reconstruction of paralytic deformities, and (c) use of moulded soles to distribute the weight evenly over the foot.

Supplementary report on the case of chronic ulceration of the foot due to a new pathogenic mycobacterium (MacCallum)

Les auteurs ont pu continuer l´observation du cas rapporté par E. van Oye et M. Ballion. Il s'agissait d'un jeune garçon blanc au Congo Belge, porteur d'une ulcération étendue résistant à tout traitement et dans laquelle des bacilles acido-résistants étaient présents. A New-York le garçon fut traité de diverses façons. Les antibiotiques: bacitracine per os ou localement, streptomycine, auréomycine, chloromycétine, polymixine B et aussi parachlorophénol se montrerent sans action sur les acido-résistants, mais limitèrent plus ou moins la flore associée. La disparition des acido-résistants (germs thermophobes) fut obtenue par des applications chaudes puis le nettoyage chirurgical, et enfin des greffes activèrent la guérison que la flore associée n'entrava du reste pas. Les premiers essais de culture furent infructueux mais ultérieurement des cultures sur Loewenstein furent obtenues à 32º (négatif à 37º). Les recherches bactériologiques continuent. Les auteurs croient se trouver devant l'affection décrite en Australie par MacCallum et Col.

O mal perfurante plantar na lepra: estudo clínico

Os AA. se det~em sôbre as particularidades clínico-estatísticas que oferece o mal perfurante plantar nos doentes do Asilo de Cocaes. Observaram-no com a frequencia de 25,9 por cento dos casos; único em 215 doentes, múltiplo em 196. Ao exame radiológico foram observadas várias lesões osseas (osteolise, osteoporose, osteoperiostite, osteoartrites com anquilose ou destrutivas, fraturas patológicas) que os AA. discutem se estão ou não na dependência direta do mal perfurante. Quanto á sua localização, verificaram que êle tem sede nas partes do pé mais sujeitas á pressão, sendo mais frequente sob o 1º metatarsiano, 1º artelho, 5º, 2º e 3º metatarsianos e calcanhar. Discutindo a patogenia, acham que o mal perfurante tem uma gênese nervosa, sendo sua séde condicionada pelos agentes mecânicos (traumatismos e pressão).